by Monitoring Mother Earth Monitoring Mothers’ Milk B I O M O N I TO R I N G , the analysis of human fluids and tissues for the presence of environmental chemicals and their by-products, indicate that all inhabitants of the globe carry hundreds of environmental chemicals within their bodies. Breastmilk biomonitoring, when implemented with sensitivity and a profound sense of responsibility for the health of infants and mothers, can create data indicating how levels of toxic chemicals in human bodies may rise or fall in response to public health policies. Breastmilk monitoring implemented in the absence of consultations with those individuals and communities being tested and without substantive support measures for breastfeeding may turn breastfeeding mothers away from breastfeeding. Governments, researchers and communities of concern need to determine how to best craft the complex message that will ensure breastmilk data will be used to decrease levels of toxic chemicals in all our bodies rather than decrease the number of women who breastfeed. Breastmilk that protect the health of the baby until its body’s immune Four young mothers from the Philippines, Kenya, Mexico, and the Czech Republic have chosen When a baby is given breastmilk system has grown strong.2 to have their breastmilk tested for the presence from its mother, she or he learns Breastmilk has the capacity to of toxic chemicals because they are concerned for the first time that this world assess a baby’s needs, adjusting about the health of their families and their can be a source of nourishment communities. The chemicals tested for include its contents to supply what is and comfort. Breastfeeding PBDEs, lindane, endosulfan, DDT, and other POPs required at a particular time of chemicals. Detectable levels of many of these can create a profound relation- development.3 chemicals were found in all samples. ship, rich in caring and trust, between the mother and her In general breastfed babies Each young mother is deeply committed to child. Babies seem to sense that around the world are healthier breastfeeding, and each is discussing with breastfeeding provides every- than those fed milk substitutes.4 her family, her community and her lactation thing they need to flourish. Worldwide, according to the consultant or pediatrician, how she might choose Bellagio Study Group, 1.3 mil- to speak publicly about her own individual results Breastmilk contains all the nutri- lion children die each year who documenting the presence of toxic chemicals in tional components required for a likely would have survived had her breastmilk. Some have begun to make healthier healthy baby during the first six choices in food and products, and others are they been breastfed as recom- months of life. Breastmilk con- planning to join efforts to halt the tide of toxic mended by the World Health chemicals all our bodies experience each day. tains fatty acids that support the Organization.5 WHO suggests development of a healthy brain; breastfeeding exclusively for The story of each young mother as she makes these babies who are breastfed have a the first six months of life, with decisions will be presented on the Moms and POPs higher IQ than babies who are continued breastfeeding for the Project website. not breastfed.1 Breastmilk also first year of life.6 provides enzymes and antibodies www.momsandPOPsproject.org Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 3 But breastmilk carries toxic chemicals as well as nutritional Biomonitoring breastmilk needs to be done in ways that will not to discuss concerns, ask ques- tions and learn about personal Biomonitoring components. Measuring levels of toxic chemicals in breastmilk discourage nursing mothers, will apprise us of the levels of and political choices that may lower exposures; and full support As A Public can be accomplished by biomon- toxic chemicals in breastmilk is given within the context of Health Tool itoring. This safe and relatively and that ultimately, will help community for breastfeeding. Human biomonitoring, the test- simple public health tool can lower the levels of environmen- Well-crafted breastmilk moni- ing of human fluids and tissues help us understand trends in tal chemicals in all our bod- toring studies can move com- for the presence of environ- chemical use and the effective- ies. Preliminary observations7 munities, mothers and policy mental chemicals, chemical ness of regulations in lowering indicate that biomonitoring makers away from the despair, by-products, or other evidence exposures to environmental data can support both continued perplexity or denial concerning of chemical exposure, provides chemicals, Biomonitoring also breastfeeding and chemicals the grim message that breast- us with a snapshot in time of helps us learn whether the policy reform when: biomonitor- milk contains toxicants, towards individual histories. An indi- unmatched benefits of breast- ing studies provide information concrete measures that not only vidual’s own biomonitoring data milk, nature’s perfect food, is about the critical importance will protect breastfeeding and can indicate to some extent the being threatened by the pres- of breastmilk for the health of the integrity of breastmilk, but choices made by individuals, by ence of toxic chemicals. the baby and the mother and the health of future generations regulatory