Risk-Benefit Analysis for the Breastfed Infant Based on the WHO- and UNEP Human Milk Surveys for Dioxin-like Compounds

Dioxin-like compounds (DLC) are still present in human milk and this chapter describes a risk-benefit analysis based on decades of WHO global human milk surveys. At present there is no health-based guidance value (HBGV) available for the breastfed infant. Although formally these HBGVs have been set to protect human health for a lifetime exposure period, much of the underlying experimental data focus on the perinatal and/or childhood period. Therefore, it is justifiable to use these HBGVs for early life and shorter than lifetime exposures, e.g. breastfeeding. With this approach the present HBGVs for DLC were generally exceeded one order of magnitude or more in industrialized countries over the period 2000 to 2019. If HBGVs of 1 or 0.1 pg TEQ/kg/day are used to calculate toxicological acceptable levels for DLC in human milk, it can be estimated that such levels will not be reached before, respectively, 2030 or 2050. When the subtle adverse health effects of DLC in the breastfed infant reported in the 1990s were compared with benefits of breastfeeding for the infant and mother, it is concluded that benefits grossly outweigh the potential adverse health. Therefore, it is concluded that the WHO has rightfully encouraged breastfeeding for the last decades.