Breastfeeding Baby: A Modern Dilemma
Air Date: Week of May 17, 1996
Nature's most perfect food, breast milk, helps growing infants develop resilient immune systems. But along with the welcome antibodies are the persistent toxins she may have ingested in her lifetime which are stored in mother's fatty tissue and are also passed on to baby. As the mother of a newborn, reporter Andrea DeLeon recently grappled with the dilemma of balancing the health risks against the benefits of breastfeeding and shares her findings with us.
CURWOOD: This is Living on Earth. I'm Steve Curwood. For a newborn baby, there is no better food than mother's milk. It contains a perfect balance of nutrients, antibodies, and hormones, and the feeding itself helps to forge the vital emotional link between mother and child. But as much of Western society evolved, it began shaming women about their bodies and the exposure of their breasts. Many deemed breastfeeding crude and primitive, even though breastfed babies tend to have fewer illnesses and better growth than their bottle-fed brethren. Of course, some people have always breast fed, and recently activists have encouraged mothers to give it a try. But society is still uncomfortable with it. And now comes another major threat to breastfeeding: worry about pollution. Dioxin, PCBs and other persistent toxic chemicals in the environment, tend to concentrate in body fat, including milk fat, and get passed on to babies. Reporter Andrea DeLeon of Maine Public Broadcasting gave birth to her second child a few months ago. We asked her to investigate this worrisome trend, and share both her findings and her feelings about it.
(A baby babbles)
DeLEON: That's my son Carter. Four months old and he still wakes me each night at about this time: 3 AM, hungry.
DeLEON: I can stumble to the cradle in the dark, now, without knocking into the rocking chair. I take him into my bed to nurse. He stops crying as we lie belly to belly under the covers in the dark. In this position I can bend my face down to kiss the top of his fuzzy head, to breathe his baby smell as I doze. In all the chaos of my days, the only word that even comes close to these moments is peace.
DeLEON: Peace at least until a month ago, when I tuned my car radio to a speech about a health threat long suspected by scientists but only now gaining public attention.
(Lois Gibbs on radio: "Dioxin affects every man, woman and child. It comes from solid waste incinerators...")
DeLEON: The speaker was Lois Gibbs, the Love Canal homemaker who turned activist when she discovered her neighborhood was built on a toxic waste dump. Her topic: dioxin and a host of other persistent toxic chemicals which she says are waging covert war on the human population.
(Gibbs: "It goes out into the air, it goes out into the water, it gets into our food supply. It gets into the cow. When the cow is milked, it gets into our bodies. And ladies and gentlemen, the top of the food chain is our infants. Women who are breast feeding their babies are the top of the food chain. So when the cow is ... ")
DeLEON: That evening, when my son fell back, milk drunk and ruddy cheeked in my arms, I carried him upstairs with a sense of unease. Was he really as all right as he looked? I needed to know if my milk contained chemical time bombs that might wait half his life to go off. I called Dr. Beverly Pagan, a senior staff scientist at the Jackson Laboratory in Bar Harbour, Maine. She told me she hated to talk about contamination in breast milk, and then reluctantly agreed to meet with me.
PAGAN: Breastfed babies are taking in dioxin at a level that is 10 to 100 times more than an adult is getting. This is quite a serious issue. In fact, a breastfed baby takes in 10 to 15% of his entire lifetime dose during that first year.
DeLEON: Dr. Pagan told me that dioxin, PCBs, furans, and other persistent toxics have been entering my body in minute servings as part of the food I eat, and accumulating over my lifetime in my fatty tissues. I get my largest doses in meat, dairy fat, and freshwater fish. The older I get, the higher my levels become. When I nurse my son, Beverly Pagan says, toxics long stored in my fat migrate into the fatty breast milk.
PAGAN: Particularly, these chemicals are often an antagonist to the male hormone. These chemicals also might increase cancer in hormone target organs, such as breast cancer, testes cancer, prostate cancers. All 3 of these types of cancer are going up dramatically in America. And we don't know any reason, except for the exposure to these chemicals.
DeLEON: And there was more.
PAGAN: The sperm count in men has been falling. We think this is because of these hormone-disrupting chemicals, because most of them seem to interfere with the male hormone. We know that they can decrease sperm production in animals.
DeLEON: Breastfeeding is the only natural way humans can rid their bodies of some of these poisons, but with the demeanor of a friend breaking bad news, Pagan told me that most human mothers are carrying around enough chemicals to pose some threat to their children. But a single conversation and a couple of magazine articles didn't convince me that my own milk could bring harm to my baby. My bedside table sprouted stacks of literature on the subject. I read about the alleged dangers of nursing while nursing. I learned that the endocrine system is kind of like the postal service, delivering messages to all parts of the body, using cortisol to regulate my metabolism, releasing estrogen to trigger and modulate my reproductive cycles, telling my son's genes when to trigger each miraculous stage of his journey from egg to embryo to baby. I needed someone to explain how chemicals in such small amounts could affect my hormone system and my child's as well. If my endocrine system is the postal service, toxicologist Linda Birnbaum explained that dioxins, PCBs, furans, and certain persistent toxics were keeping some of the mail from getting through, delivering letters to the wrong addresses, or forging messages of their own. I reached Dr. Birnbaum in North Carolina, where she heads the Environmental Toxicology Division at the Environmental Protection Agency's Health Effects Research Laboratory. She says that while there's a lot researchers don't know about how these chemicals do their work in the human body, they do know a great deal about the effects of dioxin.
