Policy Statements on Breastfeeding and Human Milk: Additional Comments

Abstract

The American Academy of Pediatrics publishes periodical breastfeeding policy statements; the latest1 updated previous recommendations and added new topics. These statements have long been a reference for clinical pediatricians and public health professionals worldwide. Accustomed to the breadth of research in these statements and knowing their importance, I felt the lack of 2 topics of current interest to pediatricians and public health workers: pollutants in breast milk and interactions between of vaccines and breastfeeding. Environmental pollutants and hazardous substances have become part of modern life as a result of widespread use coupled with inadequately controlled (or unenforced) environmental policies. Because of their ubiquity, they reach all forms of life, entering and contaminating aquatic and terrestrial food chains; at the top of the ladder, we find breastfed babies. Only under exceptional circumstances (such as after accidents) does the occurrence of environmental chemicals in breast milk result in a recommendation to avoid breastfeeding. Indeed, most studies of background exposure suggest that breastfeeding can counter subtle adverse effects associated with in utero …