Breast Milk and PFASs - Part 2

Let's look at their paper (sorry, its behind a paywall so I cannot link to it.):

Breastfeeding as an Exposure Pathway for Perfluorinated Alkylates

Why the big deal?  Why do the five authors believe that PFASs in breast milk is a potential concern?

If it is in breast milk, then there is uptake by the baby.  Now the baby has PFASs in their system.  What's so bad about that?

PFASs can have immunotoxic effects, and a major concern is that PFAS exposure may undermine childhood immunization programs.

and...

Due to the particular vulnerability of the immune system during early development, the sources of PFAS exposure in infants are of special interest.

That's why these guys think their study is important.  Because "PFAS exposure may undermine childhood immunization programs."

What is that based on?  They cite a paper called "Serum Vaccine Antibody Concentrations
in Children Exposed to Perfluorinated Compounds" (which is behind a paywall so I cannot link it).

Our findings are supported by several, though not all, experimental studies in rodents, in which adverse effects of PFOS on humoral immune function were observed at serum concentrations similar to those reported in the present study and at levels prevalent in the United States.

There were adverse effects on humoral immune function observed.

An antibody concentration greater than 0.1 IU/mL is considered an important indicator of protection in accordance with the public health rationale for routine vaccinations. Prenatal and postnatal PFOS exposures, as well as postnatal PFOA exposure, were associated with increased odds of antibody concentrations below the protective level. 

Exposure increased the odds of antibodies being below the protective level.

If the associations are causal, the clinical importance of our findings is therefore that PFC exposure may increase a child's risk for not being protected against diphtheria and tetanus, despite a full schedule of vaccinations. 

What they found was this:

Most clearly, a 2-fold increase in PFOS exposure was associated with a difference in antibody concentration of -39% (95% CI, -55% to -17%) at age 5 years before the booster.

I am not going to argue CIs or PFOSs or PFASs or whatever.  I am going to take their data as is.  A 2-fold increase in concentration decreased the antibody concentration for tetanus and diphtheria, (keep reading to see how this 2-fold issue came about)

This is where I separate from the five authors.  If they are basing their concern on this:

Adverse effects of PFASs reported in children with similar serum-PFAS concentrations include immunotoxicity, as revealed by decreased antibody concentrations toward childhood vaccines and increased frequency of common infections.

...then the benefits they attribute to WHO:

Breastfeeding is recommended by WHO as the exclusive food source for infants during the first 6 months after birth and onward partially with supplementary food up to age 2 years.

...must be less then the risk of a "decreased antibody concentrations toward childhood vaccines and increased frequency of common infections" for a mother to stop breastfeeding.

PFASs are a concern because of a "decreased antibody concentrations toward childhood vaccines and increased frequency of common infections" according to the papers authors.

Their paper generated this news article stating:

BREAST MILK IS BEST FOR BABIES BUT THE MOMS COULD ALSO BE PASSING HARMFUL CHEMICALS

See what you started?  Hopefully you can see where I am going with this and why it bothers me.  If one mother changes her mind about breastfeeding because she does not want to pass harmful chemicals to her baby, then the positive benefits of breastfeeding, as described by WHO, will not be received by that baby.  One risk is substituted for another risk. 

This means that there had better be a real risk of "decreased antibody concentrations toward childhood vaccines and increased frequency of common infections" when breast milk is given to the baby., and that risk is substantially decreased if the baby receives formula.

Then, if formula is used, the benefits not received from breastfeeding are negated by that decrease in risk of decreased antibody and frequency of common infections,

This makes me ask the question; how confident am I in the data they used to make the statement "decreased antibody concentrations toward childhood vaccines and increased frequency of common infections."

I am pretty confident in the data that WHO used to recommend breastfeeding.  There is a lot of it out there.  But for PFASs and PFOS there is not.  There seems to be a small group looking at into them and they seem to cite each other's papers.  That makes me a little skeptical in how "bad" they might be.

Now I am writing this, like I usually do, in real time.  That is, I do not have the data in front of me.  I write as I look it up.  I have no pre-formed conclusion on the validity of their findings and data.  I am concerned/agitated because I think they found all the attention on their work outweighed their concern that women may look at it and chose not to breastfeed, because, you know, these smart scientists, one from Harvard no less, found that breast milk could be exposing a baby to toxic chemicals.

There had better be some convincing data to justify the decision a women might make to not breastfeed based on this journal article and the news stories about it.

Next Post: Part 3