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How an emergency medicine physician chooses baby food for her kids


Feeding a baby is something a parent must do multiple times a day, every day, and yet it can be one of the most confusing and stressful things that any parent does.

Homemade baby food could potentially pose the same problems as store-bought when it comes to heavy metals, according to one advocacy group's analysis that has not been vetted through the normal scientific review process.

Toxicologists say that at very low levels, heavy metals are unlikely to pose a serious health threat.

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Hand spooning baby food.

But making the issue even more complicated is that a safe level of heavy metals in foods for children has not yet been established, according to Dr. Stephanie Widmer, an ABC News medical contributor, board-certified emergency medicine physician and medical toxicologist.

Widmer said research into heavy metals in baby foods is in the early stages, and that the Food and Drug Administration and other government agencies are working on initiatives to test the levels of heavy metals and establish safe levels.

In the meantime, she acknowledged it is a confusing and sometimes scary time for parents.

"This can be a lot of overwhelming information for parents," said Widmer, also a mother of two children, ages 3 and 5. "There are just a whole lot of unknowns."

What to know about heavy metals in baby foods

Exposure to toxic heavy metals poses a specific risk to toddlers and infants because they absorb more than adults and their brains are still developing, according to the National Institutes of Health.

Even low levels of lead in blood may go on to affect IQ, a child's ability to pay attention and academic achievement, according to the American Academy of Pediatrics.

"The concern is not that the amount that's in baby foods or the amount that babies are consuming is going to make them acutely sick," Widmer said. "The concern is long-term effects on neurodevelopment, brain function, possibly the long-term risk of cancer down the road, and it's really difficult to establish what levels are increasing your risk for danger. "

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Experts, including Widmer, point out that heavy metals are naturally occurring and are found in all of our foods, which makes it hard to tell parents a specific type or brand of baby food to avoid.

"Rattling off a list of which ones are safe, which ones are not would be probably impossible," Widmer said. "Because everything really out there has some level of heavy metals in it. It's in the soil and things that grow in the soil."

In order to suffer detrimental effects, a person would have to be exposed to toxic heavy metals for a prolonged period of time. Periodic ingestion of the levels found in baby food products would generally not be considered dangerous.

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Jars of baby food are seen here.

Diagnosing heavy metal poisoning can also be difficult and symptoms may be easy to miss. Those symptoms include things ranging from dehydration and abdominal pain to changes in behavior, weakened bones, anemia, numbness and weakness, and edema, according to the NIH.

The American Academy of Pediatrics recommends screening for elevated lead levels in children 9 to 12 months old, and again around age 2.

Therapies to help children who have been overexposed to heavy metals are available, experts say.

MORE: Some popular baby foods contain 'significant levels' of toxic heavy metals, report says

There are also steps that parents can take to limit their child's exposure to heavy metals, according to Widmer.

What parents can do

Here are four things Widmer said she did when her two children were in their baby food stages.

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1. I varied my kids' diets.

"I made sure there was variability in their diet," Widmer said. "Heavy metals are in everything, so if you're not eating the same thing, the same food group every day, you are decreasing your risk."

Widmer said varying her kids' diets included switching back and forth between feeding them homemade baby food and store-bought baby food, as well as frequently rotating the types of foods they were eating.

"Bananas one day, baby spinach another day and just making sure that variability is there," she said. "Not getting the same repeat exposure to the same food and whatever compounds are in that food is the best thing that parents can do."

2. I didn't lose sleep over it.

"Parents of little ones have plenty on their plate already, they have plenty of things on their minds and plenty of things to worry about, and I would not put this at the top of the list," said Widmer, who noted that babies only eat baby food for a short period of time. "I would not lose sleep over this."

She continued, "It's something that is being paid closer attention to and will be regulated more and more and more, and parents shouldn't feel pressure. The thing you can do is pay more attention to the variability in the diet."

