Information about Breastfeeding, Including Recognized Toxins
Mothers receive a great deal of promotion of breastfeeding, but most of what they are told is both one-sided and based on weak evidence. The purpose of this website is to attempt to correct that situation, especially in order to help protect infants from being fed a substance that is known to the EPA to often contain toxins; the hazardous contents are known to the EPA to be very high if the milk is from mothers who have environmental exposure that is typical in contemporary developed countries. Some of the toxins present in breast milk will be discussed below, and more on that subject can be read about at www.babyfeeding.info\toxins-in-breastmilk-and-formula.htm
Breastfeeding rates in the U.S. and most developed countries increased greatly beginning in the 1970's, following a mid-century low level. At that time there was no knowledge about environmental toxins that tend to become concentrated in breast milk, and in fact at that time the levels of those toxins were low compared with what has come to be the case in later years. It was known that some substances were present in human milk that were not present in cow's milk, and it seemed logical that those substances would be sufficiently valuable to infant development that breastfeeding would be unquestionably better for the child than cow's milk or infant formula. A strong movement built up promoting breastfeeding, at a time when the case in favor of it was strong on the basis of what was known at that time. A number of studies were done, most of which concluded that breastfeeding was beneficial.
But, according to U.S. Surgeon General Regina Benjamin, all of the studies that found benefits of breastfeeding were of a kind (observational) that can only yield "associations" or "inferences," rather than real knowledge about pros and cons of alternative types of infant feeding.(1) The U.S. Agency for Healthcare Research and Quality (AHRQ) points out that observational studies are subject to false conclusion,(2) because of the difficult-to-determine effects of confounding factors. As an example, a study would find death rates in Florida to be associated with sunshine; and the advanced average age of Florida residents would be a confounder. In that case, the confounder is easy to see, but in the case of breastfeeding, the confounders of low income and household smoking (disproportionately characteristic of bottle-feeding households) were normally not dealt with or dealt with properly. Those confounders are known to lead to the same diseases that have been attributed to bottle feeding.(3)
Aside from the weaknesses of the evidence that points to benefits of breastfeeding, there is considerable relevant historical evidence covering the period of transition from low-breastfeeding to high breastfeeding. This evidence shows that health outcomes among the highly-breastfed generations of infants have become substantially worse with respect to all but one of the diseases or conditions alleged to be reduced by breastfeeding. In three or more of those areas, new "epidemics" have been declared among children and young people whose infancies took place during the period of higher breastfeeding.(4) Details can be found at the links shown just below.
For discussion about probable effects of breastfeeding specifically on incidence of obesity, diabetes, allergies other than asthma, and the other diseases that are alleged to be reduced by breastfeeding, go to www.breastfeedingprosandcons.info . For discussion about probable effects of breastfeeding specifically on childhood cancer, go to www.breastfeeding-and-cancer.info. For discussion specifically about probable effects of breastfeeding on ADHD and serious psychological problems, go to www.babyfeeding.info. For discussion about the more complicated case of effects of breastfeeding in leading to autism, go to the rather large website at www.pollutionaction.org/breastfeeding-and-autism-and-cancer.htm .
Below will be discussion about effects of breastfeeding related to asthma.
Introductory note to discussion about asthma as related to breastfeeding or not breastfeeding:
According to the NIH (www.ncbi.nlm.nih.gov) ”an allergy is an immune response or reaction to substances that are usually not harmful."
It is well-known that immune cells from the mother are transmitted to an infant in breast milk, and that is clearly helpful to an infant in areas with poor sanitation. But in developed countries, the benefits of those immune cells are very much in question. A web page of the U.S. Food and Drug Administration favorably presents a line of reasoning according to which proper infant development depends on “the necessary exposure to germs required to “educate” the immune system.... In the period immediately after birth the child’s own immune system must take over and learn how to fend for itself.” The FDA reports that this “hygiene hypothesis” is supported by epidemiological studies. A prominent doctor uses stronger language, describing the “critical importance of proper immune conditioning by microbes during the earliest periods of life.” A study found on the NIH’s website discusses “the microbial exposure which may be critical for immune priming” and suggests it would be helpful to re-name the “hygiene hypothesis” as “microbial deprivation hypothesis.” (9) According to the UCLA Food and Drug Allergy Care Center, "Overwhelming evidence from various studies suggests that the hygiene hypothesis explains most of the allergy epidemic."(9a) Given the above, there are strong reasons to question whether breastfeeding's transmission of immune cells to an infant, and the resulting reduction in exposure to everyday microbes (below the already historically low levels in developed countries), is anything but harmful to a child's long-term health.
