FFF Sarah, who is currently trying to induce lactation for her upcoming adoption, emailed me this afternoon with an interesting question:
So, I’m pumping all of this crap into my body in an attempt to see if I’m able to lactate.
Today, I was telling my husband why I buy x-type of dairy milk (b/c it doesn’t have rBGH)…I read him this tidbit from the dairy’s page:
rBGH is “recombinant bovine growth hormone” and also known as recombinant bovine somatotropin (rBST). Developed by Monsanto Corporation, rBGH is an artificial hormone that causes cows to artificially increase milk production.
We love our cows and believe that pure, natural milk tastes best and is healthiest for you. Here at Brown’s, our cows are not treated with artificial growth hormones like rBGH.
He said…”um…isn’t that what you’re doing? Taking stuff to artificially increase milk production? How is that good for a kid then?” I said I thought the ingredients were better, but honestly…I don’t know. Is it better? Do we know the danger of Reglan or Domperidone or Fenugreek or Blessed Thistle or any of the other crap we take in order to make milk or more milk for our babies?
Honestly, I had no idea how to answer this; however, I thought it was one of the most interesting questions I’d ever been asked. Even the mere concept of rBGH-free milk is worth talking about, and I can’t believe I’ve never thought about it before. Of course, we’ve discussed the fact that breastmilk can be a veritable smorgasboard of chemicals; in fact, scientists use this particular bodily substance for bio-monitoring (a way of measuring how many toxins are being stored in the human body). Typically, this concern is squashed by folks telling us not to worry, breastmilk is so amazing that it counteracts or cancels out all the bad stuff, or yelling at us not to peek at the man behind the curtain, like the titular dude in Wizard of Oz. (Read this article from Mothering.com to gain a frustrating, bang-your-head-against-the-wall understanding of why some breastfeeding advocates are fighting the trend of using breastmilk in bio-monitoring.)
So, isn’t it kind of funny that everyone is so concerned with the mercury in fish; the hormones in beef and milk… and not the food our own bodies produce?
There is ample proof that what we eat, breathe and absorb goes through our breastmilk. In fact, the NRDC has an entire website dedicated to the chemicals present in breastmilk, and they admit that “infant formula contains far lower quantities of dioxins, PCBs and organochlorine pesticides than breastmilk”. Of course, they go on to assure mothers that “formula has serious drawbacks that tip the scale against it”, and then list all the “risks” we have discussed on this blog, time and time again. The chemical contamination dangers they cite pertaining to formula are “contamination with substances such as broken glass, fragments of metal and salmonella and other bacteria. The fungal toxin aflatoxin has also been detected in some commercial formulas. Although detected levels were very low, this toxin is known to cause cancer and is not present in breast milk. Infant formulas also may contain excessive levels of metals, including aluminum, manganese, cadmium and lead.” However, many of these contaminants are avoidable if we could improve manufacturing processes; the first few listed, when discovered, led to recalls.
The important message here should not be choose formula over breastmilk, or vice versa. It should be, let’s all become more aware of the chemicals our babies are exposed to. Formula is a product; if we want to discuss the chemical contaminants in formula, we can address manufacturing processes, corporate responsibility, quality assurances, ingredient sources, etc. If we want to discuss the chemical contaminants in breastmilk… well, chances are we won’t be discussing that, because its tantamount to yelling fire in a crowded movie theater. Us girls are, like, panicky and hysterical, dontcha know?
Back to the original question which spawned this post, though. It’s one thing to worry about chemicals we have no real control over; quite another to discuss intentionally ingesting something potentially harmful to increase milk supply or induce lactation in the name of Liquid Gold. But could Reglan, Domperidone, Fenugreek, or Blessed Thistle really be harmful? Doctors prescribe them for nursing women all the time, and these folks would never prescribe something that they don’t know 100% for certain won’t harm a baby, right?
