Monitoring Mother Earth by qjc19528

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									       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




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