IS MOTHER'S MILK SAFE?
Hart, Kathleen
Is Mother's Milk Safe? Dioxin climbs to the top of the food chain BY KATHLEEN HART Kathleen Hart is a free-lance medical and science writer in Philadelphia. Kathy Ruben gave birth to her second...
...ten years later, Joseph Mi-celi and his coworkers at Wayne State University Medical School found levels indicating it could take seventy years for the PBBs ingested following that single accident to be eliminated completely from the tissues of Michigan residents...
...Schecter reported these findings last fall: "There is no doubt whatsoever that in one to two years, the average North American nursing infant will be given more exposure to dioxin than the CDC considers allowable in a lifetime...
...Concern about potentially hazardous low-dose exposures from infant feeding places one between the devil and the deep blue sea," Lawrence Berger wrote in 1981 in the journal Pediatrics...
...the samples are analyzed within a week, for a fee of $125...
...Given the resistance of the medical and business communities and the callousness of government officials, Schecter's proposal is not likely to be adopted any time soon...
...Advocates of this risk-versus-benefit analysis also point out that infant feeding is simply one source in what will be a cumulative lifetime intake of toxic chemicals...
...There is, noted Rogan, a "universal prevalence of low-level chemical contamination" of human milk...
...Schecter and his fellow investigators sought, but did not receive, U.S...
...In Germany, any woman can have a complete analysis done on her milk for twelve deutsche marks—or about $6...
...Ruben, and other mothers, had cause for worry...
...But neither the Federal Government nor private insurance companies will pay for the tests that would either confirm her fears or set her mind at rest...
...Dioxin is the chemical that turned Times Beach, Missouri, and Seveso, Italy, into ghost towns...
...Humans store the chemicals they ingest from animals and fish—along with those they inhale, drink, and come into contact with at home and work—in their fat, which is in turn mobilized and excreted during lactation...
...It is the chemical culprit that made Agent Orange so toxic...
...Human milk is about 4 per cent fat...
...Renate Kimbrough of the Centers for Disease Control agrees...
...Finding someone to test human milk for dioxin is one hurdle...
...Parents are left with a painful choice: Either they expose their baby to an unknown quantity of hazardous chemicals or they deprive both mother and child of the emotional and physiological benefits of breastfeeding...
...But everyone told me there was no reason to worry about environmental contaminants in my milk...
...The U.S...
...In 1980, Walter Rogan and his colleagues reported in The New England Journal of Medicine that nursing infants in the United States typically exceed both the World Health Organization and U.S...
...Physicians are given a container to ship frozen milk samples to the lab...
...They did receive enough support from private foundations and the Canadian government to test 200 pooled samples of North American breast milk...
...Nursing infants sit at the top of the food chain where dioxin—and the other members of the organochlorine family of chemicals such as DDT, PCBs, and PBBs—concentrate...
...Kathy Ruben's experience may be typical...
...Officials of the American Academy of Pediatrics echo the sentiments of Julie Stock of La Leche League, who says that "there is no question that the proven benefits of breastfeeding outweigh the hypothesized risks of low-level chemical contaminants...
...they had measured dioxin levels in fatty tissue obtained during autopsies of women throughout the state of New York and then calculated the amount of dioxin that presumably would make its way into breast milk...
...Nursing infants in the United States, said Schecter, could be imbibing dioxin with their milk at levels 1,300 times those considered acceptable by the Centers for Disease Control (CDC...
...Contamination of breast milk with trace amounts of chlorinated compounds," she says, "should not discourage women from breastfeeding except under unusual circumstances...
...When asked in August about the health threats posed by Schecter's findings, Dr...
...Not one of them could direct me to a place where I could have the tests done, in any case...
...The tie to breast milk came in an April 1986 announcement by Dr...
...water supplies—and that would be mixed with powdered infant formula—are known carcinogens, whereas toxicity from chemical pollutants in breast milk has not been demonstrated...
...His qualifier about North American women was important, however, because dioxin had been found in breast-milk samples from South Vietnam, a place liberally sprayed with Agent Orange during the Vietnam war...
...Infant formula, which is made from skimmed milk, is presumed by scientists to contain much lower concentrations of dioxin, DDT, PCBs, PBBs, and dieldrin than breast milk, but the consensus of medical opinion continues to favor breastfeeding...
