Breastfeeding: a potential excretion route for mothers and implications for infant exposure to perfluoroalkyl acids

Abstract

Background: The presence of perfluoroalkyl acids (PFAAs) in breast milk has been documented, but their lactational transfer has been rarely studied. Determination of the elimination rates of these chemicals during breastfeeding is important and critical for assessing exposure in mothers and infants.

Objectives: We aimed to investigate the association between breastfeeding and maternal serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonate (PFHxS). For a subset of the population, for whom we also have their infants' measurements, we investigated associations of breastfeeding with infant serum PFAA concentrations.

Methods: The present analysis included 633 women from the C8 Science Panel Study who had a child < 3.5 years of age and who provided blood samples and reported detailed information on breastfeeding at the time of survey. PFAA serum concentrations were available for all mothers and 8% (n = 49) of the infants. Maternal and infant serum concentrations were regressed on duration of breastfeeding.

Results: Each month of breastfeeding was associated with lower maternal serum concentrations of PFOA (-3%; 95% CI: -5, -2%), PFOS (-3%; 95% CI: -3, -2%), PFNA (-2%; 95% CI: -2, -1%), and PFHxS (-1%; 95% CI: -2, 0%). The infant PFOA and PFOS serum concentrations were 6% (95% CI: 1, 10%) and 4% (95% CI: 1, 7%) higher per month of breastfeeding.

Conclusions: Breast milk is the optimal food for infants, but is also a PFAA excretion route for lactating mothers and exposure route for nursing infants.

Figure 1

Unadjusted geometric mean (GM) maternal (A) and infant (B) PFAA serum concentrations (ng/mL) and 95% CIs stratified by duration of breastfeeding.