Sandra,
I really appreciate the time and references you have given in regard to
toxins in human milk.  And I hope to access those articles and read them in
order to better understand the situation.  But I have a number of problems
with some of your comments.

Your comment about Sweden having one of the highest breastfeeding rates in
the developed world  and having a wonderful government lab to monitor
breastmilk sounds very positive.  Unless one also understands that of all the
developed countries in the world, only Sweden has made breastfeeding illegal
for hiv positive mothers.  This should serve the rest of us with fair warning
of what it means to monitor breastmilk.  While hiv is not a toxin, it
certainly seems telling to me that the country that does the most monitoring
of breastmilk, is the country who sees fit to make it illegal for mothers who
happen to test positive for hiv. (it's not illegal in the US just discouraged)

Your question about mothers giving up breastfeeding solely based on knowledge
about the contaminants their milk contains is rather useless because most
women don't get their milk tested.  But I am sure that will change.  Based on
the number of women in my area who are told to quit because they are on a
round of antibiotics (amoxicillin no less), I would say that we will be
facing an enormous problem once testing of breastmilk becomes common.

It is my understanding that PCB's are absorbed through the skin, the lungs
and the gastrointestinal tract with the GI tract the primary source of these
contaminants. What is a formula fed infant's sole source of food--formula and
water, right.  In the newborn infant who gets no breastmilk, their gut has no
protective coating against pathogens or toxins.  So why wouldn't water be a
major route of PCB's for young infants?  By the way none of my breastfed
infants drank tap water for that matter any water until they were in the 6-12
month range (and I live in Florida).  Which leads me to a major point in
regard to the research you think needs doing.

Why compare infants drinking "contaminated" milk versus "uncontaminated"
milk? (you mean human milk right?)  The comparison that has to be made is
between the health and well-being of infants drinking exclusively breastmilk
in a given environment (such as the Great Lakes area in the USA--one of the
most contaminated areas) versus the health and well-being of infants drinking
exclusively infant formula  in the same environment.  Blood samples of
infants at birth for PCB's and at regular intervals would be important.  All
drinks and foods should be documented.

I find your statement that the "risk-benefit analysis always show that breast
is best as long as the contaminants in breast milk kill only 3,999 children
or fewer each year," rather inflammatory.  Sorry, I have yet to see any data
that showed that breastmilk killed children.  Risk-benefit analysis is a game
too many researchers play and is not the same as reality.

The real problem in research is the definition of exclusive breastfeeding
(many researchers include infants who have water as exclusive breastfeeding)
and this is critical to accuracy of findings.  If, as I suspect, that water
might be a leading route of toxins for infants, then the definition would be
mighty important.  Few infants in the US are exclusively breastfed (no water,
no supplements).  Sadly what we test is breastmilk for contamination, yet it
is only 2% of infants in the USA that exclusively receive human milk.  The
other 98% get a mix of human milk and formula with some 40% exclusively
receiving formula.  Does this make sense?  One would suppose that one would
test the substance most often used by infants... and sad to say that is not
breastmilk in the USA.

What do the numbers mean anyway?  I just read an article by a researcher on
PCB's who said that the high numbers do not in any way seem to relate to
health effects in people.  Some people can have low numbers and be sick and
others can have high numbers of toxins in their blood stream and seemingly
not be sick.  So does the high numbers in breastfed infants mean anything?

The only true way to determine that toxins are being transferred by
breastmilk to infants is to look at exclusive breastfeeding (no water
supplements) and exclusive formula feeding.  Not only test the milks for
toxins but test the blood levels and also observe for health effects in each
group.  The other problem in testing human milk is that toxins concentrate in
the fat and we know that fat in women's milk is the most variable
component--so one cannot get one reading and suppose that is the number.  The
other problem is finding out how much of the toxins were transferred during
pregancy.  It has only been in the last few years that researchers have begun
to recognize the necessity of defining breastfeeding.  Lots of issues and
lots of complicating factors to consider.

While I support strongly the cleaning up the environment, I really worry
about the words and  evidence we use to persuade people that this is a
problem.  Valerie W. McClain, IBCLC

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