agencies or by chemi- discuss the disadvantages of as well. cal and manufacturing indus- breastmilk substitutes; studies tries. If an individual has eaten provide opportunities for women food grown with pesticides, some of those pesticides or their residues may well remain in the tissues and fluids of the body. 4 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 If an individual earns her or his living working in the ship- breaking industry, an industry that dismantles ships to recover reusable parts, analysis of her or his blood and urine might well indicate higher than average levels of lead or mercury. If an individual bathed in the morn- ing using a shampoo or lotions containing phthalates, her or his body will carry a quantifi- able chemical memory of those products through the afternoon and into the following day. Breastmilk substitutes (formula) may be necessary in some cases, but formula itself can be made from substances containing toxic chemicals. Cows’ milk also carries environmental chemicals,8 although usually at lower levels than human milk. Formula derived from soy may contain pesticides, and many researchers are concerned that the estrogenic properties of soy-based formula may not be healthy for a nursing infant. Formula may be sold in containers containing toxic chemicals, may be prepared using contaminated water when clean water is unavailable, and may be given to babies in bottles that leach toxic chemicals. Formula companies have used information about chemicals in breastmilk to sell their products, especially in the Global South.9 The use of formula is not the answer to the presence of toxic chemicals in breastmilk. Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 5 Although it is difficult to pre- Critical Windows of Development, dict individual adverse health a database compiling hundreds of outcomes from individual toxic lab and human studies, docu- chemical body burdens, expo- ments the health effects of low sures measured over a population level exposures to dioxin, phthal- can provide information linking ates and bisphenol A during the environmental chemical expo- gestational period. www.endo- sures to adverse health effects. crinedisruption.com10 According And because scientific advances to Dr. Theo Colborn, co-author now allow researchers to test of “Our Stolen Future,” and for very small exposure levels, originator of this database, “The new data is available linking unprecedented global increases ‘‘ low-level exposures to health in endocrine-related disorders outcomes. This data is especially such as autism, other learning poignant for exposures during and developmental disabilities, Breast feeding is one of the most beautiful moments with in utero development, when the reproductive problems, diabetes, my son. In first few months it was quite difficult for me — rapid proliferation and differen- obesity, thyroid problems, breast, feeding the baby was painful for my breasts, but I wished to tiation of cells creates a window prostate, and testicular cancers give my son the best healthy start in life and feed him with of vulnerability. and more signal the need for a mother’s milk. Now I have no problems and breast feeding crash program in “inner-space” is one of the most beautiful moments. I enjoy the feeling I research. The roles of con- have knowing that I can feed my baby with my own milk. tamination in the womb must be It’s wonderful what a woman’s body can do. addressed before it is too late.”11 ˇ Daniela Seveckova with baby, Filip Cadil – Czech Republic 6 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 Regional Biomonitoring data in the United States indicates that Biomonitoring deliberations, these govern- ments joined together to launch Biomonitoring children’s blood lead levels have decreased by 84% between for Global a landmark global initiative, the Stockholm Convention, a In addition to providing a “snapshot” of individual his- 1988-1991 and 1994-2004, and Baseline legally binding treaty that bans this decrease is linked to a series or severely restricts the use of tories, biomonitoring studies of regulations restricting lead Levels of POPs an initial list of 12 POPs. The can reveal a history of deci- exposure beginning in 1971. Convention provides a pro- sions governments have made Biomonitoring studies indicate Chemicals cess for including other POPs, about the use and production of that lead levels continue to be On the international level, as chemicals are so identified, toxic chemicals. For example, highest among non-Hispanic biomonitoring data is being onto the list of POPs targeted biomonitoring data from the black children relative to compiled to determine whether for action under the mandates Netherlands indicates that Mexican American and non- global efforts are successful in of the Convention. For the first levels of dioxin have decreased Hispanic white children, and lowering levels of persistent time the world has the capac- after regulations were put in that there is a need for further organic pollutants (POPs) in the ity to halt the tide of POPs place controlling dioxin emis- regulation to lower lead levels in bodies of the Earth’s inhabit- contamination. sions from incinerators.12 these populations.13 ants. In the first years of the 21st century, governments around The Stockholm Convention also the world met to consider mandates a process for