Breast Milk and PFASs - Part 7

In their paper:

Breastfeeding as an Exposure Pathway for Perfluorinated Alkylates

The authors state:

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.

and...

Our results show that four of the major PFASs tended to increase substantially during the breast-feeding period, thereby suggesting that human milk is a main source of exposure during infancy.

This is where the focus needs to be.  Should a new mom be concerned about this?  The news articles generated from the publication of this paper all screamed about toxic chemicals in breast milk and how they are passed on to your baby.

Here's the thing though.  This paper only looks at PFASs as a toxic chemical in breast milk. The concern therefore will only be for PFASs being present and passed on to the baby through breast feeding.  If they are present, the concern the authors tell us is because they could decrease antibody concentrations and increase the frequency of common infections.

If they are present...decrease antibodies for tetanus and diphtheria, and more common colds and gastroenteritis.

If they are present, that is what the author's of the paper contend could be the negative health outcomes.

If a new mom, because she read or was told about the news stories that resulted from this paper, chooses not to breastfeed because of this concern, then there will be zero benefits her baby receives.

Zero benefits if breastfeeding is not provided to the baby.

Zero benefits because of this paper.

The "toxic" chemical in the news stories is for PFASs.  The health concerns they tell us could result from an increase in exposure are decrease antibodies for tetanus and diphtheria, and more common colds and gastroenteritis.

What's your point Bowman?  You are beating a dead horse again.

Yeah...But that understanding is important here.  Are all mothers who want to breastfeed their baby going to put their baby at risk for decreased antibodies for tetanus and diphtheria, and more common colds and gastroenteritis.

Does this paper provide enough support for a new mother to give up breastfeeding to protect their baby from the harm of PFAS?

We can take the claim of an increase in common colds and gastroenteritis off the table of potential negative health outcomes.  It is not supported (see previous post).  This leaves the decrease in antibodies for tetanus and diphtheria.

The paper they cite; "Serum Vaccine Antibody Concentrations in Children Exposed to Perfluorinated Compounds," tells us this:

These results indicate that PFC exposures at commonly prevalent serum concentrations are associated with lower antibody responses to childhood immunizations and an increased risk of antibody concentrations below the level needed to provide long-term protection.

However...

The prenatal exposure level, as indicated by the mother’s serum concentration during pregnancy, was less clearly associated with the antibody outcomes.

That's important here.  What these guys say in their paper - the paper cited to support the negative health outcome of "decreased antibody concentrations toward childhood vaccines" - is that the mother's serum level of PFASs had a weak association with the antibody outcomes seen at 5 and 7 years.

So?

So if the mother's serum concentration during pregnancy is "less clearly associated with the antibody outcomes" then the adverse effects stated by the authors in their paper "Breastfeeding as an Exposure Pathway for Perfluorinated Alkylates" cannot support the negative health outcome of a decrease in antibodies for tetanus and diphtheria.

How can you say that Bowman?

Because these guys used the same cohort as the guys they cited.  Its the same data, the same serum concentrations, the same kids, the same mothers.

If the original paper "Serum Vaccine Antibody Concentrations in Children Exposed to Perfluorinated Compounds" tells us they found that "the mother’s serum concentration during pregnancy, was less clearly associated with the antibody outcomes" then the paper titled "Breastfeeding as an Exposure Pathway for Perfluorinated Alkylates" should not elude to negative health outcomes from breastfeeding and PFASs.

Here is what they state in the Breastfeeding paper:

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.

That's in their paper.  This is too:

Given the importance of postnatal development of acquired immune function, the shape of the serum concentration profile may be important for PFAS-associated immune deficits.

Based on what? The guys they cited, the guys who provided the data they used, tell us this:

The prenatal exposure level, as indicated by the mother’s serum concentration during pregnancy, was less clearly associated with the antibody outcomes.

So if the prenatal exposure level in the mother is less clearly associated with the antibody outcomes, should a new mother forgo breastfeeding to decrease the risk of decreasing antibody outcomes?

No.  Why? Because the prenatal exposure level, as indicated by the mother’s serum concentration during pregnancy, was less clearly associated with the antibody outcomes.

But...that's the mother's serum exposure before the baby is born.  The paper tells us that "human milk is a main source of exposure during infancy."

Work with me here...

If a baby is exclusively breastfed for six months, then the major source of PFASs would be through the breast milk.  So the higher the serum concentration of PFAs before birth in the mother, the more PFASs transferred to the baby.

So...if  "the mother’s serum concentration during pregnancy, was less clearly associated with the antibody outcomes" at 5 and 7 years then breastfeeding, and it is the decrease in antibodies found at 5 and 7 years that supports this statement:

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

 Breastfeeding is therefore not shown to be contributing to an increased risk of antibody outcomes.

How can I state that when we are talking about breastfeeding and not the mother's serum concentration?

The authors of "Breastfeeding as an Exposure Pathway for Perfluorinated Alkylates" built a model using data from "Serum Vaccine Antibody Concentrations in Children Exposed to Perfluorinated Compounds"

This model, they contend, shows this:

The duration of exclusive breastfeeding was associated with increases of most PFAS concentrations by up to 30% per month, with lower increases during partial breast-feeding.

They then tells us this:

After cessation of breastfeeding, all serum concentrations decreased.

This is where we need to look at the data they used to make their model.  This mothers serum concentration becomes really important here.  This is where I had to pause and reflect when I read this:

As we used log scale transformations of PFAS concentrations, the higher milk concentrations from mothers with elevated serum concentrations were included in the model by default. However, neither the newborn baby’s PFAS concentrations nor the concentrations in milk were measured in this study, which instead relied on the maternal serum concentrations measured at a specified point during pregnancy.

Now, one more time...

The prenatal exposure level, as indicated by the mother’s serum concentration during pregnancy, was less clearly associated with the antibody outcomes.

Next post: Part 8