2024-09-24 08:13:00
Many elements converge today to highlight the influence of the environment and diet on health from the fetal stage. Requested by the Directorate General of Health, ANSES carried out two assessments focused on breastfeeding:
an assessment of the risks linked to exposure to chemical contaminants of breastfed children, continuing its study of the total infant diet (EATi); an inventory of knowledge on the nutritional benefits of breastfeeding for child health.
This work is part of the National Nutrition and Health Program and the action plan initiated by the public authorities around Child’s first 1000 daysfrom the in utero period until the age of two years.
In this expert report, ANSES estimated the levels of exposure to chemical substances of children aged less than 6 months. via breast milk and foods introduced during dietary diversification. Thirty-two substances or families of substances were examined, based on scenarios simulating many different exposure scenarios. For the majority of substances studied, the level of exposure is not of concern for health : 20 of them do not exceed the reference health values for the food route.
However, for 12 substances or families of substances, ANSES shows that the level of exposure of breastfed children can exceed the health reference values. It is about of metallic trace elements – inorganic arsenic, cadmium, chromium, manganese, nickel and lead – and polychlorinated compounds (PCB, dioxins and lindane), polyfluoroalkyl (PFOS and PFOA) and polybrominated (PBDE). These substances are present in various foods, water and even the air.
The estimation of exposure to contaminants in breast milk is based on a study called CONTA-LAIT, based on the analysis of 180 samples of breast milk collected in different large regions of France from 2013 to 2015. It was carried out by the hospitals of Paris (AP-HP), LABERCA (Oniris VetAgroBio) and the chemical analysis laboratory Ultra Traces Analyzes Aquitaine (UT2A) and Anses.
For contaminants present in other infant foods, the expertise integrates the data produced by the study of the total infant diet (EATi). This study published in 2016 by ANSES made it possible to assess the dietary exposure of non-breastfed children under 3 years old to chemical contaminants. The analyzes focused on 670 substances sought in infant formula and foods introduced during dietary diversification.
The results of this expertise are not intended to predict the future health status of breastfed children. However, they highlight the need to act collectively on 12 substances of concern.
The majority of chemical substances identified as problematic are known to lastingly pollute the environment and accumulate in the fatty or bone tissues of the human body. Their presence in the body of breastfeeding mothers comes from all their past exposures. Infant exposure to metal contaminants mainly comes from foods commonly introduced during dietary diversification.
As these substances are very present in the environment and foods, in general, it is not relevant to recommend individual actions to women to limit their exposure and that of their child. However, in 2019, ANSES formulated fish consumption recommendations for pregnant and breastfeeding women in order to control exposure to chemical contaminants from this food family.
ANSES therefore calls for strengthen collective action already undertaken by public authorities to reduce contamination of the environment and food. This involves in particular the regulatory framework for substances, the identification and control of sources of contamination and monitoring of the food chain.
This expertise also highlights the need to carry out additional studies. It is particularly necessary to describe the contamination more precisely of breast milk in France and to monitor this contamination over time as well as its possible impact on the development of young children.
At the same time, ANSES has drawn up an inventory of scientific knowledge on the nutritional benefits of breast milk on child health. This expertise is based on numerous epidemiological studies which highlight the benefits of breast milk for the health of the child.
The conclusions of ANSES confirm the positive relationship between breast milk consumption and reduced risk of overweight at all agesor even a favorable effect on cognitive development. Data also suggests that breastfeeding could help reduce the risk of type 1 diabetes, leukemia or even acute otitis media (but only up to the age of 2 for the latter).
For the health of mothers and children, ANSES recalls that it is necessary to follow specific dietary recommendations for pregnant and breastfeeding women, in order to cover the increased nutritional needs during this period.
In addition to ANSES’s work on the health effects linked to breast milk, the Directorate General of Health also requested the High Council of Public Health in order to establish recommendations relating to the practice of breastfeeding in France.
Public Health France has also highlighted, in the second edition of the Epifane investigation published in July 2024, a progression in the practice of breastfeeding in France.
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