evaluat- biomonitoring data document- ing progress in POPs reduction ing that all humans, wherever and elimination. This program, they live, carry hundreds of toxic the Effectiveness Evaluation chemicals in their fluids and Program, calls for periodically tissues. After intense and fruitful monitoring levels of POPs Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 7 around the globe and presenting implemented by the United data has been enormously useful 10% is produced within the a first report indicating baseline Nations Environmental Program’s for establishing a baseline of breast.16 POPs chemicals and levels of exposure at the fourth Global Monitoring Program. human exposures to POPs in other environmental chemicals Stockholm Conference of Parties However, the monitoring of many countries.15 that have taken up residence in in May 2009. 14 human biospecimens such as the mother’s fatty tissue may be breastmilk can measure the move- carried along in the blood stream Because air can carry POPs ment of POPs chemicals into inside molecules of the body fat chemicals thousands of miles from points of origin, air monitor- human bodies, providing defini- tive proof of human exposure. Biomonitoring being mobilized in the creation of breastmilk. ing is a useful tool in determin- Breastmilk ing the ebb and flow of POPs The World Health The use of breastmilk as a matrix across the face of the Earth. Organization, a partner in the Breastmilk, a matrix for for POPs body burden moni- The Arctic Monitoring and UNEP Global Monitoring POPs measurement toring is ideal because POPs, Assessment Programme, the Program, is continuing its work Breastmilk is considered an upon entering the body, tend Global Atmospheric Passive in the biomonitoring of breast- ideal matrix for measurement of to equilibrate at roughly similar Sampling Survey, the Integrated milk for POPs. The result- levels of POPs chemicals. POPs levels in terms of fat-weight Atmospheric Deposition ing data will provide a more chemicals are lipophilic, or fat- among adipose tissue, breastmilk Network, the Research Center accurate picture about POPs soluble, and tend to sequester and blood.17 Breastmilk levels of for Environmental Chemistry trends and the effectiveness of in the fat found in the body’s POPs therefore provide a good and Ecotoxicology and others the Stockholm Convention. tissues or fluids. About 60 % of indication of levels of POPs to have committed resources to The WHO has provided leader- the fat in breastmilk is drawn be found in fat throughout the measuring POPs in air as part ship in developing benchmark from the fatty tissue of the body. POPs body burdens tend of the Stockholm Convention’s protocols for biomonitoring mother, with 30% coming from to increase with age, although global monitoring work being breastmilk, and the resulting her daily diet. The remaining levels are decreased through 8 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 breastfeeding. However, breast- their efforts can be supported milk monitoring of first-time by lactation counselors who can mothers can provide a baseline support a mother in her commit- of exposures to POPs. Data also ment to breastfeed and reinforce can be used to identify new the message that “breastmilk is POPs of emerging concern. best,” thereby mitigating poten- tial deterrents. Breastmilk monitoring— community promotion of Breastmilk monitoring— breastfeeding women’s health and One significant advantage of advocacy groups biomonitoring breastmilk is that As awareness about the pres- ‘‘ collection requires relatively ence of toxic chemicals in simple sampling procedures. It everyday products and in food , does not necessitate a surgical air and water increases, women’s procedure, as does fatty tissue health and advocacy groups are I wanted to contribute a breastmilk sample because sampling, or blood collection, becoming more interested in it is important for all of us to know what is in which requires professional phle- learning about their own body breastmilk in general. This information will help us botomists and medical equip- burden levels and the levels of to be aware of what toxic chemicals are present in ment such as syringes, needles toxicants in breastmilk. Groups our food and the environment. Toxic chemicals can and/or centrifuges. Community such as MOMS (Making Our affect our health and it is important that women learn health workers can readily col- Milk Safe) and other groups more about toxic chemicals so that we all can make lect breastmilk samples from around the globe want to use healthier choices, especially choosing healthier food. nursing mothers. In addition, data about toxic chemicals Karla Flores with baby, Paulo Gael – Mexico Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 9 in breastmilk to inform their could potentially result in communities about the need a decrease in related suffer- for local and global bans on all ing experienced by thousands persistent and bioaccumulative of women and their families toxic chemicals. worldwide. Many women feel that the Breastmilk Monitoring— presence of toxic chemicals in environmental chemicals in ‘‘ their bodies represents a basic breastmilk violation of bodily integrity, and Biomonitoring studies indicate The chemical manufacturing as such, constitutes a form of that a woman of childbearing companies should pay for violence against