In addition to the above-suggested indirect effect of breast milk on development of the immune system, there are also known harmful direct effects on the immune system resulting from toxins known to be contained in breast milk. According to an extensive 2011 study on environmental toxicants and the developing immune system, toxins including dioxins, PCBs, PAHs, BPA, and phthalates can harm development of the immune system.(10) Note that all of these toxins have been found in breast milk, with dioxins in doses known to be especially high in relation to the EPA-determined safe level. Moreover, in the only comparisons that can be readily found, the doses of these toxins in human milk have been found to be many times higher than those in cow's milk or infant formula. Extensive evidence for the above statements from the EPA and other trustworthy sources can be found via the following footnote: (11)
Probable Effects of Breastfeeding in Leading to Increased Asthma Levels
Observe the rate of hospitalizations for asthma for 0-to-4-year-olds, those most closely affected by the increases in breastfeeding: Serious cases of asthma actually increased over 60% from 1980 to 2004, a period in which effects of the transition to much higher breastfeeding rates would have been occurring. (Remember from the previous section about probable effects of breast milk on the developing immune system.)
The above contrasts with what happened among those age 15 and above: There were declines in serious cases of asthma among those least affected by the relatively recent increases in breastfeeding. Those declines are as would have been expected following advances in practices for treating this disease. And notice that for the 5-14 age group, affected much less directly but nevertheless affected by the increases in breastfeeding, asthma hospitalizations wavered up and down, with neither the decline that should have been expected (assuming validity in the Surgeon General's risk assessments) nor a significant increase such as occurred among the group most closely affected by breastfeeding.
Aside from information about hospitalizations for asthma, other data is available concerning childhood asthma in general. Unfortunately, this "Prevalence of childhood asthma" chart (above) again only starts at 1980, but effects from earlier years can be seen by looking at data for the age groups whose information was incorporated into this chart. Asthma prevalence among the 11-17 age group increased 140% during the years shown on this chart, far more than the increases of the two younger age groups (71% and 52%).(12) To look at the period of the infancies of the 11-17 age group, we can subtract an average of 14 years from the years shown on the asthma prevalence chart, to find the time of their average infancies in the period starting before 1970 and continuing until 1982. Then we can look at the breastfeeding-rates chart provided by the U.S. Surgeon General and see that by far the greatest increase in breastfeeding took place during those same, specific years. Breastfeeding rates were rising very unusually rapidly during the infancy years of the group that later turned out to have had unusually-rapidly-increasing asthma prevalence.
The above is only a minor part of the evidence linking increases in asthma with increases in breastfeeding. Because of space limitations here, the complete statement of the evidence on this specific subject is to found at www.breastfeedinginfo.info/asthma-and-breastfeeding.htm
A question that should be addressed to those who are recommending breastfeeding, but which they probably won't want to answer:
Given (a) the inconclusiveness of the studies that support breastfeeding,** (b) the known concentrations of environmental toxins in recent human milk,** and (c) the many close correlations between variations in breastfeeding levels and similar variations in levels of several epidemics of childhood diseases (seen in national health data**): What assurance is there that breastfeeding is more beneficial than harmful?
** Supporting information and references to authoritative sources regarding matters raised in this question are included in a one-page printable version of this question, to be found at www.pollutionaction.org/Q.pdf .
