| Discussion Paper
Risks, Rights and Regulation
Communicating about Risks
and Infant Feeding
Creating Fact Sheets when Facts are in Dispute: Toronto Workshop, November, 1999
Workshops offer opportunities to develop shared language. In the process, they reveal differences in interpretation, emphasis, and priorities. A workshop was held November 12, 1999, in Toronto to explore the process of disseminating information on breastfeeding and environmental toxins. A set of questions was prepared based on the literature reviewed and given to participants at or before the workshop. A brochure on breastfeeding and environmental toxins was developed following the workshop (see Appendix 1).
The workshop was attended by interested representatives from: Women's Network on Health and Environment; National Network on Environment and Women's Health; La Leche League, Canada; Toronto Public Health; International Lactation Consultants Association (ILCA); Stop Cancer; UNICEF, Canada; Breastfeeding Committee of Canada; South Riverdale Community Health Centre; Multi-racial Network for Environmental Justice; and the Medical Reform Group, in addition to interested faculty and students.
Following the workshop, a number of doulas (labour attendants) commented by email on the issues raised for discussion at the workshop. Other individuals and groups such as Food Share, WWF and Greenpeace requested the workshop questions and sent feedback by email. Participants attending said that they needed information on evaluating environmental risks with regard to breastfeeding. Yet they raised the question: How do you write a fact sheet when facts are in dispute? The experience of the November workshop provided some valuable insights into how differently advocacy groups deal with the question of toxins and breastmilk.
Workshop responses to questions
1. Have you or members of your organization been asked questions about the "content" of breastmilk? By whom? What prompted the questions? News stories?
Overall, participants felt that the issue of environmental pollutants was of low priority for mothers who did not generally consider these issues when deciding whether or not to breastfeed. Mothers asked questions about medications, alcohol and marijuana use, and about workplace toxins. If the issue is raised, some mothers want to know where they can get their breastmilk tested. But as one participant explained, the experience of birth and breastfeeding is so intense that broader concerns become irrelevant - until the period of breastfeeding is over.
2. What information is available to mothers on this topic?
Participants felt that "there is not much out there" on this topic; they were concerned that breastfeeding advocates "don't tell the whole story" and that some studies (about toxins in breastmilk) were kept out of public eye to "protect" breastfeeding.
3. What information is available to health professionals on this topic?
In brief, nothing, except telephone hotlines.
4. What "authoritative statements" do you trust and use with confidence? (WHO? UNICEF? LLI?)
Lactation cousellors said nothing is authoritative, but expected Sandra Steingraber's new book (2001) would be. They trusted WHO statements, and the Department of Public Health, but were wary of alternative health sources; they thought mothers should "keep a critical and vigilant eye" on these materials.
5. What information do you think should be available?
All confirmed that the message should be that breastfeeding is still the best choice. They called for instructions on how to reduce toxins in breastmilk and advice on when the process of toxin reduction needs to start - pre-conception? early pregnancy? While men should keep their body burden of contaminants down, they felt that men don't have to worry about sharing chemical contaminants with their babies. They thought that mothers should be told where to get their milk tested, and what the long and short term risks of contaminants were. They asked if reduction in breastfeeding duration reduces risks, and argued that there was a need to counter infant formula ads to produce more balanced information.
6. Is there any information on contamination that should NOT go into public information sheets?
Participants felt that if evidence is omitted, the "other side will use omitted evidence against you." The public has a right to know. Some argued that breastfeeding mothers don't need to hear about these types of problems; others, that communicating about risks and breastfeeding is just a conspiracy of infant formula companies to increase sales. All saw the need to distinguish proven facts from speculation.
7. What personal actions might women take to reduce risks to themselves and their infants?
Mother's breastmilk will reflect past exposure, and cannot be changed by "eating organic" or eating healthy while breastfeeding. Mothers should eliminate or reduce exposure to household and industrial toxic products such as cleaners, etc. Some argued that mothers should avoid breastmilk testing.
8. What political actions should be taken to reduce risks? Should a fact sheet consider personal actions, political actions, or both?
Suggestions included giving media presentations to standing committees on environmental issues, having a response plan for industrial accidents, and contacting politicians.