women. Many age will have encountered hun- the damage these chemicals POPs chemicals can damage dreds of environmental chemi- cause. It is important that reproductive processes and cals from the food she eats, the governments tighten controls are linked to pre-term birth, water and air she takes in, and on the manufacturing sector to shortened duration of lactation, the household products she ensure that harmful chemicals do breast cancer, genital malforma- uses. Many of the environmen- not enter in to our bodies. From tions and immunological and tal chemicals she encounters my understanding these harmful neurological damage.18 Our hope will take up short- or long-term chemicals are in their thousands is that using information about residence in her body, becom- and are already causing havoc women’s toxic chemical body ing part of her chemical body in our bodies. It is important that burdens, and specifically levels burden. Some of these chemicals public pressure is increased to of toxic chemicals in breastmilk, may move from a woman’s body ban these chemicals. to halt further contamination during pregnancy through the Yasher Samah with baby, Jolie – Kenya 10 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 placental barrier where, mis- scientists found that “Breastmilk Several toxic chemicals have nursing infant. Although most takenly identified as hormones appears to reduce the severity been found in mother’s milk, studies indicate that breastfed or other substances designed of the effects on the infant from including flame retardants, sol- babies are healthier than non- to regulate DNA expression, the mother’s body burdens and, vents, plasticizers and pesticides, breastfed babies, and although they may interfere with the to some extent, rescue the infant and can enter the baby’s body milk substitutes also have been developing fetus. Once errone- from these effects.” during breastfeeding.22 However, found to be contaminated with ously welcomed into the body current research indicates that toxic chemicals, it remains of the fetus, these chemicals can The importance of breastfeeding breastmilk may also contain critically important to con- wreak havoc on the developing seems even more critical given elements that prevent a baby’s tinue evaluating the presence immunological, reproductive the number and amounts of toxic absorption of toxic chemicals of environmental chemicals in and neurological systems of the chemicals found in all environ- found in breastmilk.23 Other breastmilk. unborn child. ments are increasing. Dr. Kim research indicates that the body Hooper, California Department of a human infant may be able Most current research indicates Laboratory studies indicate that of Public Health, has said, “The to metabolize and excrete toxic that “breast is best,” but without damage that may occur due to presence of chemicals in breast- chemicals quite differently from sufficient regulation, the number toxic chemicals exposure in milk should encourage rather the metabolizing processes of an and levels of toxic chemicals in utero may be reversed or pal- than discourage breastfeeding adult human.24 breastmilk may well increase. We liated by breastfeeding. One because breastmilk appears to do not know whether or when study reports, “Breastfeeding is reduce the severity of the effects However, measuring the excre- these toxicants may compro- an effective means to reduce on the infant from the mother’s tions of breastfed infants and the mise the nutritional integrity infants’ health risks from in utero body burden. He also emphasizes offspring of nursing lab animals of breastmilk, or how the levels exposures to chemicals in the the importance of breastfeed- indicates that very little of the of breastmilk-related POPs in mother’s body.19 In a study on ing in communities with higher POPs chemicals taken in from the body of the child, combined PCBs and neurodevelopment,20 levels of POPs such as PCBs. 21 breastmilk leave the body of the with exposures from other food Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 11 sources, may affect the well Trends in Chemicals in Breast Milk, Sweden being of the child. We do not 3000 4.5 know if there are levels of toxic 4.0 chemicals in breastmilk above PCBs 2500 which women should refrain from PBDE Concentration (ng/g lipid) PBDEs 3.5 Concentration (ng/g lipid) breastfeeding. We do not know PCB and DDT Metabolite DDT Metabolite 2000 3.0 if women should cease breast- 2.5 feeding after a certain number 1500 2.0 of months to avoid delivering higher than acceptable levels of 1000 1.5 certain toxic chemicals to her 1.0 child. We do not know if there 500 0.5 is a point at which the almost miraculous capacity of breastmilk 0 1970 1975 1980 1985 1990 1995 2000 0.0 to heal and nourish is seriously threatened. Without continued Source: NRDC analyses of breastmilk, answers to these questions will remain elu- The Swedish government has biomonitored breastmilk for decades. When data revealed that breastmilk was carrying flame-retardants called PBDEs and that levels of PBDEs were rapidly sive, and future generations may increasing in breastmilk, public outcry resulted in a governmental ban of these chemicals. Levels suffer from our ignorance. of these toxicants rapidly dropped in the breastmilk of women monitored. Breastfeeding rates in Sweden, among the highest in the world, did not