3. I tried to avoid a few key foods.

"Rice tends to have a lot of high levels of heavy metals," Widmer said. "So avoiding foods and cereals that are rice-based is probably best practice."

In addition to rice, Widmer said she also recommends trying to limit foods that grow in the ground, like carrots, potatoes and sweet potatoes, as they can be exposed to heavy metals in the soil.

Widmer said parents shouldn't skip those foods entirely, but rather ensure they are not a daily staple in a baby's diet.

4. I washed foods when I made homemade baby food.

"If you are making baby food at home, really washing the foods beforehand helps," she said. "If you are going to use a rice-based cereal or rice-based food, really soaking the rice and washing it with boiling water after would help. "

Widmer also recommends that parents wash their baby's hands before they eat, too.

'High levels' of toxic heavy metals found in baby food: Report

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Consumer Reports claims heavy metals were found in popular baby foods

By Katie Kindelan


Several popular baby food brands contain "high levels" of toxic heavy metals -- and they are not doing enough to stop the practice, according to a new report released Wednesday by a U.S. House Oversight subcommittee.

Brands including Gerber, Plum Organics, Beech-Nut and Walmart are named in the report, which calls on baby food manufacturers to begin voluntarily testing their products for toxic heavy metals and to phase out products that contain large amounts of ingredients that test high in toxic heavy metals.

The report also calls on the U.S. Food and Drug Administration (FDA) to hurry in releasing its standards for heavy metals in baby foods and to, in the meantime, require baby food makers to test their finished products for heavy metals.

"Today's report reveals that companies not only under-report the high levels of toxic content in their baby food, but also knowingly keep toxic products on the market," Rep. Raja Krishnamoorthi, D-Ill., chairman of the Subcommittee on Economic and Consumer Policy, said in a statement. "The facts speak for themselves, and the fact of the matter is that the baby food industry has consistently cut corners and put profit over the health of babies and children."

The FDA announced in April its Closer to Zero plan, which has a goal of reducing exposure to toxic elements in foods eaten by kids and babies "to the lowest possible levels."

In response to the call to action in the subcommittee's report, the FDA told ABC News it plans to announce "soon" the date for a public meeting that will "address questions around the scope of the Closer to Zero plan."

"We have continued our sampling to help inform our process to set levels, and we are working to strengthen our relationships with federal partners, industry and advocates to ensure that we make meaningful and lasting reductions in exposure to toxic elements from foods," the FDA said in the statement.

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In some cases, some of the baby food products analyzed carried as much as 91 times the allowable arsenic level, 177 times the lead level, 69 times the cadmium level and up to five times the mercury level, the report said.

Exposure to toxic heavy metals poses a specific risk to toddlers and infants because they absorb more than adults and their brains are still developing, according to the National Institutes of Health (NIH).

MORE: Beech-Nut to stop selling a specific baby rice cereal because of arsenic levels found in some test samples

Experts point out though that heavy metals are found all over, and in order to suffer detrimental effects, a person would have to be exposed to toxic heavy metals for a prolonged period of time, and a one-time ingestion of the levels found in baby food products would not be considered dangerous.

The American Academy of Pediatrics (AAP) recommends screening for elevated lead levels in children 9 to 12 months old, and again around age 2.

The AAP also has guidelines for parents to help shield their children from toxic heavy metals, which enter food through water and soil as well as from during the manufacturing and packaging processes.

In the new report released Wednesday, the subcommittee says Beech-Nut recalled just two of its six infant rice cereal products that tested over the FDA's limit of inorganic arsenic earlier this year, while Gerber did not recall either of its two products that also tested over the limit.

In response to the report, a Beech-Nut spokesperson told ABC News in a statement, "Our process of manufacturing baby food does not contribute heavy metals to the final product. Heavy metals are found naturally in our environment. They are in the soil, the water, the air—and are therefore unavoidable in our overall food supply."

As part of its continuous improvement practices, Beech-Nut continues to work with the FDA to identify the best practices, which may include "finished product testing," according to the statement.

