Breast still best (and Better Yet, Toxic-Free)!

The following article is based on the FAQ Sheet, "Towards Healthy Environments for Children: Frequently asked questions (FAQ) about breastfeeding in a contaminated environment," prepared by Penny van Esterik (York University, Toronto). She is the author of Risks, Rights and Regulation: Communicating about Risks and Infant Feeding and member of WABA Breastfeeding and Environment Working Group. The FAQ sheet was produced with the assistance of: Baby Milk Action, UK; Commonweal/IPEN Working Group on Community Monitoring, USA; IBFAN-GIFA, Switzerland; Initiativ Liewensufank, Luxembourg; INFACT, Canada; La Leche League international, USA; National Networks on Environments and Women's Health, Canada; and WABA Secretariat, Malaysia.

To download a pdf version of the complete document, to endorse the statement "Working Together for a Toxic-Free Future," or for more information, visit WABA's website: http://www.waba.org.my/

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Should mothers be worried about toxic chemicals M the environment?

Yes, everyone should be worried. Chemical contaminants are causing harm to our children; environmental activists, breastfeeding groups and health advocates worldwide are calling for the elimination of toxic chemicals in the environment. If we were to test infants born today, anywhere in the world, we would find in them a body burden of industrial toxins including dioxins, PCBs, mercury, phthalates, pesticides, flame retardants, bisphenol A and other dangerous substances. These chemicals pass through the placenta and into the fetus during pregnancy, and through breastmilk after birth. Babies and toddlers continue to be exposed to hazardous chemicals through contact with air, water, soil and everyday products such as carpets, clothing, furniture and household products. It is critical that chemical residues be reduced in the environment to reduce both the prenatal and postnatal health risks they pose to infants, children and the general public.

How do chemical residues end up in our bodies and the bodies of our infants?

Many chemicals can travel far from their sites of origin or use, polluting the air we breathe, the water we consume, the food we eat and the everyday products (such as cosmetics and certain plastics) we touch and use. Some of these chemicals resist metabolic breakdown and excretion or break down into harmful derivatives that accumulate mainly in our body fat, becoming part of our chemical body burden. Some chemicals act as endocrine disruptors and can damage the reproductive system. No matter where we live or how we live, none of us can avoid being exposed to a wide variety of chemicals and passing on this chemical body burden to the next generation. Children are at higher risk than adults because they are undergoing rapid development and consuming more food in relation to their body weight compared to adults. The only way to reduce their body burden is to eliminate hazardous chemicals from production and use and replace them with less hazardous chemicals and products.

When does exposure to contaminants start?

Children's exposure to toxic chemicals starts before birth and comes from everything their parents were exposed to--the air they breathed, the food they ate, the products they used and the water they drank. After birth, a child continues to be exposed to chemicals through contact with air, water, soil, food and household items. Even toys and pacifiers may contain harmful chemicals. The biggest impact of pollutants occurs prenatally when the fetus is passing through critical stages of development. Tiny doses of chemical residues can have a dramatic effect on the developing fetus. Levels of mercury that would have little or no impact on an adult can harm the developing fetal brain. Tiny amounts of dioxins and PCBs can damage the developing immune and nervous systems; the phthalate DEHP can disrupt the development of the male reproductive system. Pollutants and heavy metals readily cross the placenta, and some also enter breastmilk.

Why are chemical residues found in breastmilk?

Chemicals accumulate in different body parts including adipose tissue, brain, bone, blood, liver, placenta and semen and are also found in breastmilk. Chemical residues accumulate in the body fat which is used to produce breastmilk. Because breastmilk is convenient and inexpensive to test for those contaminants stored in body fat, it is often used to monitor human exposure to chemicals that should not be in our bodies. Chemical residues found in breastmilk are like the messenger, the canary in the mine, telling us about the body burdens found in everyone.

Is the presence of these chemical residues in breastmilk a reason not to breastfeed?

No. Exposure before and during pregnancy is a greater risk to the fetus. The existence of chemical residues in breastmilk is not a reason for limiting breastfeeding. On the contrary, breastmilk contains substances that help the child develop a stronger immune system and provides protection against environmental pollutants and pathogens. Breastfeeding can help limit the damage caused by earlier fetal exposure.

Should breastfeeding mothers have their breastmilk tested?

Breastmilk testing is not necessary unless a mother has been exposed to excessive amounts of chemicals during an industrial accident or during long periods of workplace exposure involving the mishandling of pesticides, for example. In the case of industrial accidents, public health officials should provide instructions about the best way to minimize risks. Thus, individual testing of breastmilk should never be used as a basis for making decisions about breastfeeding, except in the rare case of an emergency short-term response to an industrial accident.

Are commercial baby milks a safer choice?