decrease when information about PBDE levels was published; rather, women spoke out demanding a halt to further exposures. This graph also indicates a decrease in levels of DDT, a pesticide, and PCBs, chemicals used as flame-retardants, as a result of previous government bans. 12 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 Communicating which also contain environ- mental chemicals. The decision general sense, based on discus- sions with other participants and a heightened awareness on the part of the researcher as well as Information to breastfeed should be made by each mother, based on her project organizers, that results from the project will be used to courage and commitment from a nursing mother. About situation and on sound informa- create positive changes in toxic tion from lactation consultants, chemicals policies.25 When communication is done Environmental health researchers and other well, many mothers have mothers in her community. Key to data communication is used the information to make Chemicals in an attentiveness of counselors healthier choices for their Breastmilk Preliminary research indicates that women informed about to the needs of the nursing mother. Informing moth- families. Some mothers have chosen to become politically A common concern is that toxics in breastmilk will remain ers about the toxic chemicals active, demanding corporate and information about the pres- committed to breastfeeding they may be shifting from their governmental responsibility in ence of toxic chemicals in when there is strong support bodies to their infants through banning environmental chemi- breastmilk will be publicized in within their communities for breastfeeding must be done in cals found in breastmilk and in ways that will change mothers’ breastfeeding. Participants in ways that are sensitive to the enacting measures that prevent commitments to breastfeeding. biomonitoring projects choose fact that breastfeeding is an art the entry of chemicals into the Misleading media headlines to continue breastfeeding when that mother and baby need to marketplace without adequate about chemicals in breastmilk they are well informed about the learn, and that breastfeeding is a testing for safety.26 may move women towards value of breastfeeding, coun- time of bonding for mother and unhealthy choices, especially if seled about the significance of infant. Intruding upon this time media stories fail to describe the toxic chemicals in breastmilk, of relationship development with benefits of breastmilk over the given suggestions about avoiding information that can be per- disadvantages of milk substitutes, further exposures, and share a plexing or frightening requires Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 13 Moms and embracing the responsibility for creating the messaging of POPs Project human milk monitoring to prevent an anti-breastfeeding The Moms and POPs Project response. (MaPP) is a gathering of organi- zations and individuals, includ- c. Utilize human milk monitor- ing breast-feeding, women’s ing to initiate discussions rights advocates, health profes- about how women can orga- sionals, environmental health nize to prevent further toxic activists and scientists to review chemical exposures to their the global scientific literature to families, whether they choose discern how to: to work locally, nationally, or globally so human milk ‘‘ a. Conduct culturally appro- becomes toxic-free. priate, scientifically valid, ethical and respectful human In a survey conducted by MaPP, All women should be able to learn about the presence of milk monitoring programs in several key researchers were inter- toxic chemicals in their bodies and the bodies of family accordance with the WHO viewed about their methods of members. It seems so interesting to know the toxic chemicals protocols and establish prec- communicating to breastmilk bio- in my breastmilk. I would like to share my knowledge edents for biomonitoring monitoring project participants and experiences with other women, and I am willing to around the world. their individual or pooled results. speak publicly about toxic chemicals in breastmilk and the b. Address the challenge of Researchers were selected because importance of breastfeeding as the best food for babies. promoting breastfeeding in of the integrity of their work and Mary-Ann Del Mundo-Lantin with baby, Gie Ann Gabrielle – Philippines a contaminated world by the diversity of situations and 14 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 cultural traditions in which the Four Case Studies 1 project was implemented. Because of the broad range of options and Breastmilk data released were found in hundreds of not to breastfeed her child for differing contexts, no one set of in Michigan, USA, after breastmilk samples, state officials six months. Although there is best communication practices a chemical accident and physicians were uncertain no data about the reaction of applicable to all circumstances has contaminated animal feed about the safety of breastfeeding nursing mothers to media reports emerged, but MaPP has developed MaPP interviewed Dr. Sherry and delivered contradictory and of breastmilk contamination, a set of preliminary observations Hatcher, who studied women’s ambiguous messages about the women may have turned away significance of the toxic chemical from breastfeeding after reading about effective biomonitoring reactions to a biomonitoring study conducted by Michigan, in breastmilk. headlines and conflicting infor- communications protocols. These mation provided by state agencies observations are listed follow- USA, agencies following massive contamination of cattle feed by a Within this ambience of offi- about the safety of breastmilk. 