family tools
choose a tool resource directory
find a practitioner parenting toolbox product safety media reviews family fun guide send an e-card family astrology

community features choose a feature birth stories find a Mothering friend live chat mothers' writing group teen voices

	new baby breastfeeding

Related Articles:
Sidebar: The PBDEs Problem

Don't Trash Our Bodies! Researching Breastmilk Toxins
By Christine Gross-Loh
Issue 122, January/February 2004

Is mothers' milk harmful for our babies? Recent headlines about toxins in breastmilk might have us think so. Two studies, published in August and September 2003, indicated that American women's breastmilk contained polybrominated diphenyl ethers (PBDEs), commonly used as flame retardants in many consumer products, at levels 10 to 100 times higher than those previously detected in European women.1 Such information might give mothers pause when it comes to nursing their babies. Is breastfeeding still the best choice for our babies? The answer is, unequivocally, yes. But the recent news about PBDEs, one in a long line of environmental contaminants that have been discovered in human bodies, is yet another indication that we cannot be complacent about protecting our bodies, our children, and the earth they will inherit.

What Is the Issue?
Certain environmental chemicals are present in the human body, residing primarily in the adipose, or fatty, tissues. These fatty tissues are mobilized when a woman begins lactation. Of special concern are the persistent organic pollutants (POPs), which remain in the environment for years. These include dioxins, DDT and its metabolites, dibenzofurans, and polychlorinated biphenyls (PCBs). The levels of DDT and PCBs have fallen thanks to the efforts of environmental activists of previous decades, but other chemicals continue to be widely used and contribute to our body burden. There is recent evidence that PBDEs are rapidly accumulating, as are phthalates, which are found in plastics, nail-care products, and other cosmetics. Certain solvents and toxic metals are also potential problems.2 A Centers for Disease Control (CDC) study released in January 2003 tested for 116 industrial chemicals and pesticides in the US population.3 Many more are certainly present in our bodies, but governmental regulation of the chemical industry under the Toxic Substances Control Act is such that "there is no legal requirement to test most chemicals for health effects at any stage of production, marketing, or use."4 Decades can pass before a chemical is banned, even though its dangers are evident far earlier, as was the case with PCBs.

Chemical contaminants have been circulating in the environment for decades. They are a legacy of the modern world, byproducts of industrial processes and our modern lifestyle. They enter the food chain, then enter our bodies through ingestion, inhalation, or absorption. Some are transported by sea or air currents to countries hundreds of miles from their origin. PCBs have been found in the Arctic, although they never have been used there.5 The Inuit of northern Canada have twice as much dioxin in their breastmilk as Canadian mothers south of them.6 Their body burden of POPs is among the highest in the world because of their diet, which is rich in the fat of marine mammals.7

While all humans are vulnerable, babies and young children are potentially more at risk from these contaminants than adults. Because of their size and much higher intake of fat-rich food, per pound, than older children and adults, babies consume a larger proportion of chemically contaminated food. Through a process called bioaccumulation, nursing babies take into their bodies a higher proportion of toxins than other living creatures because they ingest chemicals that have progressively accumulated at increasing concentration levels up the food chain. Chemicals bioaccumulate as plants are consumed by animals, which are consumed by humans. A human baby is on the receiving end of these concentrated chemicals, first through the placenta, then from the mother's breastmilk.

The Long-Term Ramifications of Chemical Pollution
There is no evidence that exposure to chemical contaminants in breastmilk at current typical levels results in harm. Numerous organizations, including the American Academy of Pediatrics, the World Health Organization, La Leche League, the World Wildlife Fund, and Baby Milk Action emphasize that breastmilk remains the far superior choice for infant feeding, even given what we know about the presence of contaminants in breastmilk.

However, POPs can do harm. The paramount concern is that levels of these chemicals are rising, and once they enter our environment and our bodies, they stay there. Significantly, studies indicate that if damage occurs, it almost always occurs during pregnancy. A 1996 study by two researchers at Wayne State University, Dr. Joseph L. Jacobson and Dr. Sandra W. Jacobson, demonstrated that 11-year-old children born to mothers who had unusually high exposures to PCBs from eating contaminated Lake Michigan fish experienced neurological delays: low-normal IQ scores, poorer reading comprehension, and memory and attention issues.8 Notably, "exposure to these chemicals after birth, through breastmilk, did not seem to cause any further harm to the children's mental abilities."9 This is despite the fact that chemical exposures through breastmilk are much higher than transplacental exposures.10 A fact sheet from the Greater Boston Physicians for Social Responsibility concurs: "Although chemical exposures before birth have been shown to have adverse effects, exposures through breastfeeding have not been shown to cause harm."11 Breastfeeding infants appear far more resilient than the fetus to these toxins.

