Should the presence of carcinogens in breast milk discourage breast feeding?

Pollutant chemicals are commonly found in human milk at levels that would prevent its sale as a commercial food for infants. The chemicals found most commonly are dichlorodiphenyl-dichloroethene, polychlorinated biphenyls, dieldrin, chlordane, heptachlor, and polychlorinated dibenzodioxins. In general, the regulatory levels for these chemicals have been set to prevent cancer in adult humans from lifetime exposure. We compared lives saved in the postneonatal period by breast feeding to the estimated excess cancer deaths attributable to the contaminants in breast milk. The results of this analysis suggest that only extreme levels of contaminants in breast milk represent more of a hazard than failure to breast feed, but clinical considerations in individual cases might override this conclusion. Our analysis depends on assumptions about how the chemicals might cause cancer in humans and on whether breast feeding prevents some postneonatal mortality. Noncarcinogenic hazards from chemical exposure, other hazards from breast feeding such as transmission of viruses, and benefits of breast feeding other than reduction in mortality were not considered.