2 ing the brief descriptions of four toxic chemical, PBB (polybromi- cial uncertainty and confusing case study biomonitoring proj- nated bisphenol, a flame retardant information, Dr. Hatcher learned Breastmilk chemicals data ects below. The MaPP website, considered to be a carcinogen, that women who asked to receive withheld in cases of extreme www.momsandPOPsProject.org, and linked to thyroid and immune their individual breastmilk results poverty and high likelihood includes the complete report of system dysfunction). Cattle tended to express denial rather of HIV/AIDs incidence these interviews, from which became ill from the contaminated than alarm, especially those MaPP interviewed Dr. Henk the following case studies were feed and needed to be destroyed. women who had the highest lev- Bouwman about breastmilk selected. Eventually, state officials released els. Clearly women were caught monitoring in rural South Africa information stating that the between wanting to nurture their where DDT is the only currently general public had likely been babies and wanting to avoid used weapon against malaria-car- exposed to the toxicant through exposing their babies to the toxic rying mosquitoes. Dr. Bouwman the consumption of beef and chemical through breastfeeding. tested women who had given dairy products. When detect- Dr. Hatcher was a breastfeeding birth to their first child in several able levels of the toxic chemical mother at the time, and chose Monitoring Mother Earth Monitoring Mothers’ Milk • Commonweal 2009 15 Monitoring Mother Earth byby Monitoring Mothers’ Milk • Commonweal 2009 15 rural areas where both DDT and to help women organize around Convention, which call for devel- was deeply concerned about the pyrethroids have been used. Dr. ending sources of contamination. opment and implementation of safety of breastfeeding and was Bouwman had concerns about Lastly, many of the young women alternatives to the use of DDT. outraged that traditional sources 3 how these chemicals might affect may have been ill with HIV/AIDS. of food contained levels of toxi- the health of the nursing infant. The researcher team believed it cants well above levels consid- Most of the women were quite would be unethical to add to this Breastmilk monitoring within ered safe. The tribe designed a young and lived in conditions of burden of disease and poverty the context of community breastmilk-monitoring project extreme poverty. information about levels of toxic MaPP interviewed tribal leader sensitive to their spiritual tradi- chemicals in women’s bodies that Katsi Cook about the breastmilk tions, the results of which were Dr. Bouwman published his they could do little about. monitoring study she helped initi- used to demand remediation. results in urban press and sci- ate among the Akawasne Mohawk, entific journals, but decided not Dr. Bouwman has spearheaded an indigenous people who occupy Equally important was the sense to communicate results to study international efforts to address traditional lands in New York state, among Mohawk women that participants for several reasons. the issues surrounding DDT and USA. The relationship between the biomonitoring information would First, there were few available malaria control. Researchers child and the mother and the rela- support the reclaiming of con- alternatives to the use of DDT or may decide in cases of extreme tionship between the Akawasne trol over their bodies by using pyrethroids, and no resources were poverty to withhold project results and their land are considered results to restore the capacity of available to develop other methods from individuals and community sacred. The tribe shares a profound tribal lands and waters to pro- for rolling back malaria incidence. members, but when information is sense of cultural stewardship and vide healthy food. Breastfeeding Second, the use of formula was withheld, some researchers have are committed to protecting the rates did not decline within the unacceptable given lack of clean taken on the task of organizing purity of breastmilk and the purity Mohawk community when data water. Third, there was little com- against the source of contamina- of their lands that have historically were published. The project munity organizing to counsel tion when biomonitoring partici- provided traditional foods. strengthened community advocacy women about the importance of pants may not have the capacity to campaigns, community cohesive- continuing to breastfeed, usually do so themselves. Dr. Bouwman Because industrial dumping has ness and women’s roles as key considered even more important has been active in promot- contaminated land and water decision makers. in a contaminated environment, or ing mandates of the Stockholm sources, the Mohawk community 16 Monitoring Mother Earth by Monitoring Mothers’ Milk Commonweal 2009 16 Monitoring Mother Earth by Monitoring Mothers’ Milk • • Commonweal 2009 4 ‘‘ Biomonitoring in support When EWG tested the breastmilk of policy reform of 20 women in 