What’s In the Baby Food You Give Your Child?

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Studies show that some of the most common baby foods manufactured in the United States contain traces of arsenic, lead and mercury. Exposure to these heavy metals can interfere with a child’s brain development and affect  learning, cognition, behavior and attention. While your child’s exposure to heavy metals from baby food is likely small compared to other sources, it’s still important  to minimize exposure from all sources -- and that includes food. UH Rainbow pediatrician Aparna Bole, MD, tells us how.

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Transcript

Pete Kenworthy

Arsenic, lead, cadmium and mercury. These are all used for various things. And their toxicity level really gives them a bad rap.

Macie Jepson

You know, I looked it up because I was just curious what the redeeming quality of these metals, if you will, really is because they get such a bad rap. So, Pete, cadmium is used in electric batteries. Lead for roofing materials and statues. See, you learn something new every day. Mercury is to manufacture industrial chemicals. Oh, and by the way, that all is in the food we eat, too.

Pete Kenworthy

Yeah. Notably in the food our babies eat.

Macie Jepson

Hi everyone. I'm Macie Jepson.

Pete Kenworthy

And I'm Pete Kenworthy. And this is Healthy@UH. So, I gave all three of my kids baby food. And honestly, I never once looked at the label about what was in it. If it said peas, it was peas. If it said carrots, they were carrots. How about you?

Macie Jepson

I thought about it. Sure. I thought about it. And then I went out and I purchased the jarred food with little hesitation. Now, I will admit, I fretted over what type of formula to use after nursing. That just really bothered me. And I did my homework. But when it comes to baby food, I really just automatically trusted that it would be safe.

Pete Kenworthy

And you look at the Food and Drug Administration, the World Health Organization, they've declared arsenic, lead, cadmium, mercury, all dangerous to human health, particularly to babies and to children who are most vulnerable to their toxic effects. And yet, you know, studies show that some of the most common baby foods manufactured in the United States have these things in them.

Macie Jepson

That’s just crazy to me. I mean, if you're a parent or a grandparent, you are likely confused and obviously worried. I mean, how does this happen? And how do we shop for foods for our babies? What ingredients should we look for? Or should we just make our own? Dr. Aparna Bole is a pediatrician at University Hospitals who is particularly interested in the intersection between environmental sustainability and pediatric public health. She serves as Chair of the American Academy of Pediatrics Council on Environmental Health, on the board of Health Care Without Harm and is a founding advisory council member of the Ohio Clinicians for Climate Action. Dr. Bole, we are so happy that you are with us today. Thank you for joining us.

Dr. Aparna Bole

Thank you. Happy to be here.

Macie Jepson

These ingredients are in major brands of baby food. I mean, seriously, how does that happen?

Dr. Aparna Bole

I think it's important to put the issue of metals in baby food in context. So, the concern about exposure to these metals relates to brain development, healthy brain development, consequences on learning, cognition, behavior, attention. We know there's no safe dose of exposure for these metals. But it's also important to remember that there's a whole context of risk factors and resilience factors that contribute to healthy brain development in children, right? There are environmental exposures. There are also, you know, genetic factors, social factors, access to developmental resources and developmental supports. There's a lot of different factors that come into play when we're talking about healthy development in children. Exposure to heavy metals is one of those factors. Another thing to keep in mind is that the dose of exposure from food is really probably a relatively small amount relative to the other larger risks for exposure to these metals.

So, for example, we need to not lose sight of the fact that in cities like Cleveland, the most common route of exposure to lead is from housing paint and soil. In some communities, it's water. Arsenic: arsenic is both released into the environment as a pollutant and found naturally in soil. So, in communities that have high arsenic levels in their soil, a common route of exposure might be through water, especially if you have well water. So, parents who are concerned about their well water can have it tested by their local health department. It's important to be cognizant of hazards related to lead in housing that was built before 1978, chipping paint, paint dust, paint from or lead from soil that's tracked into the home. I just think that's really important to kind of level set so that we don't lose the forest for the trees. Having said all that there is no safe dose of these metals. And so it's important that we minimize exposure from all sources and that includes from food.

Pete Kenworthy

So, you talk about no safe dose for these metals. What are we talking about in terms of babies ingesting these things, right? Like you see these ingredients in your baby food and then your baby eats them. What are we talking about? Is that a neurologic thing? Is that an organ function? What happens to babies or what can happen to them?

Dr. Aparna Bole

The primary concern is that the metals are toxic to the developing brain. So, that means that this is one of many risk factors that can result in issues like problems with attention, behavior and learning later in life. That's really the primary concern. There are some other issues as well. But when we talk about that exposure in infancy and early childhood, that's really, that's really what's top of mind.

Macie Jepson

Doctor, you talked a little bit about contaminants getting into the soil, but could we go back to that just a little bit and speak specifically about the manufacturing and the pollutants and how they get there exactly?