Still, contaminant exposure via breastmilk apparently can be high. According to the fact sheet, a Dutch study indicated that three-year-old children who had been breastfed for an average of four months had PCB body burdens four times that of children who had not been breastfed.12, 13 In addition, children who were breastfed by mothers with unusually high PCB levels in their bodies became equivalent to formula-fed children in their lowered resistance to infection. In other words, some studies indicate that very high levels of PCBs appear capable of compromising some of the immunological benefits of mothers' milk.14, 15

Dr. Walter J. Rogan, MD, of the National Institute of Environmental Health Sciences in North Carolina and a leading researcher on environmental chemicals and children, comments that there is a strong association between breastfeeding and level exposure, but that the issue isn't so much exposure as "whether children are exposed to enough to matter." Dr. Rogan continues, "We've been looking now for 25 years, the Jacobsons have been looking for 25 years, and the Dutch have been looking for 14 years, and thus far the effects appear to be mostly, if not exclusively, attributable to prenatal exposure."

Sonya Lunder, an environmental analyst with the Environmental Working Group, a nonprofit environmental advocacy organization, notes that studies that show that breastfed babies fare better than formula-fed ones even when they are exposed to PCBs through breastmilk are "remarkable. . . . There is strong evidence about the role of breastfeeding in reducing the impact of toxic chemicals. Several studies show that even when moms have levels of PCBs in their bodies that might damage their babies' health, breastfed babies do not show the effects of PCB exposure. Only babies who are fed formula do. We don't know if the breastfed babies are more resilient due to beneficial compounds in the breastmilk, or whether it is because the developing fetus is much more sensitive to toxins than the nursing baby, or some other reason. Still, these findings give me confidence to say without hesitation that breastfeeding is best, and that babies benefit from breastfeeding."

Finally, Dr. Ruth Lawrence, MD, a well-known doctor and professor at the University of Rochester, author of Breastfeeding: A Guide for the Medical Profession (fifth ed.; Mosby, 1999), and one of the drafters of the American Academy of Pediatrics' official policy statement on breastfeeding, states that "breastmilk is so important in terms of brain and nerve development that babies who are breastfed achieve that advantage over bottle-fed babies. If there's a small detractor of these chemicals, it's totally washed out by the fact that breastmilk is so good for the developing brain."

Dr. Rogan notes that one possible area of future concern is that some contaminants-such as DDT, which is still used in Africa to control mosquitoes-might have the potential to shorten the duration of lactation.16-18 Some studies have shown that high levels of DDT in breastmilk from women in unusually exposed populations led to early weaning. Many chemical contaminants are endocrine disrupters, immune suppressors, and carcinogens.19 Although there is no evidence of harm now to our children through breastmilk exposures, it is essential to prevent levels of chemical contaminants from further accumulating in our environment and our bodies.

The Benefits of Breastmilk and the Risks of Formula
There is unanimous consensus among experts that, for infants, no other food measures up to breastmilk. It strengthens the infant's immune system and provides protection against a variety of diseases and infections, including the common cold, ear infections, diarrhea, bacterial meningitis, and allergies.20 Breastmilk provides a variety of immunological and psychological benefits to the child, both in the short and long term. These include a decreased risk of childhood cancer in children nursed more than six months21 and a lower risk of conditions such as heart disease,22 multiple sclerosis,23 respiratory infection,24 and juvenile insulin-dependent diabetes.25 Breastfeeding also provides many health benefits to the mother-including a significantly lowered risk of breast and ovarian cancer, as well as a decreased risk of osteoporosis in later life26-and can enhance the attachment between mother and child.27 Mothers' milk is a living fluid that can never be imitated in any laboratory.

Despite the aggressive marketing practices of formula companies, there is much information available about the inferiority of formula to breastmilk. Yet some women may wonder if formula would be a better alternative to contaminated breastmilk, based on the belief that formula might be less contaminated with POPs than breastmilk is. The fats in infant formula are plant-based, and thus lower on the food chain.28 Yet infant formula provides no guarantee that a child will be protected from exposure to dangerous substances.