14 states in the United States and found high levels I am like any mother and The United States civil society of PBDE flame retardants, the fear what might affect the group, Environmental Working Group (EWG), has been a leader resulting information was presented development of my baby. I and pioneer in advocacy bio- to legislators across the country want her to have the best in monitoring, initiating in 2002 one in support of new regulations that her life and to live a full life of the first public interest group would be a step in limiting further like her grandparents did. biomonitoring projects, which exposures. Project participants included Bill Moyers, renowned were eager to speak publicly about However the fear of what television journalist, among mem- their commitment to breastfeeding might be found in my breast bers of the biomonitored cohort. and the need to stop PBDE con- milk worries me a lot even (http://archive.ewg.org/reports/ tamination. Their photos and quotes though there is little I can do bodyburden1/es.php) can be found on the EWG website. about it. You know learning of (http://www.ewg.org/reports/moth- what is in your breastmilk is EWG maintains an innovative web- ersmilk/) Part of their message was that dismay about personal pollu- like learning that you are HIV site where viewers can easily find descriptions of chemicals currently tion should be directed towards positive. You are devastated by being tested for in their biomoni- changing policy, rather than solely the fear of the consequences, toring projects, the products that attempting to avoid exposures. you get depressed but finally contain these chemicals and health Choosing safer products is impor- you end up being a strong outcomes associated with toxic tant, of course, but biomonitoring advocate for prevention. I think chemical exposures. Also reported project participants emphasized the same will apply to me. I are proposed legislative initiatives that personal choice will not miti- would like to tell every mother designed to reform the US toxic gate a problem ultimately solvable about the chemicals. chemicals regulatory system. only by government regulation and corporate practices. Yasher Samah with baby, Jolie – Kenya Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 17 A Call to Medical monitoring is tradi- tionally carried out with the intent of assessing whether cases of very high exposure), is very relevant in “treating” a sys- tem that does not protect those linked to toxic chemical expo- sures, including asthma, birth defects, learning disabilities, Biomonitor medical intervention is required. Examples include dental x-rays it is charged with caring for from toxic contamination. And this is children’s brain cancer, fertility compromise, heart disease, dia- or colonoscopies. Biomonitoring why breastmilk monitoring may betes, and other adverse health Breastmilk is different because it is usually intended to determine expo- be import. outcomes. 27 sure levels of populations for Women, often the primary fam- However, to ensure that breast- the purposes of public health ily health caregivers and pur- milk biomonitoring studies policy. Levels of contamination chasers of most of the food and are well-implemented, the at the individual level are not goods a family consumes, have a Commonweal Biomonitoring predictive of individual health deep interest in toxic chemicals Resource Center calls on govern- outcomes, and the long-term exposures. The power of the ments to: effects of a personal chemical women’s health and environ- 1. Involve biomonitoring partic- body burden may be unknow- ment movement combined with ipants and their communities able, given the complexities of the power of those working to in the design and implemen- factors linked to ill health. But maintain the integrity of breast- tation of breastmilk monitor- what is implicit in body bur- milk has the potential to reverse ing projects, including best den measurements may be an the tide of toxic chemicals in all practices for the release of assessment of the health of the our bodies. Such reversal, result- information about chemicals regulatory system; the concept of ing from women’s united efforts, in breastmilk; intervention, not applicable on may ultimately help lower the the individual level (except in incidence of those diseases 18 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 2. Ensure that health profes- 5. Honor biomonitoring partici- Learning more about how best to eliminate sionals, government agen- pants by acknowledging their cies, and civil society health courage and commitment exposures to toxic chemicals in order to and advocacy groups work to toxic chemicals policy protect current and future generations together to deliver a strong reform, evidenced by their public message about the engagement in biomonitoring from harm is critically important. importance of breastmilk for projects; Developing a base line of exposure the health of the baby and 6. Work cooperatively with the mother; breastfeeding advocacy through biomonitoring, the ultimate proof 3. Develop respectful and sensi- groups to enhance breastfeed- of exposure, is an important first step in tive methods for the use of ing practices; biomonitoring data to main- 7. Communicate individual this process. However, biomonitoring must tain the integrity of breast- biomonitoring results to be