We have good reason to say that those who recommend breastfeeding probably will not have an answer to the above question. A slightly different version of essentially this same question was mailed to four different high officials at the U.S. Department of Health and Human Services, who are heads of divisions that are involved in promoting breastfeeding. As of 7 and more weeks after mailing those letters, no reply has been received. Several months earlier, each of those officials had sent one response to an earlier letter that brought up the matters above, and none of their responses said anything in criticism of any of those points. Those points are all well substantiated. So the question that comes at the end, above, is a logical question to ask. But the promoters of breastfeeding appear to be unwilling or unable to respond to it. If they can't or won't answer that question as part of an informed debate on this matter (therefore to firstname.lastname@example.org, as well as to you), should anybody pay attention to their advice?
Message to health professionals and scientists reading this paper: This author cordially invites you to indicate your reactions to the contents presented here. As of now, new parents almost never hear anything but completely one-sided promotion of breastfeeding, with no mention of possible drawbacks except in cases of serious problems on the part of the mother. If you feel that parents should be informed about both sides of this question and thereby enabled to make an educated decision in this important matter, please write to the author of this paper. Also, if you find anything here that you feel isn't accurately drawn from trustworthy sources or based on sound reasoning, please by all means send your comments, to email@example.com.
Comments from readers:
From this paper's inception in early 2012 until present, the invitation has been extended to all readers to submit criticisms of contents of this paper, asking them to point out how anything written here is not well supported by authoritative sources (as cited) or is not logically based on the evidence presented. As of May 4, 2013, after more than a year, no criticisms of contents of this paper have yet been received in response to that invitation. (That is significant, considering the thousands of visits we receive from readers every month.) We have received some e-mails that have not criticized contents of this paper but which are of interest; several of those comments or inquiries and our responses to them are entered at www.pollutionaction.org/comments.htm . All comments are welcome, especially those that point out any deficiencies in our evidence in relation to conclusions drawn or any lack of quality in the reasoning as presented. Please send comments or questions to firstname.lastname@example.org .
* About Pollution Action: Please visit www.pollutionaction.org
(1) "Surgeon General's Call to Action to Support Breastfeeding, 2011," p. 33 at http://www.surgeongeneral.gov/library/calls/breastfeeding/calltoactiontosupportbreastfeeding.pdf
(2) Agency for Healthcare Research and Quality, U.S. DHHS, Systems to Rate the Strength of Scientific Evidence, Evidence Report/Technology Assessment: Number 47 http://archive.ahrq.gov/clinic/epcsums/strengthsum.pdf
(4) Type 2 Diabetes in Children and Young Adults: A “New Epidemic” Francine Ratner Kaufman, MD Clinical Diabetes • Volume 20, Number 4, 2002 at http://clinical.diabetesjournals.org/content/20/4/217.full.pdf+html
Food allergy: Riding the second wave of the allergy epidemic Susan Prescott http://onlinelibrary.wiley.com/doi/10.1111/j.1399-3038.2011.01145.x/pdf
Research needs in allergy: an EAACI position paper, in collaboration with EFA Papadopoulos et al. Clinical and Translational Allergy 2012, 2:21 http://www.ctajournal.com/content/2/1/21
CDC web page, http://www.cdc.gov/CDCTV/ObesityEpidemic/Transcripts/ObesityEpidemic.pdf Obesity increase data also at CDC's Health United States, 2008, Data Table for Figure 7.
Examination of historical data with regard to all of the diseases and conditions said by the Surgeon General to be "excess risks" of formula feeding, with sources, can be found at www.breastfeedingprosandcons.info
(9) http://www.fda.gov/biologicsbloodvaccines/resourcesforyou/consumers/ucm167471.htm Also Clin Exp Allergy. 2006 April; 36(4): 402–425. Blackwell Publishing Ltd "Too clean, or not too clean: the Hygiene Hypothesis and home hygiene," SF Bloomfield et al. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448690/ Also Cell Research advance online publication 24 April 2012; doi: 10.1038/cr.2012.65 "Early exposure to germs and the Hygiene Hypothesis" Dale T Umetsu Division of Immunology, Karp Laboratories, Children's Hospital Boston, Harvard Medical School, Boston, MA http://www.nature.com/cr/journal/vaop/ncurrent/full/cr201265a.html
(9a) http://fooddrugallergy.ucla.edu/body.cfm?id=40 "About Allergies/ Why Are Allergies Increasing?"
