Breastfeeding Initiation and Duration after High Exposure to Perfluoroalkyl Substances through Contaminated Drinking Water: A Cohort Study from Ronneby, Sweden

Christel Nielsen, Ying Li, Magdalena Lewandowski, Tony Fletcher, Kristina Jakobsson

Forskningsoutput: TidskriftsbidragPublicerat konferensabstract


BACKGROUND AND AIM: The drinking water in parts of Ronneby municipality was heavily contaminated with perfluoroalkyl substances (PFAS) for decades. Although PFAS has endocrine-disrupting properties and may interfere with breastfeeding, the supporting epidemiologic literature is conflicting and based solely on populations with background levels of exposure. The effects on breastfeeding in populations with a point source of exposure are unknown. The aim was to investigate the potential associations between high PFAS exposure and 1) initiation and 2) duration of breastfeeding in a population-based cohort. METHODS: We retrieved data on infant feeding practices for 2,374 children born between 1999 and 2009 from Child Health Care centers in Ronneby and Karlshamn, a nearby municipality with background levels of exposure. Maternal residential address before delivery was used as a proxy for exposure, and confounder data were obtained from charts and national registers. We used modified Poisson regressions to estimate the risk of not initiating breastfeeding and, among initiators, the risks of not breastfeeding exclusively after 3 months and not breastfeeding at all at 6 months. RESULTS:Mothers who had received the contaminated water at their residential address had a 2.4 times higher risk (95% CI: 0.8, 6.7) of not initiating breastfeeding. Among initiators, primiparous mothers from the exposed area were at a 1.2 times increased risk (95% CI: 0.9, 1.6) of not exclusively breastfeeding at 3 months and a 1.6 times increased risk (95% CI: 1.2, 2.1) of not breastfeeding at all at 6 months. Multiparous women seemed less vulnerable to these effects, although we observed slightly increased risk estimates towards the end of the study period. CONCLUSIONS:Exposure to high levels of PFAS was associated with increased risks of not initiating breastfeeding as well as with shorter breastfeeding duration. Initiation among primiparous mothers was the most critical outcome, and targeted intervention might be warranted.
TidskriftEnvironmental Health Perspectives
StatusPublished - 2021
EvenemangInternational Society for Environmental Epidemiology 2021: Promoting Environmental Health and Equity in a Shifting Climate - Online, New York, USA
Varaktighet: 2021 aug. 232021 aug. 26
Konferensnummer: 33

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