by Jack Newman, MD, FRCPC
The question of toxins in breastmilk is being addressed in a patient information sheet because the issue comes up every few months in the media, as regular as clockwork. It frightens many pregnant women out of breastfeeding their babies and many women who are already breastfeeding into stopping.
Journalists do not seem to know how to handle this question very well. Some may have an ulterior motive ("my baby wasn't breastfed and he's okay") thus finding a way of getting back at breastfeeding advocates and justifying their "choice of infant feeding." It is, of course, unprofessional to do this, but that doesn't stop them.
Others are merely trying to get out the news but often without understanding what they are doing. They don't understand, for example, that by talking about toxins in breastmilk and considering formula as an almost as good alternative, they are striking a blow against breastfeeding.
Why are there all these studies that look at toxins in breastmilk? One gets the impression that there is panic about the state of breastmilk in the modern world, that it is so polluted that everyone is trying to study it. But the reason that breastmilk is being studied so often is that it is easily available, and gives us an easily obtained sample of human fluid.
That's the reason, not because scientists are worried about breastmilk in particular. We need to be worried about all our bodily fluids given the levels of pollution we have created in the world.
This question needs to be considered in trying to understand the issue of toxins in breastmilk and the answer is no, formula is not almost like breastmilk, not by a long shot. Just because every few years the formula manufacturers add something to their formulas that we knew was in breastmilk for years but the manufacturers denied were of any importance, doesn't mean that the "new and improved" formula is just like breastmilk.
In some cases, the formula is improved, but remember, they were telling us that the formula before the "new and improved" version was also "almost like breastmilk." This is true, for example, of the long chained polyunsaturated fatty acids (DHA and AA) that are supposed to make your baby smarter (one company even calls their formula A+, but it deserves a C- at best).
We've known how important these fats are for many years, but for many years (before they were added to formula, of course), the manufacturers, echoed by many health professionals, just kept saying that it didn't matter, and that there was no proof that these fats were of any importance at all (this is still in the Canadian Paediatric Society's 1995 statement on the nutrient needs of premature babies). This cycle of "our milk is just like breastmilk" followed by "we have now added x to our milk so that it is even more like breastmilk" has been going on since the 19th century.
The truth of the matter is this:
1. Just adding something to formula, even if it is in the same amounts as in breastmilk, does not mean that the baby will get the amount he needs or the best sort of this something that he needs. The example of iron helps us understand this. Breastmilk contains enough iron (with the stores the baby has during pregnancy), to keep the baby iron sufficient for at least 6 months. To maintain iron sufficiency in formula fed babies, formula needs to contain at least 6 times more iron than breastmilk, just because iron does not get absorbed from the baby's gut as well from formula as it does from breastmilk.
2. There are still hundreds of components of breastmilk that are still not added to formulas.
3. Breastmilk varies in what it contains, from morning to evening, from day to day, from beginning of the feeding to the end, from day 1 to day 4 to day 10 to day 100, so there is no way we can know what breastmilk really contains. This means that there is no way to duplicate breastmilk because there is no such thing as a standard breastmilk. In fact, since every woman produces somewhat different breastmilk, the notion of a standard breastmilk becomes an absurdity. Breastmilk is a living, dynamic fluid. Formula is a chemical soup.