Gerber told ABC News that it is "committed to reducing the levels of heavy metals in our baby foods to the lowest levels possible."

"The FDA made us aware of their contact from the State of Alaska about a sample of our rice cereal that tested slightly above the guidance level for inorganic arsenic set by the FDA, and was referenced in the report. The FDA retested the sample, was unable to confirm the result by Alaska and confirmed to Gerber that no action was needed," the company said in a statement. "While the Subcommittee report notes proposed limits on specific heavy metals, those are based on proposed standards from the Baby Food Safety Act, which are not current law or regulation. All Gerber foods have and continue to meet all applicable guidelines and limits set by the FDA, the governing body for safety regulations in the food industry."

The subcommittee report also names Plum Organics, whose products it says are "tainted with high levels of toxic heavy metals." It also calls out Walmart for weakening its arsenic standard in baby food products, calling the decision "an extreme course reversal on efforts to protect babies' neurological development. "

Sun-Maid, which purchased Plum Organics in May from Campbell Soup Co., did not respond to ABC News' request for comment.

Campbell Soup Co. told ABC News that it continues to "support the FDA's efforts in setting clear and specific science-based federal standards."

"For more than 150 years, Campbell has placed the safety of our consumers above all else," the company said in a statement. "We have cooperated with the subcommittee throughout this process and will continue to do so. In fact, we released the data highlighted in this report in February 2021 and published it on our web site at that time."

Walmart said in response to the report's findings that it has "always required that our suppliers' products meet the guidelines established by the FDA."

"Our specifications have always been aligned with or below the FDA requirements for naturally occurring elements and the FDA noted in April that its testing shows that children 'are not at an immediate health risk to exposure," Walmart said in a statement to ABC News. "We are encouraged the FDA launched a collaborative process to establish science-based standards for infant and baby foods and look forward to further guidance."

Hungry children of the superpower: the US is facing a baby food crisis

The country lacks food for the little ones - the supply of infant formula has almost halved. Parents are encouraged to temporarily use cow's milk to feed their babies, but if possible, not to do so for a long time. Mothers dilute mixtures, feed their children less, spend several hours a day looking for food for their babies. Urgent flights of military aircraft deliver shipments of baby food from abroad by order of the President.

Empty shelves for baby food in a New Jersey store, USA

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All of this is not a reality in any third world country, but the daily life of the last weeks of many families in the United States. The causes of the crisis are exclusively internal - monopoly in the economy, plus excessive, but, as it turned out, ineffective state regulation, as well as protectionism.

A real American taste

In February, when the US administration began mobilizing support for Ukraine from the West, as well as increasing sanctions pressure on Russia, the news about the shutdown of the plant for the production of Abbott infant formula in the town of Sturgis, Michigan, passed almost unnoticed. Only about 10 thousand people live in Sturgis, located between Chicago and Detroit, and hardly anyone would remember this town if it were not for the plant. Abbott controls about 42% of the US infant formula market, and half of its products are made at this facility - the largest in the country in this area.

The story began with the fact that four children were poisoned by mixtures from the plant, two of them fatally, and the enterprise temporarily stopped working. So the market lost about 20% of the supply.

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The situation was aggravated by other circumstances closely related to the peculiarities of the economic and state structure of the United States. The Federal Food and Drug Administration (FDA) could not agree on the opening of the enterprise for three months. And prohibitive trade tariffs, which were introduced to support American companies like Abbott, prevented exports from replacing their missing products - Abbott and three other similar corporations together control 90% of the US infant formula market. Another factor was that current social assistance programs in a number of states provide benefits to needy families, by virtue of contracts in force with Abbott, only when purchasing products from this manufacturer.

It is also worth noting that breastfeeding is not common in the US, as there is no paid parental leave. And measures to promote breastfeeding in the workplace have had limited impact and are more of a symbol of corporate progressiveness than widespread support for mothers, especially when it comes to low-paying jobs.