(Pause for diabolical laughter…)
Fenugreek and Blessed Thistle are probably the least concerning of these substances, as they are herbal remedies. However, while NIH’s Medline Plus cites “increasing breastmilk quantities” as one of Blessed Thistle’s uses, they also warn, “Don’t take blessed thistle by mouth if you are pregnant. There is some evidence that it might not be safe during pregnancy. It’s also best to avoid blessed thistle if you are breast-feeding. Not enough is known about the safety of this product” and list “irritat(ion of) the stomach and intestines” as a possible side effect. As for Fenugreek, Kellymom warns that while “(m)ost of the time, baby is unaffected by mom’s use of fenugreek (except that more milk is usually available)”, sometimes “baby will smell like maple syrup…some moms have noticed that baby is fussy and/or has green, watery stools when mom is taking fenugreek and the symptoms go away when mom discontinues the fenugreek. Fenugreek can cause GI symptoms in mom (upset stomach, diarrhea), so it’s possible for it to cause GI symptoms in baby too.” A search on WebMD’s database found that “(s)ome reports have linked fenugreek tea to loss of consciousness in children”.
(I feel I should interject here to remind everybody that just like everything else we discuss on here, we should look at these warnings in terms of relative risk. If you read the possible side effects on a bottle of Children’s Advil, it’s a hell of a lot scarier. I’m merely trying to illustrate a point, so bear with me, please, and don’t panic if you’ve been binge-drinking Fenugreek tea.)
Reglan and Domperidone carry more severe warnings. Reglan is one of those drugs that repeatedly come up on litigator’s websites (never a comforting sign), and it has been suggested that it can cause a condition called Tardive Dyskinesia. As one of the litigators explains, “Before Reglan was released, the FDA only approved its use for 12 weeks at a time, which means that women who are breastfeeding are at an even higher risk for developing TD because of the timeframe spent breastfeeding.” (Ironically, I found a really great opinion piece about the relative risks of Reglan on another of these lawyer sites. Go figure.) Perhaps a more real-world concern – and definitely one that worries me a great deal, what with PPD being such a real threat to new moms – Reglan is also linked with depression.
Domperidone, a drug typically used for cancer patients or those with gastrointestinal issues, does seem to be a safer bet, although on a UK site detailing the prescription use of Domperidone, it clearly states that “this medicine passes into breast milk in very small amounts that are not expected to be harmful to a nursing infant. However, the medicine is not recommended for use in women who are breastfeeding unless the potential benefit to the mother outweighs any risks to the nursing infant. Seek medical advice from your doctor.” If that doctor happens to be breastfeeding guru Jack Newman, you’ll be reassured that it is indeed safe (“Worldwide experience with domperidone over at least two decades suggests that long-term side effects also are rare. Some of the mothers in our clinic, breastfeeding adopted babies, have been on the medication for 18 months without any apparent side effects…patients using domperidone for stomach disorders may be on it for many years. I hope you won’t need domperidone for very long, but if it’s necessary and helpful, stay on it,” he breezily suggests, adding links to back him up (nearly all of which are dead links, btw, save for one study which simply proves that Domperidone increases milk supply. Sort of a moot point, don’t you think?)
If a mom needed to take either of these drugs for a medical condition, I would think the benefits absolutely outweigh the risks. Aside from the depression risk, neither seems to be that scary, especially when you consider Reglan was discussed as a potential therapy when my infant daughter was suspected to have delayed gastric emptying (so one would hope it isn’t all that toxic to babies).
But we’re talking about selectively consuming these drugs in order to do something which is often marketed to women as the “natural” choice, the “biological norm”. If a woman wants to breastfeed, I would totally understand her desire to try these drugs, and more power to her. If a woman feels like she has to breastfeed, and has to take these medications in order to fulfill her biological and maternal responsibilities, that’s another story. And regardless, let’s stop the hypocrisy and ignorance so prevalent in the way we view and discuss breastmilk. If it is full of chemicals, the answer is obviously not to discourage breastfeeding, but shouldn’t it also be obvious that we can’t ignore the problem? Likewise, if someone has to take medication in order to breastfeed, we need to support her in her goals in whatever way we can, but we also need to ensure that she has adequate research on her side that proves she is not putting herself or her baby at risk.
Breastmilk, left to its own devices, is one of the most amazing and purest foods in the universe. Unfortunately, we live in a time when pretty much nothing has been left to its own devices. Nobody is saying that breastfeeding isn’t worth it, but in the world we currently inhabit, I don’t think we should view breastmilk as unadulterated, absolute perfection. It can be corrupted, like any biological substance.
So, FFF Sarah’s husband… I’m not sure what the answer to your question is, exactly. But I can tell you that while writing this, this image kept running through my head of one of those “Not treated with rBST!” messages stamped on a nursing bra. Thanks for that, buddy.