implemented with care, based on the milk and to support measures individuals who request this for lowering levels of POPs information, accompanied recommended activities listed above in chemicals; by appropriate contextual order to fulfill its role as an important tool 4. Create national dialogues information that will support about the effective use of bio- healthy choices. for good public health policy. monitoring as a public health tool essential for documenting the effectiveness of measures designed to lower or eliminate exposures to toxic chemicals; Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 19 For more information about the importance of breastmilk, disadvantages of formula, suggestions for healthy choices, Endnotes 1 Caspi et al. “Moderation of breastfeeding effects on the IQ by genetic linkages between environmental threats and health, variation in fatty acid metabolism.” PNAS 20 Nov 2007 vol 104 no.47 and information about policy reform campaigns, 2 Phil Landrigan, “Chemical Contaminants in Breast Milk” http://ehpnet1.niehs. please consult: nih.gov/docs/2002/110pA313-A315landrigan/abstract.html/ www.momsandpopsproject.org 3 LaKind J, Wilkins, Berlin C. Environmental chemicals in human milk; a review of levels, infant exposures and health, and guidance for future research.. www.IPEN.org Toxicology and Applied Pharmocology 198 (2004) 184-208 4 American Public Health Association. “A Call to Action on Breastfeeding; A www.healthandenvironment.org Fundamental Public Health Issue policy number: 200714 11/6/2007 5 Jones G, Steketee R, Black R, Bhutta Z, Morris S. The Bellagio Child Survival www.nrdc.org/breastmilk Study Group. How many children deaths can we prevent this year? Lancet. 2004;362:65 www.waba.org.my/resources/tenlinks.htm 6 WHO/UNICEF.WHO/UNICEF Global Strategy for Infant and Young Child Feeding. Geneva, Switzerland:WHO:2003 www.womenshealthandenvironment.org 7 Wu N, McClean M, Brown P, Aschengrau A, Webster T. Participant experiences in a breastmilk biomonitoring study: A qualitative assessment. www.env-health.org Environmental Health 2009: http://www.ehjournal.net/content/8/1/4 www.llli.org 8 APHA 2007 9 http://www.breastfeeding.com/advocacy/advocacy_boycott.html www.ewg.org 10 Barrett J. Developmental Picture Window. Environmental Health Perspectives March 2009. Vol 117/No.3 A101 www.chemtrust.org.uk 11 http://www.endocrinedisruption.com/prenatal.criticalwindows.press.release.php www.chemicalshealthmonitor.org 20 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 12 Personal interview with Dr. Janna Koppe, professor of neonatology at the 21 Hooper 2003 University of Amsterdam; interviewer: Jessica Wellborn, Moms and POPs 22 http://www.nrdc.org/breastmilk/envpoll.asp Project. 2008. 23 Berlin CM Jr, LaKind JS, Fenton SE, et al. Conclusions and recommendations 13 Jones RL, Homa DM, Meyer PA, Brody DJ, Caldwell KL, Pirkle JL, Brown MJ. of the expert panel: technical workshop on human milk surveillance and Trends in Blood Lead Levels and Blood Lead Testing Among US Children Aged biomonitoring for environmental chemicals in the United States. J Toxicol 1 to 5 Years, 1988–2004. Pediatrics 2009 Mar;123(3):e376-e385.) Environ Health A. 2005;68:1825–1831. 14 http://chm.pops.int/Programmes/GlobalMonitoringPlan/ 24 APHA 2007 15 GEMS/FOOD International dietary survey: Infant Exposure to Certain 25 Wu 2009 Organochlorine contaminants from Breast Milk-A Risk Assessment (1998), WHO/FSF/FOS98.4http://www.who.int/foodsafety/chem/POPprotocol.pdf 26 http://www.ewg.org/reports/mothersmilk 16 Sandra Steingraber, Having Faith (New York:Berkeley, 2001) 262 27 http://www.healthandenvironment.org/resources/database 17 Hooper K, McDonald T. The PBDEs: An Emerging Environmental Challenge and Another Reason for Breastmilk Monitoring Programs. Environmental Health Perspectives May 2000. Vol 108/No 5 18 http://www.ipen.org/ipenweb/generalpublic/whatpops.html 19 Patandan, S, Lanting CI, Mulder PG, Boersma ER, Sauer PJ, Weisglas-Kuperus N. Effects of environmental exposure to polychlorinated biphenyls dioxins on cognitive abilities in Dutch children at 42 months of age. Journal of Pediatrics 1999: 134(1):33–41 20 Hooper K, She J. 2003, January. Lessons from the polybrominated diphenyl ethers (PBDEs): Precautionary principle, primary prevention, and the value of community-based body burden monitoring using breast milk. Environmental Health Perspectives, 111(1):109-114. Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 21 Special thank you to: Making Our Milk Safe – USA Partners of Moms and POPs Project; www.momsandPOPsproject.org Arnika – Czech Republic Physicians for Social Responsibility – Kenya Pesticide Action Network – Philippines Global Anti-incineration Alliance – The Philippines Centro de Analisis y Accion en Toxicos y sus Alternativas – Mexico International POPs Elimination Network This report was supported by funding from: The Watson Family Foundation New York Community Trust International POPs Elimination Network anonymous donor 22 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 Monitoring Mother Earth by Monitoring Mothers’ Milk • Commonweal 2009 23 For more information, contact: Sharyle Patton Commonweal Biomonitoring Resource Center P.O. Box 316 • Bolinas, CA 94924 • USA Spatton@igc.org Design by Winking Fish. Printing by Inkworks Press. 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