Blog by: Holly Lefevre

A common topic in public health today is the presence of Per- and Polyfluoroalkyl Substances (PFAS) in our environment. PFAS are particularly concerning because they persist indefinitely, earning them the nickname “forever chemicals.”[i] Because they are difficult to eliminate, PFAS remain in mothers’ bodies and have been found in human breastmilk.[ii] While their presence is unlikely to warrant widespread shifts to formula feeding, this issue deserves the attention of public health experts.[iii] We must use environmental regulations, product liability, and public health policy to reduce the risk these forever chemicals pose to our most vulnerable—our babies.

PFAS are manufactured chemicals which are utilized in consumer products and industrial applications, including nonstick cookware, food packaging, waterproof clothing, and firefighting foam.[iv] Due to their widespread use, PFAS are now found throughout our environment—in water, food, and household products.[v] Research has shown varied impacts on humans, including altered cholesterol levels and liver enzymes, pregnancy-induced hypertension, decreased birth weight, and kidney and testicular cancer.[vi] Given the range of health concerns linked to PFAS, their ingestion by infants is troubling. This is a global issue affecting more than just the United States, as PFAS have been detected in breastmilk samples worldwide.[vii]

The CDC, WHO, and AAP recommend breastfeeding as the best feeding method for infants.[viii] But with rising concern about PFAS contamination, agencies must weigh the potential risks of PFAS against the known benefits of breastfeeding.[ix] Alternative feeding methods are unlikely to be PFAS-free.[x] Drinking water is contaminated in many regions, and some formula products have been found to contain PFAS.[xi] Given the health benefits of breastfeeding, it likely remains the best option for most infants. However, this situation demands a serious reckoning with the regulatory failures and corporate negligence that created an environment where such tradeoffs are even necessary.

The EPA has taken several actions in response to the growing concern over PFAS.[xii] It has established enforceable drinking water standards and declared PFAS hazardous substances, improving accountability for cleanup.[xiii] The agency also issued updated guidance for PFAS disposal and is working to disincentivize the development of new PFAS-containing products.[xiv]

Beyond legislation, companies have faced accountability through tort law.[xv] 3M and DuPont were found to have known about the dangers of many of their chemicals but failed to warn the public or discontinue their use.[xvi] Internal documents show they were aware of high inhalation and moderate ingestion toxicity as early as 1970, while the public health community remained unaware until nearly 2000.[xvii] This extreme disregard for the public’s health resulted in several large settlements.[xviii] While these settlements have been put to some productive uses, PFAS are now entrenched in our ecosystems and bodies through contaminated food, water, and everyday products.[xix]

The best way forward is to use all legal avenues available to reduce the current and future harm of PFAS exposure. Gone are the days when industry self-regulation can be tolerated—this crisis has shown that strong oversight is needed.[xx] The Toxic Substances Control Act (TSCA) will require manufacturers using PFAS to disclose their uses, disposals, exposures, and hazards in consumer products, allowing the EPA to more closely monitor and regulate these uses.[xxi] The EPA has also enacted national drinking water regulations that set standards for PFAS contamination.[xxii] This regulation requires disclosure of PFAS contamination rates, which can allow market pressure for safe drinking water. These regulations must be enforced, and federal legislation is needed to ensure all Americans are protected.

Continued PFAS production and use in consumer products must decline. Consumer education programs can raise awareness about the risks of these “convenience” consumer items, such as nonstick cookware and food packaging. Regulatory agencies can host exchange events that encourage consumers to replace old nonstick cookware with safer options.

Continued research on the presence and quantity of PFAS in breastmilk can allow us to establish the current baseline and monitor for improvement over time. Engaging stakeholders and ensuring broad access to data can help create market pressure for change. Further, evidence has shown that low-income and minority populations have higher bioaccumulation of these toxic materials.[xxiii] Because of this, these communities deserve enhanced access to healthcare resources and legal aid options should they find themselves personally affected by an adverse event due to PFAS contamination.

PFAS in breastmilk is a wake-up call for us all. Much like the death of a keystone species signals ecosystem collapse, the presence of PFAS in breastmilk is a signal that we are harming life at its most vulnerable stage. We need bold, widespread change to protect mothers and babies by removing PFAS exposures and restoring environmental safety. The most vulnerable among us are at risk. They need our action now.

[i] PFAS Explained, U.S. EPA, https://www.epa.gov/pfas/pfas-explained (last visited Sept 28, 2025) [https://perma.cc/8XCC-HT8U].

[ii] Judy S. LaKind et al., Per- and Polyfluoroalkyl Substances (PFAS) in Breast Milk and Infant Formula: A Global Issue, 219 Env’t Res. 115042 (2023), https://doi.org/10.1016/j.envres.2022.115042.

[iii] Id.

[iv] Our Current Understanding of the Human Health and Environmental Risks of PFAS, U.S. EPA, https://www.epa.gov/pfas/our-current-understanding-human-health-and-environmental-risks-pfas [https://perma.cc/LYD6-CBVY].

[v] Id.

[vi] About PFAS — Health Effects, Agency for Toxic Substances and Disease Registry, https://www.atsdr.cdc.gov/pfas/about/health-effects.html (last visited Sept 28, 2025) [https://perma.cc/6LFL-3FSX].

[vii] LaKind, supra note 2.

[viii] Breastfeeding Recommendations and Guidance, CDC, https://www.cdc.gov/breasafeeding/php/guidelines-recommendations/index.html [https://perma.cc/X4XZ-5SKJ]; Breastfeeding Overview, WHO, https://www.who.int/health-topics/breastfeeding#tab=tab_1 [https://perma.cc/4DXE-W9NH]; Breastfeeding and the Use of Human Milk, Am. Academy of Pediatrics, 129 Pediatrics e827 (2012), https://doi.org/10.1542/peds.2011-3552.

[ix] LaKind, supra note 2.

[x] Id.

[xi] Id.

[xii] Key EPA Actions to Address PFAS, U.S. EPA, https://www.epa.gov/pfas/key-epa-actions-address-pfas (last visited Sept 28, 2025) [https://perma.cc/JK5L-AL6L].

[xiii] Id.

[xiv] Id.

[xv] Nadia Gaber et al., The Devil They Knew: Chemical Documents Analysis of Industry Influence on PFAS Science, 89 Ann. Glob. Health 37 (2023), https://doi.org/10.5334/aogh.4013 [https://perma.cc/STE5-C23H].

[xvi] Id.

[xvii] Id.

[xviii] Id.

[xix] Id.

[xx] Id.

[xxi] Risk Management for Per- and Polyfluoroalkyl Substances (PFAS) under TSCA, U.S. EPA, https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/tsca-section-8a7-reporting-and-recordkeeping (last visited Sept 28, 2025) [https://perma.cc/JM7J-S3M3].

[xxii] Final PFAS National Primary Drinking Water Regulation, U.S. EPA https://www.epa.gov/sdwa/and-polyfluoroalkyl-substances-pfas (last visited Nov 6, 2025) [https://perma.cc/67PB-4HG9].

[xxiii]Communities of Color Disproportionately Exposed to PFAS Pollution in Drinking Water, Harv. T.H. Chan Sch. of Public Health, https://hsph.harvard.edu/news/communities-of-color-disproportionately-exposed-to-pfas-pollution-in-drinking-water/ (last visited Sept 28, 2025) [https://perma.cc/47DG-SLJU].