The heart of the matter on breastmilk and environmental chemicals: essential points for healthcare providers and new parents.

Abstract The increasing number of environmental chemicals measured in breastmilk is a consequence of improved analytical capabilities and the increased interest in biomonitoring. It has been generally concluded that the benefits to the infant from breastfeeding outweigh potential risks associated with environmental chemical exposures associated with breastfeeding. However, there have been reports of subtle effects on infants associated with chemicals in breastmilk. Associations between concentrations of chemicals in breastmilk and a biochemical or other change in infants may signal the need for further study or regulatory action, whereas on an individual level, these changes may not be considered adverse. For healthcare providers, this distinction is critical, as many in the field are being asked for nuanced information on risks and benefits associated with breastfeeding, and this information is not readily available. Recognizing the challenge faced by healthcare providers, we have explored and developed a case study on dioxins in breastmilk. The essential conclusion for healthcare providers and new parents is that in studies of breastfed versus formula-fed infants across time, including times when levels of environmental chemicals such as dioxins were higher, beneficial effects associated with breastfeeding have been found. The current evidence does not support altering the World Health Organization recommendations promoting and supporting breastfeeding.