Mothers' Milk Should Not Be Such a Mystery

Karen Florini, Lynn R. Goldman / SF Chronicle 29nov00

A NEW MOTHER nurses her child, humming as she caresses the baby's downy hair. She knows that her milk is providing disease-fighting antibodies, along with vital nutrients and calories. But what else is the baby getting? Surprisingly, nobody really knows.

Despite the fact that 60 percent of newborns in the United States are breast-fed, nobody in America -- not doctors, university scientists, government or industry -- systematically collects and analyzes breast milk for possible contaminants. Breast milk still is the best food for babies, but steps should be taken to ensure its quality.

Sporadically, researchers (including some funded by the Environmental Protection Agency in the 1970s) have looked for, and found, a few specific compounds such as PCBs, DDT, dioxin and a handful of pesticides. However, there has never been a systematic attempt to identify the full range of potential contaminants.

We don't know all the compounds present in mothers' milk, much less whether levels are rising or falling. And until we do, we may be missing important opportunities to ensure that babies' first food is as safe as it can be.

None of this suggests that mothers should refrain from breast-feeding. In all but the very rarest of circumstances, the nutritional and other health benefits of breast-feeding dramatically outweigh concerns about contaminants.

Indeed, a national breast milk monitoring effort should be coupled with aggressive efforts to promote breast-feeding. The American Academy of Pediatrics recommends exclusive breast-feeding for the first six months and partial breast-feeding through 12 months of age, but many mothers often wean their infants far earlier.

Simply identifying contaminants in mothers' milk isn't the end of the story.

Once a contaminant is identified, its toxicity needs to be assessed -- if that hasn't been done already. Unless those compounds are found to be safe, efforts to reduce unnecessary human exposure to them should be given a high priority. Assessing contamination of breast milk not only helps identify potential problems, but also signals successes -- for example, the significant decreases in PCBs and DDT in recent years.

Studies to determine what can contaminate mothers' milk are under way in Sweden, Germany and the Netherlands. They have revealed some surprising findings, such as a dramatic increase in levels of a flame retardant also commonly used in the United States.

Are these increases seen in the breast milk of American women? Nobody knows and we won't until we collect and analyze breast milk. In doing so, we need to avoid merely looking for contaminants that we already know are present; we need to look for the broader array of potential pollutants.

Congress should direct the Department of Health and Human Services to launch a pilot program to identify the full range of contaminants in human breast milk. With this data in hand, a program can be established in consultation with local and state organizations, as well as citizen groups, to ensure that populations at risk are identified and monitored.

Such a program won't come cheap. It may cost as much as $20 million a year, but it's hard to imagine a more compelling use of society's tax dollars.

New findings on breast milk would have to be communicated with great care. The basic message must be clear: that while mothers' milk is clearly the best first food for babies in almost all instances, identifying its contaminants will allow us to take actions needed to make it even better. But the critical first step is finding out what is in mothers' milk that Mother Nature didn't put there. We won't know until we look.

Karen Florini is a senior attorney with Environmental Defense. Lynn R. Goldman is a pediatrician and a professor at Johns Hopkins University School of Hygiene and Public Health.