No. Even in areas where the contamination is highest, the risks of artificial feeding and not breastfeeding are even greater. There are different contaminants in commercial feeding products, including infant formula, the water in which it is mixed, the containers in which it is stored and often in the bottles used for feeding. Heavy metals such as lead, aluminum, cadmium and mercury, chemical residues from pesticides and fertilizers, and hormone-disrupting plasticizers have all been found in commercial infant foods. Recalls of infant formula from the market are frequent because of industrial and bacterial contamination; they are not sterile products. Reports and advisories in recent years have warned that infant formula can be contaminated with pathogenic bacteria, after several infants died or became seriously ill from consuming infant formula contaminated by Enterobacter sakazakii. In addition, while some common contaminants such as nitrates in ground water may be tolerated when ingested by a breastfeeding mother, they can be fatal if the water is given directly to the baby.

The use of genetically engineered ingredients (such as soy in soy-based infant formulas) and the inclusion in infant formula of components produced by genetic modification pose new and as yet unknown risks. Although these are not chemical contaminants, they underscore the importance of promoting breastfeeding as the healthier choice.

Who is to blame for this situation?

The blame for this chain of contamination which produces chemical body burdens in all of us must be placed on the sources of contamination--the chemical industries which produce them and the governments which fail to regulate them or who fail to enforce and monitor protective laws and regulations.

Whose responsibility is it to protect the health of individual families and their children?

As with other public health problems such as epidemics and infectious diseases, it is the government's responsibility to protect the health of families and their children, not the responsibility of the individual alone. Communities can mobilize to ensure that governments regulate the industries that pollute, and do not compromise the health of their citizens for the interests of business and industry. Successful interventions to reduce pollution occur at the community, national and global levels when citizens concerned with women's health, children's health and environmental health and justice band together to take action against the polluters. As consumers, we can change our buying habits and lifestyle choices and choose not to use or buy products whose production or waste disposal may further pollute the environment.

What can governments and international organizations do to reduce environmental pollution?

Governments have to be sensitized to the importance of the issue and urged to act in the best interests of children. Some countries have taken positive steps. In Europe, strong governmental programs to eliminate persistent organic pollutants like DDT, dieldrin, PCBs and dioxin have resulted in dramatic decreases of these residues in breastmilk. As a result of controls, Sweden has seen a decline in breastmilk PBDE levels. In the United States, bans on lead in gasoline and smoking in public places have resulted in dramatic decreases in the levels of these dangerous substances and their by-products in the blood of young children. In Canada, several local governments have banned the use of pesticides for cosmetic use on lawns.

These public health achievements show that reductions in the production, use and disposal of toxic chemicals, along with the destruction of toxic chemical stockpiles and reservoirs, can all decrease the body burden of noxious materials in our children and in us. Regulatory frameworks by governments and international organizations are important to minimize and eliminate exposure to harmful contaminants.

International Labour Organization (ILO) Conventions, especially Convention No. 184 on Health and Safety in Agriculture, have been particularly helpful. The United Nations Stockholm Convention on Persistent Organic Pollutants (POPs) needs to be ratified by 50 countries before it enters into force. These conventions must be implemented nationally. The Stockholm Convention calls for national bans on incineration. In addition, there are local and national efforts to restrict the use of pesticides and to ban the sale of mercury-containing products. All of these efforts deserve our energetic and sustained support.

Breastmilk is the most ecologically sound and complete first food available to infants. It is the foundation of food security for all children in the first six months of life and one of the world's most valuable renewable natural resources. Breastfeeding is a basic human right of every mother and is essential to fulfill every child's human right to adequate food and to the highest attainable standard of mental and physical health.

Taking Action for Healthier Environments

At a workshop on breastfeeding and toxins hosted by the Women's Health and Environment Network and the World Alliance for Breastfeeding, researchers and activists agreed on a number of personal and political actions to promote healthier environments especially for breastfeeding mothers.

Personal Actions

* Eat lower on the food chain.

* Eat organic fruits and vegetables.

* Limit consumption of fatty meats and dairy products,

* Wash and peel fruits and vegetables, (if organic food is not available or affordable).

* Remove skin from chicken.

* Avoid crash dieting while breast-feeding.

* Choose small fish, such as sardines, rather than large fish (like tuna).

* Reduce the use of toxic household cleaners.

* Avoid contact with pesticides at work and at home.

* Avoid cigarette/cigar smoke. Political Actions.

* Link breastfeeding, environmental and cancer prevention groups

* Find out the location of land use developments in your community.

* Explore the possibility that standards for tolerable levels of pollutants should be lower for girls and women.

* Lobby regulatory agencies for effective environmental risk assessment and food safety assessment.

* Set workplace safety standards suitable for pregnant and lactating women

* Lobby for intentional conventions such as the WHO/UNICEF Cede for the Marketing of Breastmilk Substitutes and the environmental conventions to reduce persistent organic pollutants CPOPs).

* "Fax the feds"--tell your government to make cleaning up the environment a priority.

From: Dorothy Goldin Rosenberg, "Education for a Healthy Future," WNH&E Connections. Issue 15. Spring/Summer 2000.