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Safety and the Precautionary Principle Public Health vs. Profit Lessons from the Past - Ongoing Risks
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Communicating about Environmental Risks and Infant Feeding Penny Van Esterik, Professor, Department of Anthropology, York University, World Alliance for Breastfeeding Action (WABA), National Network on Environments and Women’s Health
Breastfeeding as a media subject is both sexy and emotional. Sometimes the media extols the many, well-documented benefits of breastfeeding. But on the subject of environmental toxins in mother’s milk, newspapers and television frequently sensationalize the degree of threat. "Babies in Poison Peril from Breastfeeding", "Scientists Find Deadly Toxins in Mothers’ Milk" are typical headlines on the subject.[1] Media reports seldom stress that it is not mothers who are poisoning their babies, but chemical companies and identifiable industrial processes. Rarely cited are studies that indicate the levels of toxins found in breastmilk are falling.[2] Media reports can have a direct impact on policy and on breastfeeding women. An article in the Bangladesh Observer stated, "With new information on the hazards of breastfeeding and the link between dioxins and cancer, it may be necessary to review our position on advocating breastmilk".[3] Bangladesh has an infant mortality rate of 69.68 per 1000 live births;[4] any decline in breastfeeding would significantly increase that rate. Reports about toxins in the breastmilk of Inuit women in Canada left some women frightened and desperate. One mother decided to stop nursing in an effort to protect her new baby; after several weeks of being bottle-fed a mixture of water and Coffee-mate, the baby was hospitalized.[5] Hazards in infant formula, which is marketed as the best alternative to breastmilk, is rarely publicized by the media. Clinical evidence provided by medical research shows there is cause to be concerned about, as one example among many, the dangers of nitrates in water used to reconstitute infant formula.[6] In the face of commercial interests that benefit from casting doubts on breastfeeding, it is essential that there be accurate reporting about the risks and benefits of all forms of infant feeding. In order to determine what the accumulating, and often contradictory, evidence concerning breastfeeding and environmental toxins tells us and to consider what messages should be communicated to women about this evidence, I reviewed the medical, social science, and advocacy literature on the topic. The scientific research indicates that, first of all, everyone, not only breastfeeding women, carries a body burden of toxic chemicals. All babies, not just breastfed ones, are exposed pre-and post-natally. Breastmilk is often used by medical researchers as a gauge of human exposure to environmental toxins not because it is "more toxic" than other substances such as urine or blood, but because breastmilk fat is more easily and cheaply obtained for testing[7] and because the "fat soluble pollutants are likely to be found in higher concentrations in milk than in blood or urine".[8] Some of the most exhaustive studies of toxic contaminants in breastmilk have been done in the Netherlands where the population has been exposed to the heaviest industrial pollution in Europe.[9] The work of Rogan and associates in North Carolina represents a second cluster of exhaustive studies.[10] PCBs, dioxins, pesticides, phthalates, and heavy metals have been found in samples of breastmilk from some women. The longterm effects of contamination are not yet known, but the evidence suggests that no adverse effects on growth or occurrences of illnesses in the first year of life are attributable to the presence of these chemicals in human milk, except in the case of extreme levels of contamination as in accidental industrial spills. One of the most authoritative reference texts on this subject, Chemical Compounds in Human Milk, concludes: "Virtually all national and international expert committees have hitherto concluded—on the basis of available information—that the benefits of breastfeeding outweigh the possible risks from contaminants present in human milk at normal levels."[11] How can accurate information about risks and infant feeding be communicated to the media and to breastfeeding women? By placing the issue in a broader environmental health context. The following principles might serve as guidelines for coalitions of breastfeeding advocates, health advocates, and environmentalists who want to work together to send clear and accurate messages to the public:
Women have the right to know the milk they produce is as pure as it can be. Only by reducing environmental pollution can this right become a reality. Penny Van Esterik’s book, Risks, Rights and Regulation:
Communicating about Risks and Infant Feeding (2002) is
available from the World Alliance for Breastfeeding Action
(e-mail: secre@waba.po.my) and on-line as a discussion
paper from: NOTES [1] The Geneva Infant Feeding Association collected headlines from North American and European newspapers between 1980-2000. [2] Levels of toxins in breastmilk in European women fell by about 35% between 1988 and 1994. World Alliance for Breastfeeding Action. Breastfeeding: Nature’s Way (brochure). Penang, Malaysia, 1997. [3] Bangladesh Observer 1989 Sept 13. [4] Dowling MR. The Interactive Table of World Nations and Infant Mortality, 2000. Web reference: http://www.mrdowling.com/800infantmortality.html [5] Colborn T, Dumanoski D, Myers J. Our Stolen Future. New York: Plume, 1996;108. [6] Lietuvos rytas (Lithuania) 2001 Nov 14. [7] Jensen A, Slorach S. Chemical Contaminants in Human Milk. Boca Raton: CRC Press, Inc., 1991;22. [8] Pellizzari E, et al. Purgeable organic compounds in mother’s milk. Bulletin of Environmental Contamination and Toxicology 1982;28:322-328. [9] For example: Koopman-Esseboom C, et al. Effects of polychlorinated biphenyl/dioxin exposure and feeding type on infants’ mental and psychomotor development. Pediatrics 1996;97:700-706; Huisman M, et al. Neurological condition in 18-month-old children perinatally exposed to polychlorinated biphenyls and dioxins. Early Human Development 1995;43:165-176; Weisglas-Kuperus, et al. Immunologic effects of background exposure to polychlorinated biphenyls and dioxins in Dutch preschool children. Environmental Health Perspectives 2000;108:1203-7; Women in Europe for a Common Future (WECF). Women and POPs: Women’s View and Role Regarding the Elimination of POPs. Report on the Activities of the IPEN’s Women’s Group. Utrecht, Netherlands, 1999;11-12. [10] Rogan W. Pollutants in breast milk. Archives of Pediatric and Adolescent Medicine 1996;150:981-990. [11] Jensen and Slorach, 1991:246. |
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