(10) "Environmental toxicants and the developing immune system: a missing link in the global battle against infectious disease?" Bethany Winans, et al., Reprod Toxicol. 2011 April; 31(3): 327–336. Published online 2010 September 22. doi: 10.1016/j.reprotox.2010.09.004 PMCID: PMC3033466 NIHMSID: NIHMS245165 accessed at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033466/ citing the following:
Heilmann C, Grandjean P, Weihe P, Nielsen F, Budtz-Jorgensen E. "Reduced antibody responses to vaccinations in children exposed to polychlorinated biphenyls." PLoS Med. 2006;3:e311. [PMC free article
Weisglas-Kuperus N, Patandin S, Berbers GA, Sas TC, Mulder PG, Sauer PJ, et al. "Immunologic effects of background exposure to polychlorinated biphenyls and dioxins in Dutch preschool children." Environmental health perspectives. 2000;108:1203. [PMC free article]
Glynn A, Thuvander A, Aune M, Johannisson A, Darnerud P, Ronquist G, et al. "Immune cell counts and risks of respiratory infections among infants exposed pre- and postnatally to organochlorine compounds: a prospective study". Environmental Health. 2008;7:62. [PMC free article]
Dallaire F, Dewailly E, Muckle G, Vezina C, Jacobson SW, Jacobson JL, et al. "Acute infections and environmental exposure to organochlorines in Inuit infants from Nunavik." Environ Health Perspect. 2004;112:1359–63. [PMC free article]
Dewailly E, Ayotte P, Bruneau S, Gingras S, Belles-Isles M, Roy R. "Susceptibility to infections and immune status in Inuit infants exposed to organochlorines.” Environ Health Perspect. 2000;108:205–11. [PMC free article]
Jedrychowski W, Galas A, Pac A, Flak E, Camman D, Rauh V, et al. "Prenatal ambient air exposure to polycyclic aromatic hydrocarbons and the occurrence of respiratory symptoms over the first year of life." European journal of epidemiology. 2005;20:775–82.
Weisglas-Kuperus N, Vreugdenhil HJ, Mulder PG. "Immunological effects of environmental exposure to polychlorinated biphenyls and dioxins in Dutch school children." Toxicol Lett. 2004;149:281–5.
Guo YL, Lambert GH, Hsu CC, Hsu MM. Yucheng: "Health effects of prenatal exposure to polychlorinated biphenyls and dibenzofurans." Int Arch Occup Environ Health. 2004;77:153–8.
Vos JG, Moore JA. "Suppression of cellular immunity in rats and mice by maternal treatment with 2,3,7,8-tetrachlorodibenzo-p-dioxin." International archives of allergy and applied immunology.
(11) U.S. EPA. "Estimating Exposure To Dioxin-Like Compounds - Volume I": U.S. Environmental Protection Agency, Washington, D.C., EPA/600/8-88/005Ca., 2002, revised 2005 – http://cfpub.epa.gov/si/si_public_record_Report.cfm?dirEntryID=43870, Section II.6, "Highly Exposed Populations" (nursing infants are considered to be one of the highly-exposed populations), 4/94 (p. 39): "Using these procedures and assuming that an infant breast feeds for one year, has an average weight during this period of 10 kg, ingests 0.8 kg/d of breast milk and that the dioxin concentration in milk fat is 20 ppt of TEQ, the average daily dose to the infant over this period is predicted to be about 60 pg of TEQ/kg-d."
http://www.epa.gov/iris/supdocs/dioxinv1sup.pdf in section 4.3.5, at end of that section, "...the resulting RfD in standard units is 7 × 10−10 mg/kg-day." (that is, 0.7 pg/kg-day of dioxin) In the EPA’s “Glossary of Health Effects”, RfD is defined: “RfD (oral reference dose): An estimate (with uncertainty spanning perhaps an order of magnitude) of a daily oral exposure of a chemical to the human population (including sensitive subpopulations) that is likely to be without risk of deleterious noncancer effects during a lifetime.”
