Toxic Breastmilk?

"'Cocktail of chemicals' found in UK mothers' breast milk due to home furnishings" 

The Telegraph

Household chemicals blamed as UK mothers have highest levels of toxins in breast milk

Daily Express

And yet again I wondered who really funds these clickbait headlines.

The paper that provoked such a media response is an environmental audit called "Toxic Chemicals in Everyday Life".  It explores the toxic contamination of our environment, the impact to wildlife, the food chain and society as a whole - with a particular focus on the aftermath of the Grenfell Tower fire. It discusses the levels of toxin exposure we face and how these can affect our health.

They note that toxins from fire-retardant sprays for home furnishing are at significant and worrying levels in everything they tested - from newborn cord blood to the urine of adults.

What's truly bizarre is that the media ran with the breastmilk angle - which is only noted briefly in one of the subsections, and frankly is a drop in the ocean in terms of the level of the problem.

The relevant section reads:

"44. Flame retardants have been detected in air, soil, water, food, wildlife and humans. They are present in homes and offices via dust and on surfaces including windows, floors and carpets.151 Exposure occurs when additive flame retardants leach from goods into the air, dust and surfaces.

So in short, flame retardants (PBDEs) have contaminated everything from the air in your home, to the soil your food is grown in. Oh and the formula you have to use if you don't breastfeed.

"152 Breast Cancer UK suggests the US and UK have the highest levels of flame retardants in human body fluids."

I dug out the Breast Cancer UK briefing which states:

"In general, the USA and the UK have the highest recorded levels of flame retardants in human body fluids (36). The highest concentrations of legacy PBDEs in mothers’ milk have been detected in American women, and the second highest levels in those from the UK (37). Elevated levels of PBDEs have also been found in human blood serum in Californian children at 5 times the US average, and 10-100 times the European and Mexican average"

Oh, so hang on Daily Express - UK mothers don't have the highest levels, Americans do. 

Reference 36 is a 2008 study exploring the US population - it highlights that there are significant differences recorded depending on area and age.

Reference 37 is a 2009 review with particular focus on external exposure routes (e.g. dust, diet, and air) and the resulting internal exposure to PBDEs (e.g. breast milk and blood).

So let's pause a moment to consider that yesterday's headlines were in fact based on a TEN YEAR OLD study...

They note that fats contain higher levels of contaminants presenting an important exposure pathway for humans. This includes foods like fish, dairy products and breastmilk,

They state blood serum levels are 10 times higher in the US in their study than in Europe.  Yet they  couldn't find ten times the difference in the food chain.

But do you know where they did?

Dust

"The ingestion of dust conveys the highest intake of BDE-209 of all sources, possibly also of other PBDE congeners. The PBDE exposure through dust is significant for toddlers who ingest more dust than adults.
Indoor air and dust concentrations have been found to be approximately one order of magnitude higher in North America than in Europe, possibly a result of different fire safety standards."

To compare breastmilk, researchers searched for recorded data from different countries. We're not really comparing like for like, since not all data compared is from the same time period, nor using the same techniques or sample sizes. In the context of contaminants this is a significant flaw, because even within the same area, research highlights massive variations from sample to sample based on their immediate surroundings; some data pooled was samples from 10 people, some from 100, we have no idea what the ages of the sampled were (as the previous study highlights, the older we are - the higher our toxin level).

Everything tested recorded higher in the UK than other parts of Europe, in the one data sample we provided - blood serum, dust etc.

Peeing your pants about breastmilk, is like realising the entire second floor house is on fire, about to burn to the ground - and you make a public announcement your ashtray downstairs in the basement has just caught alight, distracting everyone from the actual imminent disaster.

What the media also fail to recognise - is that by scaremongering against breastmilk, not only will infants continue to be exposed (via the placenta, maternal blood flow, infant formula, the air they breathe and so on), but parents may wrongly believe it to be beneficial to their infant to not receive breastmilk.

In fact - this is like swapping the water you were pouring on the fire to cooking oil.

Exposure to environmental chemicals has been linked to dysregulation of the immune and reproductive system, diseases like cancer - and are known to alter the gut bacteria (microbiome).

Numerous studies have demonstrated that breastmilk is significant in terms of the developing microbiome, contains factors that assist regulation of the immune system and in short, assist the body in dealing with the effects of exposure (1-8).

It's time some media sources started sorting fact from fiction, before they write their headlines.

1. Pannaraj PS, Li F, Cerini C, et al. Association Between Breast Milk Bacterial Communities and Establishment and Development of the Infant Gut Microbiome. JAMA Pediatr. 2017;171(7):647–654. doi:10.1001/jamapediatrics.2017.0378
2. Van den Elsen LWJ, Garssen J, Burcelin R, Verhasselt V. Shaping the Gut Microbiota by Breastfeeding: The Gateway to Allergy Prevention?. Front Pediatr. 2019;7:47. Published 2019 Feb 27. doi:10.3389/fped.2019.00047
3. Alba Boix-Amorós, Fernando Puente-Sánchez, Elloise du Toit, Kaisa M. Linderborg, Yumei Zhang, Baoru Yang, Seppo Salminen, Erika Isolauri, Javier Tamames, Alex Mira, Maria Carmen Collado. Mycobiome profiles in breast milk from healthy women depend on mode of delivery, geographic location and interaction with bacteria. Applied and Environmental Microbiology, 2019; DOI: 10.1128/AE
4. Cacho NT, Lawrence RM. Innate Immunity and Breast Milk. Front Immunol. 2017;8:584. Published 2017 May 29. doi:10.3389/fimmu.2017.00584
5. Hsu PS, Nanan R. Does Breast Milk Nurture T Lymphocytes in Their Cradle?. Front Pediatr. 2018;6:268. Published 2018 Sep 27. doi:10.3389/fped.2018.00268
6. Laura M'Rabet, Arjen Paul Vos, Günther Boehm, Johan Garssen, Breast-Feeding and Its Role in Early Development of the Immune System in Infants: Consequences for Health Later in Life, The Journal of Nutrition, Volume 138, Issue 9, September 2008, Pages 1782S–1790S, https://doi.org/10.1093/jn/138.9.1782S
7. Molès, J‐P, Tuaillon, E, Kankasa, C, et al. Breastmilk cell trafficking induces microchimerism‐mediated immune system maturation in the infant. Pediatr Allergy Immunol. 2018; 29: 133– 143. https://doi.org/10.1111/pai.12841
8. Babak Baban, Aneeq Malik, Jatinder Bhatia, Jack C. Yu. Presence and Profile of Innate Lymphoid Cells in Human Breast Milk. JAMA Pediatrics, 2018; DOI: 10.1001/jamapediatrics.2018.0148