Formula can be contaminated with dangerous toxic metals such as cadmium or lead,29 with bacteria that causes sepsis or meningitis, with fungal toxins that cause cancer, or with weed killers, insecticides, and solvents. It can be diluted with polluted water that can cause diarrhea or other serious infectious diseases.30 Aluminum, silicon, monosodium glutamate, and genetically engineered corn and soy have been found in many infant formulas, and all have the potential to do significant harm.31 The use of bottles also increases the risk of toxic materials leaching from the bottle into the formula: phthalates and bisphenol-A are endocrine-disrupting chemicals that have leached into formula from bottles and cans.32

Furthermore, there are many uncertainties associated with formula use. For example, a recent study indicates that palm oil and palm olein, used in some formulas to imitate fatty acids found in breastmilk, may adversely affect bone development in infants.33 Formula has been recalled for containing contaminants such as salmonella and glass particles, for causing gastrointestinal illness, and for being mislabeled or deficient in nutrients.34 Even small amounts of supplementation by formula can increase the chance that a susceptible child will develop a sensitivity to cow's milk35 or develop juvenile diabetes.36 Finally, notes Judith S. Schreiber, PhD, senior public health scientist with the Office of the Attorney General, New York State Bureau of Environmental Protection, "in developed countries, reductions in mortality rates in breastfed infants have been estimated to range from about 2,500 to 5,000 per million infants when compared with formula-fed infants."37

Formula is associated with proven risks to a child's health and well-being. Breastmilk is not. There is no benefit in switching to formula because of worries about environmental contaminants. Dr. Jay Gordon, MD, a well-known pediatrician and author of several parenting books, including Listening to Your Baby: A New Approach to Parenting Your Newborn (Perigee, 2002), tells me, "Everyone should know that the standard is breastfeeding, and introducing artificial food to babies is just really a grand experiment we've been conducting for 50, 60 years. And it's not working. We've seen it can increase the incidences of everything from disease to allergies to malignancy." Dr. Ruth Lawrence agrees that breast is best: "The single most important reason for giving human milk to human infants is species specificity. It was meant for the human infant. It is precisely what the human infant needs in terms of brain growth, tissue growth, infection protection, all of the parameters." In the end, any argument over formula versus breastmilk leads us away from the most important issue: Breastmilk is the only ideal food for our babies, and it is their birthright to drink it uncontaminated.

Why the Silence about Chemical Contaminants?
The first step in combating chemical pollution is awareness. Yet environmental contaminants in mothers' milk is a sensitive topic. There is some concern that if this issue is discussed openly, it will turn women away from breastfeeding. This is not the case in Sweden, where this has been a well-known public health issue for some years, and where women have the option of having their breastmilk tested. Still, 92 percent of Swedish women breastfeed their newborns without formula supplementation; 80 percent are still nursing without supplementation at two months, and 33 percent at six months.38 Compare this to the US, where recent statistics show that only 46.2 percent of mothers exclusively nurse their newborns, a number that falls to 17.2 percent at six months.39

Low breastfeeding rates are linked to the marginalization of breastfeeding in the US. Numerous studies point out that the duration of breastfeeding roughly correlates to the length of maternity leave.40 The US, in guaranteeing only 12 weeks' unpaid maternity leave-and not for every working mother-stands in bleak contrast to nations such as Sweden, where a couple receives 450 days' paid leave to share between them to care for a new child. Women also receive protected time at work to breastfeed in Sweden, so pumping actually is uncommon.41 In Norway, mothers receive a full ten months of paid maternity leave, and the average length of breastfeeding is 9.5 months, with 70 percent of mothers still nursing at one year.42

Adequate time to establish breastfeeding and sufficient financial support to stay with the baby during the period of lactation is crucial in order to create a breastfeeding-friendly society. In such a society, the choice to use formula over breastmilk would probably not be made without very serious thought. In our society, where breastfeeding lacks social support, scare stories about contaminated breastmilk might provide yet another reason for women to abandon breastfeeding. It is becoming apparent that the solution to the problem of chemical body burden includes finding ways to make breastfeeding a true cultural norm in this society.

What Else Stands in the Way of Progress?
Despite the urgency of the chemical body burden problem, research has been slow. Dr. Gina Solomon, a senior scientist at the National Resources Defense Council, an assistant clinical professor of medicine at the University of California at San Francisco, and an expert on pollution and mothers' milk, states, "The main stumbling blocks right now are a lack of money for research, fear of the information, and chemical industry pressure. Many people, especially politicians, are afraid of being confronted by data indicating a problem of contaminants in breastmilk. . . . One of the hot issues right now is the PBDEs. . . . There is a powerful industry supporting continued manufacture and use of these chemicals, and they do not welcome new data indicating a problem with their product."

Because POPs recognize no national borders, international cooperation in eliminating them is essential. The Stockholm Convention on Persistent Organic Pollutants, signed by 122 nations in May 2001, provides a means for 12 of the most dangerous POPs to be banned or phased out over time. It needs to be ratified by 50 countries to be activated as international law, and its ratification by the US has been slow. Industry pressures against the treaty are significant. Solomon remarks that "there is concern in the chemical industry about the mechanism in the treaty for adding additional chemicals. Thus, although there isn't too much industry concern about the 12 chemicals subject to the original treaty, there is some concern about future developments if new chemicals are listed."