Infant Exposure to Dioxin-like Compounds in Breast Milk Lorber1 and Phillips2 VOLUME 110 | NUMBER 6 | June 2002 • Environmental Health Perspectives http://cfpub.epa.gov/ncea/cfm/recordisplay.cfm?deid=54708#Download
(12) Table 1 from Measuring Childhood Asthma Prevalence Before and After the 1997 Redesign of the National Health Interview Survey --- United States in MMWR of CDC found at www.cdc.gov/mmwr/preview/mmwrhtml/mm4940a2.htm#fig1
(12a) “New Asthma Estimates: Tracking Prevalence, Health Care and Mortality,” NCHS, CDC, 2001.
This organization consists to a great extent of one person, me (Don Meulenberg), but I receive considerable data-gathering and analysis assistance from several associates, as mentioned below. I am not a scientist, but my education included challenging biology and chemistry courses, in which I did well; and I am quite able to accurately pull together and summarize relevant sections from the many scientific studies and health data sources that are available in the fields I am concerned with. This orientation has some advantages compared with studies by PhD's, which tend to go into great detail in narrowly-defined areas, and which typically conclude with recommendations for future multi-year studies on the subject. I received scores in the top 1% on standardized tests when in high school, hold a B.A. cum laude from Oberlin College, and stood in the top third of my class during a year at Harvard's Graduate School of Business Administration. There were important aspects of the business-school case-study method that have been helpful in making my work more practically useful (I believe) than much or most of what has been written on these subjects, as follows: After carefully studying large amounts of printed matter on a subject and doing whatever numerical calculations seem relevant, one is expected to come up with well-considered recommendations for action. Apparent insufficiency of information available on a subject should not lead one to be satisfied to recommend future long-term studies, if there is a serious problem now. Work around gaps in the available data as best you can, and come up with an action plan reasonably quickly that you can defend in plain English on the basis of the data and common sense. As applied in this case, that approach meant poring through hundreds of studies and reports, plotting local disability data and analyzing pollution figures (with the aid of spreadsheet software), then winnowing out some apparent patterns for closer looks, utilizing the excellent computer expertise, diligent data analysis and real-world knowledge of Matt Hulbert, proof-reading, general assistance and excellent advice of Greta Hammen, accurate data entry, computations, and map-shading assistance from various associates (especially Richard Hybl and Tim Gill), considerable and invaluable assistance from reference librarians at the Central Rappahannock Regional Library (especially Lee Criscuolo and Courtney McAllister) in locating difficult-to-access scientific articles, very helpful thoughts and guidance to information sources from Professor James Corbett of the University of Delaware's College of Earth, Ocean, and Environment, and drawing on insightful comments and suggestions from various acquaintances, employees and friends, including parents from three separate families each with at least one boy and one girl.
I own a small U.S. manufacturing company and manage it when I'm not working on pollution and developmental matters. We are located in Fredericksburg, Virginia, USA. Since my company's products compete in a minor but significant way with imports from Asia, my attention was originally drawn to the subject of environmental toxins when I became aware of the increasing pollution emitted by ships bringing imports to U.S. shores. I was also inspired to look into the subject of sources of mental impairment by seeing an increase in sales of my company’s damage-resistant products for use in residences for mentally-handicapped young people.
I strongly encourage any reader to look in my writing for any statement that does not appear to be well supported by valid evidence or reasoning, or any passages that don't seem to make sense, and to inform me (and anyone else) about any apparent flaws. All comments that criticize specific passages will be posted at the end of the appropriate paper and responded to. I realize that many people won’t like my conclusions, but if you can’t say anything about what is inadequate with the evidence or the reasoning that led to the conclusions, please don’t bother sending a negative response. (But non-negative responses are always welcome.) My e-mail address is email@example.com .
Full disclosure: The name of my small Virginia manufacturing company is not mentioned here because doing so might cause some people to think that my writing and publicizing of findings is intended to generate publicity and sales for my company. But anyone who is curious could find out the nature of my business with little difficulty. I have no financial or other interest in infant formula or in anything that could benefit from my research.
Office Address: Pollution Action, 27 McWhirt Loop, Ste. 111, Fredericksburg, VA 22406
www.pollutionaction.org 540-370-1555 E-mail: firstname.lastname@example.org