Healthy Milk, Healthy Baby
Chemical Pollution and Mother's Milk
Ask Dr. Gina
Dr. Gina Solomon, M.D., M.P.H., is a senior scientist at NRDC and an assistant clinical professor of medicine at the University of California at San Francisco. She is an expert on pollution in mother's milk, and the author of many of the materials on these pages.
Q: Is breastfeeding safe, or has pollution made it dangerous for my baby?
A: There's no question in my mind that breastfeeding is still the way to go if mothers are able to do it. The pollutants in milk are troubling, but, apart from women who for some reason have been exposed to very high levels of dangerous chemicals, the health benefits of nursing far outweigh the potential hazards. So, even allowing for the problem of persistent organic pollutants, breastfeeding is a better alternative than formula.
Q: What are POPs, and why are they in breast milk?
A: POPs is an abbreviation for "persistent organic pollutants," environmental pollutants that have certain hazardous characteristics. For example, POPs don't break down quickly in the environment or in our bodies, remaining unchanged for decades. POPs also seek out and accumulate in fat, so they end up in the fish and meat we eat, and then begin to build up in our own fat. Since mothers' bodies produce breast milk by tapping fat supplies in the body, POPs accumulate to high levels in breast milk. Examples of POPs include DDT, PCBs and dioxin.
Q: Does formula feeding avoid the hazards associated with environmental toxins in the food chain?
A: Absolutely not. Feeding a baby infant formula does not mean the child is protected from chemicals in the environment, in large measure because the formula is diluted with water. That makes water pollution a potential problem, even if the water is sold in a bottle. We've also seen reports of contamination of infant formula with toxic metals, bacteria and other environmental toxins. So, no, formula feeding won't keep your baby free of toxins. Indeed, because breast milk helps children fight disease and infection, switching to formula will probably make your baby more vulnerable.
Q: How can I reduce my infant's exposure to chemicals in my breast milk?
A: Avoid using chemicals that may get into your milk while you are breastfeeding. Don't smoke, avoid unnecessary medications and avoid alcohol. To be on the safe side, try to avoid inhalation of or skin contact with solvents (paints, thinners, recently dry-cleaned clothes, nail polish, gasoline, many glues) and avoid using pesticides in your home and garden or on your pet. Eat organic food if available, and eat lots of fruits and vegetables and less meat and high-fat dairy products. If your work involves handling chemicals, check with your doctor for a referral to a specialist who can give you advice about whether those chemicals may get into your milk.
Q: What are the health benefits of breastfeeding?
A: Mother's milk is the perfect food for babies. It has the ideal balance of nutrients and is also packed with specific proteins that help transmit immunity from infections. Decades of scientific research have shown that children who were breast-fed have lower risks of many diseases, ranging from diabetes to ear infections to cancer. Breastfeeding also has health benefits to the mother and helps reduce the risk of breast cancer and other diseases.
Q: What if breastfeeding doesn't work out for me? Will feeding my child formula cause health problems?
A: Many mothers have difficulty breastfeeding, especially the first time. Although it may not be easy, I urge you to give breastfeeding a try. If you encounter problems, lactation consultants can often help. Sometimes, however, breastfeeding really doesn't work out for people. That's OK, and that's what infant formula is for. If you are unable to breastfeed, consult with your pediatrician for the best option for you and your child. If you choose a formula that needs to be reconstituted with water, check on the safety of your water supply. Also, if you live in an older home, you might consider getting your water checked for lead. Water filters can help if there is a problem. Although formula lacks some of the advantages of breast milk, millions of babies raised on formula are doing just fine.
Q: Should I get my breast milk tested? And how do I get it done?
A: The United States has no breast milk monitoring program, and no centralized place for women to get their milk tested. Fortunately, levels of many of the persistent organic pollutants have declined in breast milk samples in European countries, and most (but not all) of these chemicals have also been declining in the small studies done more recently in the United States. Most women are safe, therefore, in assuming that any contaminants in their milk are likely to be at low levels. So we don't recommend breast milk testing for women at this time. Of course, if you think or know that you've had exceptional exposures, check with your doctor about the advisability of getting your milk tested; they can find out where and how to get it done. By the way, this is a perfect example of why the United States needs a systematic breast milk monitoring program that allows tracking of chemical pollutants across the population.
Q: What foods should I avoid while breastfeeding?
A: If you are breastfeeding, it is important to eat a healthy, balanced diet. Drink lots of water, and try to avoid alcoholic beverages. If you can get organic food, this might be a particularly good time to eat organic. Avoid fish that are high in mercury, such as swordfish, shark and tuna (for more information see NRDC's guide to Mercury Contamination in Fish). Avoid eating locally caught sport fish when you are breastfeeding, since many of these are high in mercury or other contaminants. While short-term dietary changes won't significantly affect levels of POPs in your milk, it is always a good choice to eat lots of fruits, vegetables and grains, while minimizing fatty animal foods.
Q: What is being done about hazardous chemicals in breast milk?
A: A lot of good things are being done about the chemicals that are known to accumulate in breast milk, but not enough is being done to detect new chemicals that may be present but so far unnoticed. Many of the persistent organic pollutants known to be breast milk contaminants have been banned in dozens of countries. In countries with bans, the levels of these chemicals in breast milk have dropped, sometimes by a factor of 100 over the past 20 years. That's a major health and environmental victory! The Stockholm Convention to phase out 12 POPs is a major step toward bringing exposures down even more. What we still need is a breast milk monitoring program that analyzes mother's milk looking for chemical residues. We know that there are other chemicals out there likely to make their way into human milk. We need to be vigilant to protect ourselves.
Q: What monitoring is being done?
A: Not enough. Some countries, such as Sweden and Germany, have ongoing breast milk monitoring programs. These countries are staying alert to new chemical contaminants that may become a problem in breast milk. That's how the polybrominated diphenyl ethers (PBDEs) were recognized as a problem. The United States has no monitoring program in place for breast milk. Fortunately, the Centers for Disease Control and Prevention is monitoring for over 100 chemicals in blood and urine samples from across the United States. This gives us some important information about what is going in the right -- or wrong -- direction.
Q: How can I support the POPs elimination treaty?
A: The POPs elimination treaty, known as the Stockholm Convention, was signed on May 22, 2001, and took effect on May 17, 2004. Unfortunately, the U.S. Senate has not yet ratified the treaty. Worse still, the legislation that would ratify the treaty has been hijacked by polluting industries that want all kinds of limitations and exemptions that would essentially make the treaty worthless. You can write to your senators to ask them to vote to ratify the Stockholm Convention without any limitations or restrictions.
last revised 3.25.05