PFAS Concentrations in Human Milk: A Sibling Study

The EPA has called for aggressively expanded research on PFAS health effects. Breastfeeding and childbirth are the major excretion pathways for maternal serum concentrations of PFAS and thus serve as major sources of concentrated infant exposure at a critical period for development. This pilot and feasibility study will employ a paired sibling design to assess human milk PFAS concentrations from 25 exclusively breast-feeding women from the MILK Study who have stored samples obtained from both their first-born and second-born children. PFAS will be estimated using liquid chromatography tandem mass spectrometry (LC/MS/MS). Outcomes: infant adiposity (weight for length z scores/changes, and body composition from DXA) and neurodevelopment (using an innovative method of auditory and visual evoked-response potentials, or ERPs) from 1 to 6 months. Analysis: In Aim 1, each individual PFAS concentration will be examined for distributional characteristics and modeled using linear mixed effect models that address clustering by sibship, testing effects of birth order  testing effects of birth order (first or second) and time (1 or 3 months lactation), and adjusting for multiple maternal and infant covariates. In Aim 2, we will again use linear mixed models nested by sibship testing the association of PFAS dosage (concentration x daily intake) with infant growth, adiposity, and memory/cognition (ERP), adjusting for infant sex, gestational age, and maternal factors.