I find some of the little tidbits of information on Lactnet so interesting,
then I start thinking about these tidbits and questions start popping into
my head and I just can't resist the urge to ask.

After Rachel Myr's comments about cod's liver oil in Norway, I realized I
had not thought through what happens to mercury distribution in the body
and had just assumed that everything evil and toxic ends up in the fat and
liver (even though my long forgotten and/or suppressed biochemistry tells
me otherwise).  So, I decided to try to look up as much as I could on what
happens to mercury distribution in the body and burned the artichokes I was
fixing for dinner. So, I decided it was time to stop investigating this
topic and give it a rest.

What I did find out from the Food and Drug Administration background
reference documents before the artichoke episode was:

1) Yes, methyl mercury is distributed throughout the body (meaning also fat
and liver) but is not concentrated in the liver - it is concentrated in the
kidney.  I already knew it had a short half life of two weeks from other
sources.
2) Methyl mercury is lipid, not water soluble.  However, I did not get far
enough into the literature to find out whether or not the long-term boiling
practiced in Norway might still get rid of the methyl mercury.

Also, Rachel importantly pointed out something I had not made clear.
Vitamin A is found in fish liver and oils and cod's liver oil is an
excellent way of avoiding vitamin D and A deficiency. Fish by itself
(including cod) is not considered exceedingly rich in vitamin A.

The FDA report refers to fish in the United States, not Norway.  So, there
could very well be differences in contamination of cod between the two
countries.  The FDA report did mention that cod can be eaten once a month.
I wish I had as much faith in our vitamin and mineral supplement industry
in the United States as the industry in Norway.

So far, I find the research on autism and mercury to be extremely
speculative and I'm assuming that there will be much more research and
controversy before the most likely multicausal mechanisms leading to autism
are fully understood. I guess I did wonder whether one could go overboard
trying to cure or reduce the effects of autism by giving large amounts of a
substance that might contain a chemical suspected by some to cause it and,
even if future research shows that it doesn't cause autism, large amounts
of mercury do have negative neurologic effects.

I think the FDA report is helpful to pregnant and breastfeeding women in
the United States for striking a balance between getting adequate DHA in
their diets and avoiding excessive amounts of mercury.  Clearly its not so
helpful for many others of you who are not in the United States.

Now, what I really need to focus on is learning how to do a better job of
oral assessments. Apart from tongue humping and retraction, I find all of
the rest to be extremely subjective and difficult.  I was in a total state
of despair about my skills on Wednesday when I felt what I thought was low
lip tone on a premie who was very difficult to arouse.  My supervisor
assessed the same infant once he was more awake and hungry and his lip tone
was just fine. Seems so obvious now in retrospect that behavioral state
could affect tone.

Susan Burger, PhD, MHS

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