...I tried calling everyone," Ruben says, "the Childbirth Education Association, La Leche League, the public-health department, even the Mother's Milk Bank of Wilmington...
...Food and Drug Administration allowable levels for the intake of DDT, dieldrin, PCBs, and heptachlor...
...Arnold Schecter does not agree that we can live with these chances...
...Dioxin, like PCBs (polychlorinated bi-phenyls), PBBs (polybrominated biphen-yls), dieldrin (a pesticide often used against termites), and other toxic chemicals known to contaminate human milk, is not evenly distributed throughout the population...
...Concerned, Ruben wanted her own milk tested and was willing to pay...
...Other physicians, including Lawrence Berger, take a risk-risk approach, noting that the lead and asbestos that contaminate some U.S...
...Whereas here, even if I, as her physician, order a breast-milk analysis for a woman, it is not covered by health insurance...
...Walter Rogan, a researcher at the National Institute of Environmental Health Sciences, said that "dioxin has never been found in milk from lactating North American women...
...The samples, taken during the early 1970s, were stored in a freezer at Harvard University...
...Environmental contamination of breast milk has been a concern since DDT was first detected in it in 1951...
...Arnold Schecter, professor of preventive medicine at the State University of New York at Binghamton...
...But deciding whether the levels found are "safe" to pass on to nursing infants requires a leap of faith into the quasi-science of risk assessment...
...When she asked her pediatrician if it would be prudent to have her milk tested for dioxin, the doctor replied: "I haven't read about dioxin turning up in breast milk and, frankly, I'd rather not know about it...
...Peter Kahn, a biochemist at Rutgers University, recently measured dioxin levels ten times the average U.S...
...He and his colleagues had not tested actual breast-milk samples...
...The immediate response was alarm, but it was followed by an avalanche of assurances from public-health agencies and breastfeeding support groups, who questioned Schecter's methods and results...
...Schecter predicts "a coming dioxin epidemic" unless industrial pollutants are controlled...
...And a woman may have reason to suspect that her milk has toxic levels that are higher than "normal"—reasons such as occupational exposure, an industrial accident, repeated treatment of her house or workplace with pesticides, aerial spraying of herbicides, or proximity to a municipal incinerator or one of the nation's thousands of hazardous-waste-disposal sites...
...Measurements suggested that in a year of breastfeeding, South Vietnamese infants were consuming 100 to 400 times the CDC's estimated allowable lifetime dose of dioxin...
...He is concerned that the health effects of exposure to low-level doses of dioxin and PCBs can already be seen in our population, and he is by no means alone among scientists in citing environmental contaminants as the cause of increased rates of cancer, immune-system deficiencies, and reproductive disorders...
...In the meantime, he proposes that the screening of breast milk for chemical contaminants become routine in the United States...
...These persistent chemicals accumulate in living organisms...
...Wide variations exist from one woman's milk sample to the next...
...Government funding to look for dioxin in American milk samples...
...Minute quantities can cause skin rashes, deficiencies in the immune system, birth defects, spontaneous abortions, and, in the opinion of many researchers, cancer...
...Dr...
...Five years later, 97 per cent of the state's residents still carried PBBs in their bodies...
...background level in the blood of Vietnam veterans exposed to Agent Orange fifteen to twenty years ago...
...It can test for PCBs, PBBs, and pesticides...
...But it is not equipped to look for dioxin...
...Schecter's findings and the premature dismissal of their significance by the medical community and Federal agencies have left unanswered the vital question: Is human milk safe...
...Kathy Ruben gave birth to her second child in New Jersey last spring, just about the time when newspapers published stories about the possibility that highly toxic traces of dioxin were finding their way into breast milk...
...Commonly, mothers' milk contains concentrations of these chemicals exceeding the FDA's "action levels," above which cows' milk would be removed from the market...
...Dioxin is so resistant to breakdown that it stays in humans for decades...
...Pacific Toxicology Laboratories in Los Angeles is one of the few facilities licensed to do clinical screening of human-milk samples for diagnostic purposes...
...In 1973, about 500 kilograms of a commercial fire retardant composed of PBBs were accidentally added to livestock feed in Michigan...
...Government has an ostrichlike attitude about the adverse health effects of environmental contaminants," says Schecter, noting that this country lags far behind Europe in concern about human milk pollution...
Vol. 51 • March 1987 • No. 3
