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3981439 
Journal Article 
Shorter duration of breastfeeding at elevated exposures to perfluoroalkyl substances 
Timmermann, CA; Budtz-Jørgensen, E; Petersen, MS; Weihe, P; Steuerwald, U; Nielsen, F; Jensen, TK; Grandjean, P 
2017 
No 
Reproductive Toxicology
ISSN: 0890-6238
EISSN: 1873-1708 
68 
164-170 
English 
The aim of this study was to determine whether maternal exposure to persistent perfluoroalkyl substances (PFASs) affect the capability to breastfeed. In two Faroese birth cohorts (N=1130), concentrations of five PFASs were measured in maternal serum during pregnancy or two weeks after term. Duration of breastfeeding was assessed by questionnaire and clinical interview. In adjusted linear regression models, a doubling of maternal serum PFASs was associated with a reduction in duration of both total and exclusive breastfeeding, most pronounced for perfluorooctane sulfonic acid (PFOS) where a doubling was associated with a reduction in total breastfeeding of 1.4 (95% CI: 0.6; 2.1) months and perfluorooctanoic acid (PFOA) where a doubling was associated with a reduction in exclusive breastfeeding of 0.5 (0.3; 0.7) months. The associations were evident among both primiparous and multiparous women, and thus cannot be explained by confounding from previous breastfeeding. 
Breast milk; Breastfeeding; Endocrine disruption; Lactation; Maternal health; Perfluoroalkyl substances 
IRIS
• PCBs
     Excluded
     Litsearches
          LitSearch: August 2016-August 2017
               WoS
PFAS
• Additional PFAS (formerly XAgency)
     Literature Search November 2019
          Other Sources
               TEDX
     Screened Studies
          Included
               Include (TIAB)
          Excluded
               Exclude (Full Text)
• Expanded PFAS SEM (formerly PFAS 430)
     Litsearch: September 2019
          PubMed
          Web of Science
          Other Sources
               PFAS TOX Database
     Screened Studies
          Included
               Include (TIAB)
          Excluded
               Exclude (Full Text)
     Perfluorooctane
• ^Per- and Polyfluoroalkyl Substances (PFAS)
     PFOA (335-67-1) and PFOS (1763-23-1)
          Literature Search – Adverse outcome pathway (2015-present)
               Pubmed
               WOS
• PFAS 150
     Literature Search Update December 2020
          PubMed
          WOS
     Literature Search August 2019
          PubMed
          Web of Science
          Other sources
               PFAS TOX Database
     Not prioritized for screening
     Ammonium perfluorooctanoate
     Perfluorooctane
     Perfluorooctanesulfonic acid
     Perfluorooctanoic acid
• PFDA
     Literature Search
          Pubmed
          Toxline
          WOS
     Title and Abstract Screening
          Full Text Screening
               Studies Meeting PECO
                    Human health effect studies
     June 2022 Pelch Database
     Submitted to EPA
     Literature Searches (through April 2023 update and post-public comment/peer review)a    
          Other
               Published PFAS SEMs
          Title & Abstract Screening
               Tagged as Supplemental
                    Full Text Screening
                         Studies Meeting PECO
                              Human health effects studies
• PFHxS
     Database searches
          Pelch PFAS SEM
          Other
     Inclusion
          TiAb
          Full Text
               Human Study
• PFNA
     Litsearch Update 2017-2018
          PFAS Untag
     Literature Search
          Toxline
     PFNA May 2019 Update
          Toxnet
     Title and Abstract Screening
          Full Text Screening
               Studies Meeting PECO
                    Human health effects studies
     June 2022 Pelch Database
• PFOA (335-67-1) and PFOS (1763-23-1)
     Literature Search – Adverse outcome pathway (2015-present)
          Pubmed
          WOS
     Screening Results
          Human/Epi studies
               Other
     Literature Search Update (2013-2019)
          PubMed
          WOS
• PFOA and PFOS OW MCLG Approaches
     Cited in White Papers