9. Any other words of wisdom, suggestions, references that might help us make a useful document?
Well-known women who have breastfed should speak out saying that breastfeeding is sacred and all must work for the purest breastmilk possible. We owe it to our children to develop the strongest possible pollution prevention laws. Address corporate boards directly. Board members are susceptible and vulnerable, particularly if they have children. Policy might consider whether tolerable levels of toxins should be lower for girls and women. Messages include: cut pollution, not breastfeeding; every baby has the right to be chemical-free; breastfeeding should be a zero-risk activity; NGOs should produce a practical guide for breastfeeding mothers to help them create the healthiest possible environment for themselves and their children; pregnant and lactating women should not have contact with pesticides.
The workshop was a valuable opportunity to assess how different constituencies approach questions concerning contaminants in breastmilk. There was obvious tension between the belief that science held an indisputable unambiguous truth on the subject of breastfeeding and contaminants (but the public needed access to it), and the awareness of the political implications of revealing that truth. Blind faith in science's willingness to reveal that truth might well be tempered by the words of Oscar Wilde; "the truth is never pure, and rarely simple".
The fact sheets produced from the workshop, along with earlier drafts of this report have been distributed at many health and environment related conferences, and incorporated into the fact sheets put together by community health centres in Toronto.
IPEN, PAN and WABA: Watching Our Language (2000-2001)
Following the workshop and various meetings, a decision was reached to produce a more comprehensive document for use internationally to be developed with global networks such as the Pesticide Action Network (PAN) and the International POPs Elimination Network (IPEN). This process was slower and more difficult because wording had to be renegotiated with several groups with very different approaches to this issue.
With the best intentions, groups with very similar approaches to the world - like IPEN and WABA - still had great difficulties developing a joint statement about breastfeeding and chemical contaminants. Initial efforts to produce a joint statement were not well received by some breastfeeding advocacy groups who preferred not to "wake sleeping dragons". On the other hand, breastfeeding advocacy groups know that they cannot avoid addressing the issue of chemical contaminants in breastmilk. As Steingraber, who participated in the delibrations, wrote:
...a failure to acknowledge the unique position of the breast-fed infant within the ecological world prevents us from having a public conversation about a very real problem: the biomagnified presence of persistent toxic chemicals in breastmilk. (2001:251)
Working together across different agendas requires both trust and trade-offs. The joint statement by participating organisations of WABA and IPEN went through many versions - gradually expanding beyond its one page format to more than four pages, and eventually contracting down to a single page. Even with several face- to-face meetings and six months of email consultation, not all groups consulted were willing to endorse the statement (see Appendix 2). To have both Greenpeace International and the Swedish Mothers' Support Group (Aminingshjalpen) endorse the statement, in the light of disagreements between them over Greenpeace's recent public installation in Stockholm displaying breastfeeding mothers and babies in a glass cases with over 300 contaminants listed on the glass wall, attests to the willingness of groups to set aside their differences to reach common goals - to reduce the chemical contamination in us all.
IBFAN: Collaboration, but Regionally and Cautiously
IBFAN (International Baby Food Action Network) groups have been working for many years with ecological groups in different countries on this topic. In Belgium, Bulgaria, and Luxembourg for example, good working relations have been built up over the years with these groups. The aim of their collaboration is to counter the use of breastmilk as a yardstick for measuring pollution in their national campaigns. The IBFAN statement of December 20, 2000 (appendix 3) is a guideline for groups and is meant to be adapted to national and local conditions. The statement was developed by the IBFAN working group on Contaminants in Baby Foods, translated from French, and reviewed by the toxicologists of the International Programme on Chemical Safety at the World Health Organization.
IBFAN groups in different countries use the statement to help them move from 'damage control' after media scares, to 'disaster preparedness' to be ready to counter media reports about breastfeeding and chemical residues before damage is done. Some IBFAN groups also endorse the WABA/IPEN joint statement; others prefer to continue to work quietly with local environmental groups until the need for action arises. The statement is currently available in English, French, Arabic, Spanish and Portuguese.
Breastfeeding and Environmental Social Justice Advocates at Work *(pdf)
Risks, Rights and Regulation: Communicating about Risks
and Infant Feeding