Poly- and Perfluoroalkyl Substances (PFAS) Exposure through Infant Feeding in Early Life
Open accessAbstract
BACKGROUND AND AIMS: Per- and polyfluoroalkyl substances (PFAS) are non-degradable, man-made-chemicals with an elimination half-life of multiple years, causing accumulation in the environment and humans with potential harmful effects. However, longitudinal PFAS levels in human milk, daily PFAS intake and the association with infant plasma PFAS levels have never been reported. We investigated longitudinal PFOA and PFOS levels in human milk and the daily PFAS intake through infant feeding in the first 3 months of life, the most important determinants and the correlation with PFAS plasma levels at age 3 months and 2 years. METHODS: In 372 healthy term-born Dutch infants, we determined PFOA and PFOS levels in human milk given at age 1 and 3 months, in 6 infant formula brands and in infant plasma at 3 months and 2 years, using liquid-chromatography-electrospray-ionization-tandem-mass-spectrometry(LC-ESI-MS/MS). We studied the associations between daily PFAS intake and predictive characteristics by multiple regression models. RESULTS: PFOA and PFOS levels in human milk decreased between 1 and 3 months after delivery, regardless whether breastfeeding was given exclusively(EBF) or in combination with formula feeding. PFOA and PFOS could not be detected in any formula feeding. Daily PFAS intake(ng/kg) was highest in EBF-infants. Higher amount of human milk, older maternal age, lower parity and first-time breastfeeding were associated with higher daily intake. Daily PFAS intake in early life was strongly correlated with PFAS plasma levels at age 3 months and 2 years(R = 0.642-0.875, p < 0.001). CONCLUSIONS: Human milk contains PFOA and PFOS, in contrast to formula feeding. Daily PFOA and PFOS intake in early life is highest in exclusively breastfed infants and it is highly correlated with infant's plasma levels throughout infancy. Our findings show that breastfeeding is an important PFAS exposure pathway in the first months of life, with unknown but potential adverse effects. Knowing the important health benefits of breastfeeding, our findings warrant more research about the health outcomes in later life.
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Exclusive breastfeeding correlates with up to a 30% monthly increase in infant PFAS levels.
“Exclusive breastfeeding correlates with up to a 30% monthly increase in infant PFAS levels, while toddlers show higher PFASs than mothers—with plasma PFOS, PFOA, and PFHpS increasing by 3.3%, 4.7%, and 6.1% per month of breastfeeding, respectively [52,64,65,81,119].”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [52]
Section 3.5 reports that PFAS intake through breastfeeding correlates strongly with infant plasma levels, and the Discussion reports higher levels in exclusively breastfed than exclusively formula-fed infants. Neither passage supports the claimed increase of up to 30% per month; the paper reports correlations and feeding-group comparisons, not that monthly rate. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredToddlers show higher PFASs than mothers-with plasma PFOS, PFOA, and PFHpS increasing by 3.3%, 4.7%, and 6.1% per month of breastfeeding, respectively.
“Exclusive breastfeeding correlates with up to a 30% monthly increase in infant PFAS levels, while toddlers show higher PFASs than mothers—with plasma PFOS, PFOA, and PFHpS increasing by 3.3%, 4.7%, and 6.1% per month of breastfeeding, respectively [52,64,65,81,119].”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [52]
Section 3.5 reports that PFOA and PFOS intake through breastfeeding correlates with infant plasma levels at 3 months and 2 years; the Discussion also describes higher serum PFAS levels in breastfed than formula-fed infants. Neither passage compares toddlers with mothers or reports monthly plasma increases of 3.3%, 4.7%, and 6.1% for PFOS, PFOA, and PFHpS. Page numbers were not provided in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredStudies show that PFOA and PFOS are present in human milk, resulting in the highest daily PFAS intake during exclusive breastfeeding, with strong correlations to infant plasma concentrations.
“Studies show that PFOA and PFOS are present in human milk, resulting in the highest daily PFAS intake during exclusive breastfeeding, with strong correlations to infant plasma concentrations [52].”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [52]
Preliminary clinical biomonitoring suggests that hospital-administered procedures, including IV infusions, catheter use, and respiratory support in neonatal and pediatric intensive care, may elevate PFAS levels via administered fluids.
“Additionally, preliminary clinical biomonitoring suggests that hospital-administered procedures, including IV infusions, catheter use, and respiratory support in neonatal and pediatric intensive care, may elevate PFAS levels via administered fluids [52].”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [52]
The Introduction and Discussion address PFAS exposure through infant feeding, not hospital-administered fluids or procedures. The Subjects section describes a cohort of healthy term-born infants and excludes those needing respiratory ventilation. Searches for IV infusions, catheters, intensive care, and administered fluids found no passage assessing the claimed exposure route. (LLM, conf=0.76)
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Briassoulis, G., Ilia, S., & Briassouli, E. (2025) · Life · doi:10.3390/life15071057 · Cited by 15 · see citing works
- Authors
- van Beijsterveldt, I. A. L. P., van Zelst, B. D., de Fluiter, K. S., van den Berg, S. A. A., van der Steen, M., & Hokken-Koelega, A. C. S.
- Venue
- Environment International
- Publisher
- Elsevier BV
- Published
- 2022-06
- Volume
- 164
- Pages
- 107274
- ISSN
- 0160-4120 (ISSN-L)
- OpenAlex
- W4229015569
- Cited by
- 58
- References
- 26
- Citations by year
- 2026: 14 · 2025: 14 · 2024: 16 · 2023: 11 · 2022: 3
- FWCI
- 3.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Environment International (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by-nc-nd)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Danone
- Danone Nutricia Research
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Keywords
- per- and polyfluoroalkyl substances, perfluorooctanoic acid, PFOS, breast milk, infant feeding, breastfeeding, infant formula, PFAS exposure, daily intake, early life exposure, maternal age, parity
- MeSH terms
- Breast Feeding, Environmental Pollutants, Female, Fluorocarbons, Humans, Infant, Milk, Human, Pregnancy, Alkanesulfonic Acids, Tandem Mass Spectrometry
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