Table 2 summarizes recommended action both clinically and in the area of public health policy. Prevention of breast milk contamination cannot be resolved on an individual basis. Primary and secondary prevention needs to be pursued through public health policy initiatives. Where available, research has indicated that the banning of organohalogen production and use has resulted in time trend reductions in their levels in breast milk.[10,13] However, the data are scattered and incomplete. To fully understand the extent of contamination, a breast milk biomonitoring program is essential. Such a program could track the POPs body burdens of mothers and infants, identify at-risk populations or POPs of emerging concern, and serve as a report card for environmental regulatory action. Breast milk collection is fairly convenient and noninvasive compared with serum or adipose tissue sampling, and the results provide an accurate measurement of body burden. Breast milk monitoring programs in other countries have helped to identify PCBs and PBDEs as important human contaminants.[9,11] Hooper and She proposed an innovative community-based breast milk-monitoring system linked to Women, Infants, and Children (WIC) clinics, which would include education programs that encourage breastfeeding.
Finally, to safeguard the health of our children, society must take steps to limit polluting the environment and ourselves while encouraging breastfeeding. It does not make sense to recommend the restriction of proven beneficial health behaviors such as breastfeeding. Although changing environmental policy is not simple, quick, nor easy, it has proven health-related benefits and should be considered an important public health initiative. The precautionary principle has been proposed as a method of reframing policy making in an era in which little is known about the long-term effects of environmental pollutants. The principle involves taking preventative action in the face of uncertainty, shifting the burden of proof to the proponents of an activity, exploring a wide range of alternatives to possibly harmful actions, and increasing public participation in decision making. The Stockholm Convention is a United Nations treaty with the goal of eliminating and limiting the use of POPs worldwide. It was ratified by over 100 nations, including the United States, and became international law in May 2004. Such action is necessary to protect future generations from potential harms that we do not yet fully understand.
The author thanks Leah Albers, CNM, DrPH, for her critique and encouragement, and Sandra Steingraber, PhD, for her inspirational and evidence-based work in this area.Reprint Address
Address correspondence to Krista Nickerson, CNM, MSN, 206 Cornelia Street, Suite 306, Plattsburgh, NY 12901. Email address: firstname.lastname@example.org
J Midwifery Womens Health. 2006;51(1):26-34. © 2006 Elsevier Science, Inc.
Cite this: Environmental Contaminants in Breast Milk - Medscape - Jan 01, 2006.