An invisible crisis

The baby food crisis lingered for three months before hitting the front pages of the newspapers and becoming a topic of discussion in Congress (while, for example, Ukraine's legislature had already approved several billion military aid). Parents bought up all the available stocks and in a matter of hours they are sorting out new batches. Stores were forced to impose restrictions on the volume of sales of mixtures in one hand, but the shelves are still empty.

If there was a 2-8% monthly mix shortage at the Sturgis plant closure due to supply chain disruptions from the COVID-19 pandemic, then in April this figure rose to 30%, by May 8 - up to 43%, by May 15 - 45%.

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The crisis developed, but did not attract much attention of the middle and rich sections of society, until the deficit grew enough to affect everyone. In large cities with a large number of retailers, which close numerous supply chains from different manufacturers, it is still possible to find the right product, although this may take some time, and salaries are usually higher there. The situation is much worse in small towns or ethnic enclaves, where there is often one large supermarket for thousands of inhabitants, which has contracts with a limited number of suppliers (for example, this was the Tops supermarket in Buffalo, where a white supremacist shot ten people on May 14) . The hardest hit are the poor, members of racial and ethnic minorities, living in disadvantaged areas with poorly developed infrastructure and dependent on federal or municipal social programs.

In recent days, another explanation has been voiced for why the crisis has been left unattended for a long time - despite all the talk in the United States about gender equality, gender roles and distribution of responsibilities, it is women who feed the children, and it is mostly men who make decisions and occupy leadership positions. In the current composition of the US Congress, only 144 of 539 seats (27%) are held by women - this is the maximum number in the history of the American legislature.

Who is to blame and what to do

Only last week, the federal authorities noticed the growing crisis. The White House ordered to organize an urgent delivery of infant formula from abroad, involving military aviation in this. Thousands of tons of baby food have already arrived in the United States over the weekend from the Ramstein base in Germany. Families in need who cannot afford subsidized formula were promised new benefits. The FDA has received an additional $28 million to improve the way it inspects and approves US and foreign products. The FDA has already agreed to reopen the Sturgis plant from this Monday, although it could be weeks before new formulas hit the shelves. US President Joe Biden activated the Defense Production Act of 1950, which allows the federal government to directly intervene in the production and distribution of products. Such measures have already been practiced in the event of shortages in the past.

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The search for the guilty began. The Speaker of the House of Representatives, the leader of the Democrats in Congress, Nancy Pelosi, threatened Abbott with criminal prosecution - after all, it was precisely because of their problems in production that the plant stopped. However, these are only assumptions - at a congressional hearing, an FDA representative said that the investigation into the incident with the poisoning of babies has not yet been completed. He also did not answer about the reasons for the three-month-long inspection of the plant, again referring to the secrecy of the investigation.

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Republicans traditionally blame Democrats: federal regulator failed in mission; democrats, boasting of being close to the people, cannot feed children in poor families. In fact, this new crisis is the very last thing the Democratic Party needs ahead of the midterm elections this fall. She responds with accusations against large corporations like Abbott that have destroyed competition, are trying to interfere with government regulation, and also seek tax breaks at the expense of voters.

Now that the problem has come to the attention of the federal authorities, it is to be expected that it will be resolved more or less quickly. Aircraft will bring baby food from abroad, redistributing supply chains will allow it to be sent to the most needy parts of the country. However, the baby food crisis was, of course, another reminder of the need to modernize the US economic and government system - bringing government regulation, tariff policy, antitrust measures, social support systems in line with the requirements of the time. Biden talked a lot about the fact that the system should first of all serve the interests of ordinary Americans, but this was during the election campaign.

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There is an acute shortage of powdered formulas for baby food in America

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The situation with infant formula has become so critical that Senator Tom Cotton has already called it a "national crisis", Congress began an investigation, and President Biden was forced to announce measures to curb the deficit.

