Cut pollution - not breastfeeding 16th July 1999 The report Chemical Trespass: A Toxic Legacy published recently by the World Wildlife Fund highlights environmental pollution by focusing on the levels in breastmilk. The report is a review of existing research and, while highlighting the levels of pollutants, " WWF insists that it is still better for babies to be breast-fed than not." (extract from the report). A number of news reports around the world have seized on the "toxins in breastmilk" aspect of the story without giving adequate weight to the advice that breastfeeding continues to confer benefits which make it far superior to artificial feeding. Key sections of the WWF report are reproduced here to put the findings in context. Reference is also made to studies by UNICEF and the UK Government. Levels of many of the pollutants found in breastmilk are falling. Baby Milk Action calls for urgent action to reduce environmental levels (and, hence, levels in breastmilk) still further. Why did WWF review research on toxins in breastmilk? [Extract from Chemical Trespass: A toxic legacy, page 12] "PART 3: CONTAMINANTS IN BODY FAT "Monitoring the concentrations of chemicals in air, water and soil, is not by itself an adequate means to assess the exposure of humans and wildlife. Useful additional data on which to base estimates of exposure can however be provided by identifying and quantifying the levels of toxic substances found in body fats [which can be done by analysing breastmilk]. This serves to integrate, over time, many kinds of exposures via different media. In the long run, this information can serve as a warning system for environmental exposures, as well as provide an insight into the causes of diseases that may be related to the environmental pollutants. Furthermore, if repeated, such studies can be used to monitor trends in exposure and to evaluate the effectiveness of regulatory programs. "Data on toxic chemicals in human body fats [such as contained in breastmilk] provide incontrovertible evidence that exposure has occurred. This review identifies the substances which contaminate humans. It can thus be concluded that the human species is now exposed to hundreds of man-made pollutants. Furthermore, foetal exposure, which is related to maternal body burden, is particularly worrying." In what ways are infants at risk from toxins? Should mothers stop breastfeeding? [Extract from Chemical Trespass: A toxic legacy, page 6] "PART 2: THE POTENTIAL EFFECTS OF CONTAMINATION IN HUMANS "The foetus is particularly vulnerable to environmental toxicants, as is, to probably a slightly lesser extent, the neonate and the infant. This is because they have a greater relative exposure per kilogram of body weight and they have increased absorption and retention as their metabolism is less developed. Also, they are at a more sensitive stage of development because their cells are growing and changing rapidly, and in the foetus there is a high rate of cell production and cell division. "Given the known benefits of breastfeeding, it is stressed that this report does not advocate that babies should not be breastfed. This is because breastfeeding undoubtedly provides immunological and psychological advantages, and human milk is the ideal nutrient for infants. The alternative of powdered bottled milk formula may anyway also be contaminated with varous pollutants. Indeed, chemicals such as phthalates, some of which possess endocrine disrupting properties, have been found in UK samples of infant formulae (MAFF, 1996; FAC, 1997). It should also be recognised that the foetus is likely to be far more sensitive that the neonate, and little can be done to avert transplacental exposure during this period if the mother is already contaminated. This report therefore reiterates the conclusion of expert committees, that on the basis of available information, the benefits of breastfeeding outweigh the possible risks from chemical contaminants present in human milk." What is happening to the level of contaminants in breastmilk? [Extract from Chemical Trespass: A toxic legacy, page 40] "PART 4: CONTAMINANTS IN BREASTMILK "Lactating women may be exposed to numerous chemicals from various sources, including food, water, air and cosmetics. Direct contact with the pollutant in both the occupational and household environments may be an important determinant of the residue levels found, but in many cases, dietary habits also play a major role. For example, several studies have indicated that eating contaminated fish may be one of the most important dietary factors influencing the levels of DDT and PCBs in human milk. Such exposure does not have to be recent, because persistent compounds can be stored in body fats for several years. Levels of organochlorines in breastmilk are therefore not very dependant on dietary intakes at the time, due to the dominating effect of mobilisation from body fat stores. "Despite the fact that the levels of certain contaminants in breastmilk exceed the levels set as tolerable daily intakes, because of the known benefits from breastfeeding, experts still recommentd that this is continued. Levels of many organochlorine compounds are now less than in the 1980s when mothers in some regions in Germany were advised to breastfeed for only a few months, and hence, this recommendation was rescinded many years ago (Rimkus, 1998). Indeed, in many countries, including the UK, the levels of several organochlorine pesticides in breastmilk have declined significantly. In Canada, for example, in the last 30 or so years, the total DDT levels found in breastmilk have decreased by 30 fold (Health Canada, 1997). However, other contaminants have now also been found. Therefore, this report argues that there is a need to fully evaluate the levels and potential effects of exposure to all the contaminants in breastmilk, and to reduce this contamination as soon as possible. "At birth, newborn infants are already contaminated by toxic chemicals due to transplacental exposure of the foetus. Furthermore, there is evidence to suggest that placental transfer may be more important, despite the fact that some studies have indicted that the transfer of several persistent pollutants across the placenta is much smaller than the transfer vial milk. This is because exposure is occurring at an earlier and a more sensitive period (Jacobson and Jacobson, 1996)"   Read the full report for further information. A similar review of research has been published by UNICEF (Breastfeeding and Environmental Contamination, May 1997). UNICEF quotes the World Health Organisation as follows: "The presence of chemicals in breastmilk must be seen in perspective. Because a chemical has been detected and measured, it does not mean that it is necessarily harmful to the infant in the quantities consumed. (1)" "The risks of continued exposure to a chemical through breastfeeding have to be balanced against the risks of infection or nutritional deprivations, where breastfeeding is curtailed or discontinued. (1)" "Despite the presence of PCBs, dioxins and furans in human milk, breastfeeding should be encouraged and promoted on the basis of convincing evidence of the benefits of human milk to the overall health and development of the infant. (2)" and the National Institute of Environmental Health Sciences, USA: "Breastfed children, even those at the extreme of the dose distribution of contaminants from breastmilk, have a net lower risk of certain categories of death and have a longer life expectancy. (3)" Two years ago the UK Government publicised research results demonstrating that levels of PCB's and dioxins in breastmilk had fallen significantly. Campaigns in the 1980s achieved a gradual reduction in the use of organochlorine pesticides contaminated with dioxins. PCBs have been progressively phased out since the mid 1970s. Production in the UK (all by Monsanto in Wales) stopped in 1977, and sale and use was banned in 1986. However the UK has been slow to destroy PCBs in existing equipment such as electrical transformers. Mike Brady, Campaigns and Networking Coordinator at Baby Milk Action said: "The level of contaminants in all types of foodstuffs should be reduced. I hope that the recent WWF report, which is based on existing research, will give regulators and companies renewed determination to take action. Contamination of the food chain with dioxins through animal foodstuffs in Belgium earlier this year has already demonstrated the need for strict controls. Mothers, as always, deserve independent and correct advice on relative risks, not scare stories. As WWF itself concludes, the health benefits of breastfeeding continue to make it the best option." (1) WHO. Principles for evaluating health risks from chemicals during infancy and early childhood: The need for a special approach. Enir Health Criteria 1986;59 (2) WHO. PCBs, PCDDs, and PCDFs in breastmilk: Assessment of health risks. WHO/EURO Environmental Health Series 1998;29 (3) Rogan WJ, Blanton PJ, Portier CJ, Stallard E. Should the presence of carcinogens in breastmilk discourage breastfeeding? Regulatory Toxic Pharm 1991;13:228-240