Endocrine-disrupting chemicals and breastfeeding duration: a review

Curr Opin Endocrinol Diabetes Obes. 2020 Dec;27(6):388-395. doi: 10.1097/MED.0000000000000577.


Purpose of review: The purpose of this review is to describe epidemiologic and toxicological literature investigating how endocrine-disrupting chemicals (EDCs) affect mammary gland development and function, thereby impacting lactation duration.

Recent findings: Perfluoroalkyl and polyfluoroalkyl substances appear to reduce breastfeeding duration through impaired mammary gland development, lactogenesis, and suppressed endocrine signaling. Halogenated aromatic hydrocarbons have differing associations with lactation duration, likely because of the variety of signaling pathways that they affect, pointing to the importance of complex mixtures in epidemiologic studies. Although epidemiologic literature suggests that pesticides and fungicides decrease or have no effect on lactation duration, toxicology literature suggests enhanced mammary gland development through estrogenic and/or antiandrogenic pathways. Toxicological studies suggest that phthalates may affect mammary gland development via estrogenic pathways but no association with lactation duration has been observed. Bisphenol A was associated with decreased duration of breastfeeding, likely through direct and indirect action on estrogenic pathways.

Summary: EDCs play a role in mammary gland development, function, and lactogenesis, which can affect breastfeeding duration. Further research should explore direct mechanisms of EDCs on lactation, the significance of toxicant mixtures, and transgenerational effects of EDCs on lactation.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Benzhydryl Compounds / toxicity
  • Breast / drug effects
  • Breast / growth & development
  • Breast / physiology
  • Breast Feeding / statistics & numerical data*
  • Endocrine Disruptors / toxicity*
  • Environmental Exposure / adverse effects
  • Environmental Exposure / statistics & numerical data
  • Female
  • Humans
  • Lactation / drug effects*
  • Lactation / physiology
  • Mammary Glands, Animal / drug effects
  • Mammary Glands, Animal / growth & development
  • Mammary Glands, Animal / physiology
  • Pesticides / toxicity
  • Phenols / toxicity
  • Phthalic Acids / toxicity
  • Time Factors


  • Benzhydryl Compounds
  • Endocrine Disruptors
  • Pesticides
  • Phenols
  • Phthalic Acids
  • phthalic acid
  • bisphenol A