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Deliveries of infant formula to stores have been so reduced that large retail chains and pharmacies are forced to limit the number of cans "in one hand." For example, CVS and Walgreens only sell three packages of dry mix at a time. According to Datasembly, a company that tracks price indexes and sales of various products, in the first week of May, the lack of milk formula in warehouses across the country was 43% (for comparison, in April - 40%, and in November last year - 11%). Worst of all is the situation with warehouses in the states of Iowa, South Dakota, North Dakota, Missouri, Texas and Tennessee. Accordingly, prices rose sharply - by 18%. On eBay, some savvy sellers offer a $200 can of powdered formula, and there are sure to be buyers: in the US, three-quarters of children receive either full or partial formula in their first six months of life. Worst of all are those families whose children, for medical reasons, cannot eat anything other than these mixtures.

Abbott fights bacteria

What caused this crisis? The official version, which we already wrote about: in February, the Food and Drug Administration (FDA) stated that certain mixtures of Similac (Similac), Alimentum (Alimentum) and EleCare (EleCare) are contaminated with the dangerous bacterium Cronobacter sakazakii, which can lead to death. Four kids were hospitalized, two died. Abbott Nutrition has announced a voluntary recall of some batches of this baby food that was produced at its plant in Sturgis, Michigan (these powdered formulas were found to be contaminated). In early March, several more dry mixes produced at the same plant were recalled due to Salmonella contamination.

Bacteria in baby food is not uncommon. Back in 2004, the Codex Committee on Food Hygiene (CCFA) of the World Health Organization revised the International Code of Hygienic Practice for Foods for Infants and Older Children, tightening the requirements, including due to cases of contamination of mixtures with bacteria. A review of Abbott's records shows that the company has had to destroy batches of premixed formulas in the past due to the presence of Cronobacter. In addition, in February, the FDA emphasized that the recall only applies to dry powder from certain batches, and does not apply to liquid infant formula and other baby foods manufactured by Abbott Nutrition. In other words, it is hard to imagine that a temporary shutdown of the production line of several (!) dry mixes at one plant can lead to such a large-scale national crisis. Not to mention the fact that other manufacturing companies were not affected by the recall, and they continue to produce their products.

Furthermore, the company's official statement dated May 11 states: “After careful examination of the situation, there is no evidence that these cases [infant deaths - Ed.] are associated with the consumption of our baby food; the bacterium Cronobacter sakazakii, which was found during testing, was in areas not in contact with products. The bacterial samples found at the plant did not match the strains found in the babies' tests. An Abbott spokesperson also said that all products tested for Cronobacter sakazakii and Salmonella were negative and that no Salmonella was found at the Sturgis facility during the investigation.

However, the FDA insisted that infant formula was produced in unsanitary conditions, and Abbott's internal records showed that the company destroyed some of its products due to bacteria in the factory. On May 16, Abbot reached an agreement with the FDA that allowed the production lines to restart. The company reportedly acknowledged the unsanitary conditions at the plant and is committed to rectifying the shortcomings. In addition, Abbott has agreed to engage external experts who will develop a plan to reduce the risk of bacterial contamination at the plant and conduct periodic assessments to ensure the company is in compliance. In the event that any products again test positive for bacteria, the company will be required to dispose of them and stop work until the source of infection is eliminated. If Abbott does not comply, it faces $30,000 in damages per day of violation (up to $5 million in annual fines). The terms of the agreement are valid for at least 5 years.

FDA chief Robert Kaliff stated, "The public can be assured that our FDA will do everything possible to ensure that baby food continues to meet safety and quality standards." The agreement between Abbott and the FDA has been approved by the US District Court for the Western District of Michigan. However, it’s too early for parents to rejoice: Abbot said that a restart is possible within two weeks, and mixtures will appear on store shelves no earlier than in 6-8 weeks.

Disrupted logistics and monopolies

Another reason that is less talked about is disruptions in the supply chain. Everything affects: a critical shortage of labor (which we have already written about more than once), problems with the production of packaging and transportation. All this together affects the production and distribution of goods. According to Datasembly CEO Ben Reich, "the economic situation affects this category of goods more than others."

