by Donna Walls, RN, BSN, IBCLC, ANLC, Certified Aromatherapist, Master Herbalist

Each year, the World Alliance for Breastfeeding Advocacy (WABA) chooses a theme for World Breastfeeding Week celebrations around the world which is celebrated every August 1- 7. For 2020 the theme is, “Support Breastfeeding for a Healthier Planet.” The objectives for 2020 are:

1. Inform people about the links between breastfeeding and the environment/climate change
2. Anchor breastfeeding as a climate-smart decision
3. Engage people and organizations for greater impact
4. Galvanize action on improving the health of the planet and people through breastfeeding

But can breastfeeding really effect climate change and create a cleaner, healthier environment? We know the health of the planet is closely tied human health and there is a growing interest in learning how to protect the health of the environment. We recognize there are numerous activities that protect the environment, breastfeeding being one of the most important. Breastfeeding is the best example of clean, eco-friendly actions to protect and improve the health of planet earth. Breastfeeding is the ultimate natural, sustainable resource. It requires no raw materials needed for processing, no energy consumption in production or transportation, it does not produce any material waste or by-products, does not require any packaging materials, water resources or electricity and creates no pollution of the air or water. Lactation is a perfect partner for environmental health and the ultimate example of “eating local.” Even those mothers who choose to express their milk and feed from bottles are also providing a more planet-friendly feeding as this method avoids the energy and materials involved in formula manufacturing and transportation- so breastfeeding, whether from the breast or bottle is the most climate smart feeding choice to protect the planet and human health Looking at the carbon footprint of breastfeeding gives us another glimpse of the impact of breastfeeding on the earth. Wikipedia defines carbon footprint as ”the total greenhouse gas emissions caused by an individual, event, organization, service, or product, expressed as carbon dioxide equivalent.” In simple terms, it shows us what the impact is on the health of the environment. The carbon footprint of breastfeeding is based on the production and transportation of food for the mother based on the RDA of an additional 500 kcal/day recommended during breastfeeding. According to research from the United Kingdom, the carbon footprint of breastfeeding is estimated at 5.9 (this figure varies between countries). In comparison, the carbon footprint of formula feeding is based on the use of resources, animal, and factory production emissions and transportation of the formula as well as supplies, preparation and storage of formula at home, and is estimated at 11.0 (again, this figure varies between countries). On average, feeding breast milk substitutes had a higher climate impact than breastfeeding in all countries studied. This certainly demonstrates the positive impact on the environment when the infant feeding choice is breastfeeding. (Bodkin, 2019) (Meade, 2008) International Baby Food Action Network (IBFAN) is a group of individuals and organizations supporting optimal infant feeding practices. IBFAN also works for the universal and full implementation of the International Code of Marketing of Breastmilk Substitutes which is an international health strategy recommending restrictions on the marketing of all formulas and supplies intended to discourage breastfeeding. In 2015, they developed and implemented their statement on breastfeeding and the environment. The statement includes:

“Breastfeeding protects our health and our planet – right from the start breastfeeding is the first step towards protecting human health, short- and long-term. It is also the first step towards protecting the health of our environment and conserving our planet’s scarce natural resources. We need to start at the beginning, with infants and young children. Our babies and children are in no way responsible for climate change and environmental degradation, but instead they suffer the disastrous consequences.” (IBFAN, 2015)