Others agree. "The Stockholm Convention is groundbreaking-it gives us a chance to get rid of this whole category of chemicals that build up in our bodies," says Kristin Schafer, program coordinator with Pesticide Action Network North America. "Unfortunately, the Bush administration and the Senate are in the process of undermining the treaty with a law that allows the US to ignore international decisions to add new POPs to be banned." Clearly, as with other sensitive topics where entrenched interests impede progress, it will take an enormous amount of awareness and organized political activity to effect positive change.

What Can You Do?
Nursing mothers who hear about contaminants in breastmilk will likely be concerned about what they can do to protect their families. The good news is that levels of chemicals found in breastmilk fall dramatically once their use has been banned. Unfortunately, many contaminants remain unbanned, and an average of seven new chemicals are put on the market daily, most of them not tested for toxicity.43 Thus, not only should we act for self-protection, we should also consider advocacy. Some steps for minimizing your chemical body burden:

1. Eat a diet low in animal fats (including dairy products) to reduce exposure to fat-soluble POPs. When you eat animal fats, do so from organic sources as much as possible. If cost is an issue, prioritize organic animal products first, followed by plant foods such as vegetables, fruits, and grains. One recent study offers the most compelling proof yet that eating organic foods significantly reduces a child's intake of dangerous pesticides, so encourage your children to eat an organic diet as well.44

2. Reduce your consumption of freshwater fish to minimize exposure to PCBs and mercury.45 Remain aware of advisories and make choices accordingly. (For information on advisories, see www.epa.gov/waterscience/fishadvice/advice.html.) Also, minimize consumption of commercial fish that are high in mercury, such as swordfish, shark, mackerel, and tuna steaks. Farmed salmon has also been reported to have high levels of PCBs.

3. Avoid alcohol and cigarette use while pregnant and breastfeeding. In addition to other health concerns, contaminant levels have been found to be higher in women who smoke and drink.46

4. Limit or avoid using pesticides in your home and on your lawn. For information about alternatives, see www.pesticide. org/fact sheets.html, www.pesticideinfo.org/Alternatives. html, and www. watoxics.org/pages/root.aspx?fromMenu= 0&pos=0|2|1.

5. To minimize exposure to solvents, avoid non-water-based glues, paints, furniture strippers, gasoline fumes, and nail polish. Also reduce exposure to dry-cleaners or recently dry-cleaned clothes.47 For links to environmentally friendly products, see www.ecomall.com.

6. Most important, take heart in the knowledge that your decision to nurse your baby is not only a sound personal choice, it is an important sociopolitical action. Breastfeeding is the most ecological way to feed your baby. The production, packaging, and promotion of formula actually contribute to pollution from pesticides, dioxins, and fertilizers, thus increasing the level of toxins in the environment.48

7. Since many of the chemicals evident in breastmilk are symptomatic of a long-term problem that cannot be solved solely through short-term changes of lifestyle, take what action you can to stop the chemical pollution of our environment. Engage in awareness campaigns about chemical contaminants. Urge local schools to stop using pesticides and toxic materials. Get in touch with a nonprofit group working on this issue (see "For More Information," below). Write to your congressperson to express your support of the Stockholm Convention. Question embedded societal fears about breastfeeding to break through the silence about body burden. Is breastfeeding so precarious in our society that vital information-without which we cannot produce any change-is withheld from us?

Finally, don't fear the information about chemicals in mothers' milk. This information should always be viewed as statements on environmental contamination, not contaminated breastmilk. Harness your energy to eliciting change from the corporations that pollute our environment and the governments that are slow to stop chemical pollution at its source. Take inspiration from the words of Sandra Steingraber, author of the book Having Faith: An Ecologist's Journey to Motherhood: "Finding non-toxic alternatives for each and every toxic substance now contaminating mother's milk should be a national priority. It will not be unless we nursing mothers and breastfeeding experts demand it. The demand requires that we be unafraid of public conversation about breastmilk contamination . . . indeed that we seize control of the debate and shape it. Otherwise, those who don't understand the necessity of breastfeeding will use the issue of breastmilk contamination for their own purposes without realizing that they are further undermining the sacred communion of mother and child."49

It falls upon all of us to spread the message that breastfeeding is one of the most important ways we contribute to our children's health and well-being. All of us, as a society, will benefit when we ban the chemicals that are polluting our environment.

Unless otherwise indicated, all quotes in this article are from interviews held between March and September 2003.