The crisis has reached such proportions that even the federal authorities were forced to react. On May 12, President Joe Biden met with representatives from Walmart, Target, Reckitt and Gerber to discuss ways to reduce the deficit. He also instructed the Federal Trade Commission to use its powers to monitor allegations of price gouging and the Justice Department to work with state attorneys general to crack down on retailers who took advantage of the situation.

On May 13, the House of Representatives Oversight Committee announced the launch of an investigation into the baby food situation. Letters were sent to all four manufacturers asking them to explain how they plan to handle the crisis and what they are doing to prevent this from happening in the future. In addition, the Committee will also investigate allegations received from consumers of price gouging. The meeting of the Committee on this issue is scheduled for May 26.

At the same time, the recall of goods for one reason or another is a common occurrence. Thousands of medicines and products are withdrawn from sale every year, and yet there is no nationwide crisis, and sellers do not restrict the sale of essential items in the spirit of Soviet trade.

Four large companies now control 90% of America's supply of infant formula: Abbott, Mead Johnson, Gerber and Perrigo Nutritionals. Abbott, which makes Similac, and Mead Johnson, which makes Enfamil, have nearly 80% of the market. Mead Johnson has already stated, “We have taken steps to ramp up production of Enfamil and are currently shipping 50% more products to address consumer concerns as quickly as possible.” Considering how the prices for dry mixes have risen, the crisis is beneficial for all manufacturing companies.

Importing baby food will be easier

Another factor in the crisis is America's regulatory and trade policies. The FDA regulation of infant formula is so strict that most products coming from Europe cannot be bought here due to technical issues such as labeling requirements. There is no question about the quality of European blends: studies have shown that in some respects they can even be better than American ones, because the European Union bans certain types of sugar (for example, corn syrup). The US also restricts the import of formulas that comply with FDA regulations. For large volumes, the import tax for mixtures can exceed 17%. Currently up to 98% of the baby food on the market is made in the USA. And during a crisis, the lack of alternative supplies becomes a rather big problem.

Therefore, for the first time, an unprecedented step is announced - the US intends to increase imports of infant formula in order to reduce the nationwide shortage. Potential importers in the FDA are manufacturers from Australia, New Zealand, the UK and the Netherlands. On May 16, the FDA called on foreign manufacturers to apply to import their products into the United States. It is reported (however, without going into details) that the verification process will be "optimized". White House press secretary Karine Jean-Pierre said that "priority will be given to applications from those companies most likely to be able to prove product quality and be able to get the most baby food to American stores as quickly as possible." Thus, the advantage will be given to large manufacturing companies, which will be able to quickly cover the shortage that has arisen.

However, even if import applications and related documentation confirming the safety of mixtures are submitted, relatively speaking, tomorrow, it may be weeks before the products reach the stores. Once the application is filed, the FDA will still need to review the baby food to ensure quality control to American standards. The import facilitation policy was adopted as a temporary measure for the next six months.

In the meantime, while parents of toddlers are rushing about in search of baby food, politicians from all sides have decided to use the crisis to their advantage. So, Republican Congresswoman Kat Cammack posted a video on her Facebook account about how the federal authorities send packages of baby food to the border with Mexico: “American stores have empty shelves, there is no shortage at the border.” Cammack said the Biden administration should not put the needs of illegal immigrants ahead of the interests of American citizens. Another Republican politician, Rep. Eliza Stefanik, also said it was "absolutely unacceptable" and drew a parallel with Trump's famous slogan, "America continues to be put last." In turn, Democratic politicians Eric Svolvell and Ruben Gallego accused Eliza of wanting to "starve babies" in border centers where illegal immigrants are detained.

Only one thing can be said with certainty: even with the increase in production and the green light for imports, the situation with the shortage of infant formula will not change in the next couple of weeks.

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