We know that breastfeeding is the most climate-friendly option for infant feeding, but does the environment have an impact on breastfeeding? The answer is yes. For decades scientists around the world have used human milk to study the effects of environmental contaminants. In a study from the Journal of Health Science it was demonstrated that rats exposed to dietary bisphenol A (BPA) in early pregnancy showed cellular injury to the mammary glands as well as lower prolactin levels. (Miyaura, 2004) Rochester Medical Center studies reported in Science Daily also demonstrated damage to rat mammary glands to the extent that some mother rats were unable to nourish their pups after exposure to dioxins. Researchers noted that some rats were able recover mammary function by late pregnancy. (Lawrence, 2009) These studies are the basis for ongoing research looking into possible negative impacts on lactation in humans. The studies are also the basis of much education related to how to create a safer environment while protecting lactation. In 2013, a study was reported in the journal of Neurotoxocology and Teratology demonstrating a decrease in maternal behaviors in Wistar rats (less grooming, protection and nuzzling), a concerning finding but not yet demonstrated in humans. (Boudalia, 2013) An unpublished study from Wright State University looked at mothers with self-described low milk supply. The 78 mothers in the study were 4 weeks to 8 months postpartum and were all given education on reducing exposures to environmental estrogens (personal care products, food hormones and plasticizers). Results were seen in 1-5 weeks and ranged from the mothers stating her “breasts were fuller,” the “babies seemed more satisfied,” and fewer needed supplementation. Some found a doubling of supply (noted with pumping during work hours). Seven had no noticeable increase in milk supply and of those only two weaned from breastfeeding- the rest continued supplementation. (Walls, presented 2009) In a Mexican study of young Yaqui tribe women, those who moved and were living with the new chemical based agriculture had less alveolar tissue compared to the young woman who remained with the tribe and chose to maintain the traditional non-chemical farming techniques. Many of the agra-chemical exposed young women were found to have larger than normal breasts, but less glandular tissue (referred to as “empty breast” syndrome) and many were unable to breastfeed their infants, viewed an integral part of mothering in that culture. (Hansen, 2010) These studies can, on the surface, seem discouraging until we really weigh the risks and benefits of breastfeeding in a polluted world. When considering the properties of human milk, we need to recognize those properties in breastmilk which have been shown to mitigate some of the negative environmental effects. Studies from the Environmental Protection Agency and reported by the New York Times found “breast milk appears to be at least partly protective against the effects of toxic chemicals.” (Williams, Florence, NYT) Sandra Steingraber, biologist and author of Living Downstream and Having Faith: An Ecologist’s Journey to Motherhood stated, “We haven’t yet compromised breast milk to such an extent that it’s a worse food than infant formula…” Human milk contains bio-active components which specifically control and resolve inflammation, promote a thick, healthy gut lining to support an optimum functioning immune system and provide the most nutritious food for optimum general health for infants and children. WABA published its statement regarding breastfeeding and environmental contaminants, continuing to promote breastfeeding as the safest feeding choice.

“Is the presence of these chemical residues in breastmilk a reason not to breastfeed? No. Exposure before and during pregnancy is a greater risk to the fetus. The existence of chemical residues in breastmilk is not a reason for limiting breastfeeding. In fact, it is a reason to breastfeed because breastmilk contains substances that help the child develop a stronger immune system and gives protection against environmental pollutants and pathogens. Breastfeeding can help limit the damage caused by fetal exposure.” (WABA, 2005)

In 2017, The World Health Organization (WHO), reviewing published research on contaminants and human milk, states definitively, “The benefits of breastfeeding far outweigh the toxicological disadvantages that are associated with certain POPs” (persistent organic pollutants). Miriam Labbok, MD, physician–epidemiologist who directed the Carolina Breastfeeding Institute at the School of Public Health of the University of North Carolina, Chapel Hill stated, “The fact that studies of child [health] outcomes in highly polluted areas are still better for the breastfed infant… would seem to indicate that certain factors in the production of human milk and in the milk itself, immunological and other, may mediate the potential harm of the ambient pollution. It would appear that all the experts remain in agreement that there is no reason for WHO to change its breastfeeding recommendations.” Labbok agrees saying, “To date, no environmental contaminant, except in situations of acute poisoning, has been found to cause more harm to infants than does lack of breast-feeding. I have seen no data that would argue against breastfeeding, even in the presence of today’s levels of environmental toxicants. The World Health Organization recommends breastfeeding in all but extreme circumstances.” Additionally, the American Academy of Family Physicians (AAFP) agrees in their 2018 statement that certain components of human milk act to increase the infant’s elimination of some toxins and to protect the infant’s developing brain, central nervous system, and body as a whole. Considering the safety of human milk even when contaminants have been detected, neonatal intensive care researcher Anatolitou (2012) states, “the detection of any environmental chemical in breast milk does not necessarily mean that there is a serious health risk for breastfed infants. No adverse effect has been clinically or epidemiologically demonstrated as being associated solely with consumption of human milk containing background levels of environmental chemicals.” It is important to understand that many of the measurements of POPs in human milk are not clinically meaningful and, hence, are not a cause for alarm. Even more importantly, as mentioned earlier, a number of components of human milk act to counter potential risks of contaminant exposure. (Anitolitou, 2012) The Centers for Disease Control and Prevention (CDC) point out that the only time effects of exposure have been detected in a breastfeeding infant have been cases when the mother was extremely ill. In their review, Anadón et al. (2017) agree, further explaining that only excessive exposure would be a contraindication to breastfeeding. As lactation care providers we are in a unique position to not only support the optimum health of infants and children but also be a part of creating a healthier environment for the children to grow and thrive.

Resources

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