[Invited Perspective] Current Breast Milk PFAS Levels in the United States and Canada Indicate Need for Additional Monitoring and Actions to Reduce Maternal Exposures

By Gloria B. Post
February 28, 2022

Per- and polyfluoroalkyl substances (PFAS), a large group of synthetic chemicals that have been made for more than 70 years, are a current focus of public health concern. Several long-chain PFAS, with human half-lives of several years, are detected in the blood serum of virtually all residents of the United States and many other nations (Lau 2015). PFAS do not break down in the environment, and even low concentrations in drinking water can surpass exposures from common sources, such as food and consumer products (Post et al. 2017). There is substantial evidence for health effects of PFAS, including decreased antibody response to vaccines, increased serum lipids and liver enzymes, and decreased birth weight, even at general population exposure levels (Fenton et al. 2021), and the risks are increased with additional exposure from contaminated water. It is well established that breast milk can be an important source of PFAS exposure and that infants are a sensitive subpopulation for their adverse effects (Goeden et al. 2019). In this issue of Environmental Health Perspectives, LaKind et al. (2021) discuss measured and estimated PFAS levels in breast milk in North America and evaluate the potential significance of these levels.

First, LaKind et al. (2021) reported that data on PFAS in breast milk in the United States and Canada are very limited; only three general population studies, with 95 U.S. and 13 Canadian participants in total, were identified. The four long-chain PFAS [i.e., perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonate (PFHxS)] that are ubiquitous in the blood serum of U.S. residents (CDC 2021) were detected in breast milk in the two U.S. studies, whereas only PFOA was detected in a smaller study from Canada, possibly because of insufficient analytical sensitivity. Clearly, more data are needed.

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