Per- and polyfluoroalkyl substances (PFAS) in breast milk and infant formula: A global issue
Judy S LaKind1, Josh Naiman2, Marc-Andre Verner3
1LaKind Associates, LLC, 106 Oakdale Avenue, Catonsville, MD 21228, USA; Department of Epidemiology and Public Health, University of Maryland School of Medicine, 655 W Baltimore St, Baltimore, MD, 21201, USA.
Insights
Per- and polyfluoroalkyl substances (PFAS) in breast milk often exceed safe levels for infants. Infant formula may not lower exposure, highlighting the need for better monitoring and informed infant nutrition decisions.
Area of Science:
- Environmental Health
- Toxicology
- Pediatrics
Background:
- Per- and polyfluoroalkyl substances (PFAS) transfer from mothers to infants via breastfeeding, posing risks during a vulnerable developmental period.
- Infants can also be exposed to PFAS through the consumption of infant formula.
- Previous research indicated that four specific PFAS frequently exceeded ATSDR children's drinking water screening levels in breast milk across U.S. and Canadian populations.
Purpose of the Study:
- To compare global PFAS measurements in breast milk and infant formula against established children's drinking water screening values.
- To assess infant exposure risks from both breastfeeding and formula feeding.
- To inform decisions regarding infant nutrition in the context of PFAS contamination.
Main Methods:
- Focused on four key PFAS: PFOA, PFOS, PFHxS, and PFNA, for which ATSDR has established children's drinking water screening values.
- Conducted a literature review of published studies on PFAS levels in breast milk and infant formula using PubMed.
- Compared identified PFAS concentrations with ATSDR children's drinking water screening values.
Main Results:
- Concentrations of perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) in breast milk frequently surpassed children's drinking water screening values globally.
- Available data on infant formula suggests it does not consistently reduce PFAS exposure, particularly when reconstituted with contaminated water.
- Determining if infant PFAS exposures exceed safe levels is currently challenging for the general public.
Conclusions:
- Pregnant and lactating women, especially those in contaminated areas, require data for informed infant nutrition choices.
- There is a critical need for international monitoring of PFAS in breast milk, formula, and drinking water.
- Developing effective strategies to reduce infant exposure to emerging PFAS is essential, underscoring the importance of this research.
Background:
Per- and polyfluoroalkyl substances (PFAS) are transferred from mother to infants through breastfeeding, a time when children may be particularly vulnerable to PFAS-mediated adverse health effects. Infants can also be exposed to PFAS from infant formula consumption. Our recent literature-based scoping of breast milk levels reported that four PFAS often exceeded the United States Agency for Toxic Substances and Disease Registry (ATSDR) children's drinking water screening levels in both the general population and highly impacted communities in the U.S. and Canada. This work presents a comparison of global breast milk and infant formula PFAS measurements with the only reported health-based drinking water screening values specific to children.
Methods:
We focused on four PFAS for which ATSDR has developed children's drinking water screening values: PFOA (perfluorooctanoic acid), PFOS (perfluorooctanesulfonic acid), PFHxS (perfluorohexanesulfonic acid), and PFNA (perfluorononanoic acid). Published literature on PFAS levels in breast milk and infant formula were identified via PubMed searches. Data were compared to children's drinking water screening values.
Discussion:
Breast milk concentrations of PFOA and PFOS often exceed children's drinking water screening values, regardless of geographic location. The limited information on infant formula suggests its use does not necessarily result in lower PFAS exposures, especially for formulas reconstituted with drinking water containing PFAS. Unfortunately, individuals generally cannot know whether their infant's exposures exceed children's drinking water screening values. Thus, it is essential that pregnant and lactating women and others, especially those having lived in PFAS-contaminated communities, have data required to make informed decisions on infant nutrition. An international monitoring effort and access to affordable testing are needed for breast milk, drinking water and infant formula to fully understand infant PFAS exposures. Currently, our understanding of demonstrable methods for reducing exposures to emerging PFAS is limited, making this research and the communications surrounding it even more important.
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