BIRNBAUM: In some cases dioxins have been shown to increase the levels of hormone receptors, in other cases decrease. In some cases dioxin lead to changes in the transformation of hormones, so there are a number of ways in which compounds like dioxins or PCBs or other synthetic chemicals can impact hormone systems. There's not a single mechanism that can explain everything.
DeLEON: And higher levels of these chemicals do not necessarily mean more troubling effects on the body. But hormonal disruptions are blamed for everything from neurological problems to suppression of the immune system. Dioxin also appears to interfere with insulin. Hormonal effects have been documented in seagulls in Canada, lab mice in Maine, and victims of an industrial accident in Italy. But none of this told me my son's risk. I weighed my years of vegetarianism against my fondness for tooling down the highway with a double cheeseburger balanced on my knees, my organic garden against the pint of ice cream in my freezer. I lay in bed in the middle of the night nursing, obsessing. Beverly Pagan suggests that women have their milk tested, but such tests can cost hundreds to thousands of dollars, and with so many chemicals out there which would I test for? More importantly, what would I do with the results? My son has to eat something, and in the first months of life the choices are limited to formula or breast milk. Everyone from the American Academy of Pediatrics to the formula manufacturers themselves says that breast milk is superior. Does the information coming to light about persistent toxic chemicals mean that's no longer true for some infants? Not from what scientists have learned so far. No one I talked with for this story told me to stop breastfeeding. Lactation consultant Bettina Pearson says a woman's breast milk is perfectly suited to her child at each stage of his development. It even serves as the infant's immune system in the first few months, until the infant's own immune system begins to function.
PEARSON: So in that interim, we are providing our babies with our antibodies, and our antibodies are specifically a result of what our own environment is. So the antibodies I make, being exposed to my 5-year-old for a newborn child, would be different than someone else. And each of our environments, what we're exposed to for illnesses or contaminants.
DeLEON: She says babies fed on breast milk spend less time in hospitals and have lower incidence of Sudden Infant Death Syndrome. They also have fewer infections and fewer allergies. I'm hoping Carter won't be plagued with the ear infection so common in young children. Though how my milk adapts to his needs remains something of a mystery. Bettina Pearson says formula could never show such response. Dr. Birnbaum of the EPA says a study underway in the Netherlands demonstrates that even breast fed children born to mothers with high levels of contamination are healthier than formula fed infants whose mothers have similar levels of persistent toxics. But no one knows for sure whether breast milk actually counteracts some of the very contaminants it contains. Pregnant and nursing women are left to consider the evidence for themselves and discuss it with their caregivers. So far, these discussions seem to be few and far between. My own midwife says clients have only just begun to raise the issue. My search turns up no doctors and only one midwife who regularly discusses the issue with clients.
DANIELS: Let's take a listen. There we go. Got the heart, and I can feel the baby thumping around in there, too. There's a kick.
DeLEON: Midwife Ellie Daniels runs her hand over a young woman's rounded belly, conducting a routine prenatal exam.
DANIELS: I think the baby has the hiccups.
DeLEON: She warns her clients to avoid freshwater fish, and the clams and lobsters that are a staple for many of the coastal Maine residents in her practice. One hundred percent of the women Daniels cares for breast feed their babies: an incredibly high rate. She encourages me to continue.
DANIELS: What could we find that is better? I mean, any milk source is going to have dioxin contaminants in it. If you feed a soy formula, you're feeding a formula that's made from the most heavily sprayed soils in the country, you know, the Midwest is in a terrible crisis with all of the chemicals that we've grown our crops with and sprayed on our crops. I mean, what can we find that is better? This is just a terrible situation.
DeLEON: This terrible situation is taking its toll on my breastfeeding experience, which was already almost as difficult as it is emotionally rewarding. I tote a breast pump and cooler everywhere I go, so that I can collect milk for my son when I'm not with him. It is a struggle to keep up with his needs and work full time. I eye the free samples of formula I brought home from the hospital. Child health advocates worry that information about the potential contaminants in breast milk will drive women like me away from breast feeding, even though none of the scientists studying the effects of persistent toxics believe women should forego nursing. Lactation consultant Bettina Pearson says American culture remains anti-breast feeding. Women are criticized for nursing in public. Television programs show only bottle-feeding moms. And employers are sometimes unsympathetic to workers' needs to express milk on the job.
DANIELS: Breastfeeding is so personal an experience, and I think women feel so vulnerable emotionally around it that if you're to say to them you could be poisoning your baby, the last thing they're going to want to do is breastfeed. So until we really know if there is a reason not to breast feed, even bringing it up I think is going to decrease the rates just because women are so conscientious about what they're doing.
(Carter laughs, babbles)
DeLEON: I'm still breastfeeding, despite all that I've learned about contamination. Because I believe it's the best thing I can do for my baby. I'll try to mitigate his exposure at the breast by feeding him a diet low in animal fat when he's ready for solid food. The thing that strikes me is that these chemicals are already being reduced in the natural world, and that is good news. The fish caught in the rivers near my house last summer are cleaner than those taken the year before. But these same substances will persist in our bodies, in our breast milk, and in the bodies of our children. For Living on Earth, this is Andrea DeLeon.
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