Dr. Aparna Bole

Sure. I mean, the issue is that these metals can occur naturally in soil, and they can also be released into the environment as pollutants. So, when food is grown within the presence of these metals, they can hang around when the food is harvested and then processed. So, for example, we know that rice is relatively efficient relative to other grains in taking up arsenic. And then that is it's grown in an environment that's high in arsenic, it takes up the arsenic and then when we cook it or process it, then we have this concern that there's arsenic in the rice. So, that's one example. There are other examples of foods that can be relatively more efficient in holding onto those metals. And then when we harvest them and process them or cook them, that remains a concern. There also may be some contaminants from manufacturing. Metals are not the only concern that we have to think about in terms of food safety. So, there are definitely some issues related to manufacturing and packaging that may be more relevant in other types of contaminants. But it's important to note that these metals often contaminate the food sort of as that food is grown and harvested and then sort of moved on to the next phase of its life.

Pete Kenworthy

What I'm trying to figure out here is the jarred baby food can't all be bad for your child, right? So, what I'm trying to figure out is what are the pros and cons here, right? What’s good about if I'm a parent or I'm about to be a parent and I'm going to go out and buy those little tiny glass jars of food, right? It's convenient, of course. Are there, you know, it's easy to talk about the bad things that are in the food, but can you kind of do a pros and cons of store-bought jarred baby food?

Dr. Aparna Bole

Sure. Yeah. I think it's important when it comes to metals in foods that we not overemphasize the idea that it's exclusively manufactured baby foods that can be contaminated with those metals. That's not true. So, it's not true to say that if only I made all of my own baby food, I definitely will have a lower exposure to heavy metals. One really important thing to keep in mind is that varying ingredients is really important, whether we're buying processed baby food or making our own. So, I mentioned, you know, that rice can be relatively higher in arsenic than other grains. It's important to vary the grains that you're using. So, whether I'm buying food or I'm making my own, I don't want to have rice as the only grain in my child's diet. I would like to just, a little aside here, you know, parents may also recall that there has been media about pesticide retention and oats, right? So, if I'm a parent, I don't want this to feel like an obstacle course for parents. Like, oh my gosh, if I buy the oats, there's pesticides; if I buy the rice, there's arsenic.

Ultimately, we need to have a regulatory framework that addresses some of the issues with food safety in our supply chain across the board. It should not be a parent's job to try to purchase their way around this problem. That being said, a safe thing to do, whether it's grains or other foods, is to aim for a variety of ingredients. If I'm buying jarred or processed foods, and it says a particular flavor on the label, and say, it's a multi-ingredient food, right? And it has some flavor on the label. Sometimes even though different labels have different flavors on them, if you really turn it around, the first ingredient is the same on every single jar. So, I just encourage parents if you're buying those multi-ingredient foods, just flip it over and make sure that you're not accidentally actually feeding the same ingredient at every meal as the first ingredient. And so even if we're making our own baby food, we need to be careful about varying ingredients. Just use a variety, a variety of fruits, vegetables, grains. And I think there are other benefits, too, potentially of making our own baby food. One being that we have total control over the ingredients. We, for some families, it's a way of integrating the child's meals a little bit more fully into the family meals. It involves not buying extra. It can be more convenient and cost-effective for some families. Now, for some families, the convenience factor or other factors make it a better choice for them to buy jarred or processed baby foods.

And I think either can be a healthy choice. It's just about offering a variety of foods, making sure we've got fruits, vegetables, grains, protein, a variety of food groups. And for most families, some mixture of making our own and buying from the store is probably where people will land. And there are a couple of other tips that I usually offer parents. So, we talked about a variety being really important. There are a lot of benefits of preferring fresh or frozen produce when we're preparing food for our kids, where minimizing packaging, there's some other, you know, potential concern about packaging and manufacturing that parents might have. And so you're, you're eliminating some of those question marks, maybe not necessarily relevant to heavy metals, but potentially other issues with manufacturing and packaging that parents wish to avoid. So, offering that variety of ingredients. Avoiding fruit juices is a good idea.

I mean, we, there has been found to be heavy metal contamination in some of those infant and toddler juices, but really there are a lot of other great reasons to avoid juice in kids under two. We recommend that anyway, right? It's not a very nutrient dense option for kids. It's very high in sugar. So, a lot of good reasons to do that. Again, and offering the variety, there are a lot of good reasons to do that, too, right? Like everything that I'm saying now there are benefits regarding minimizing exposure to contaminants, but just as importantly, or even more importantly, a lot of nutritional benefits as well.

The other thing I often tell parents is for some families, it's really important in our culture to eat a lot of rice, right? Like it's center of the plate for many cultures.

So, what I say is, first of all, if you're going to be cooking your own rice and you eat a lot of rice, just know that not all rice is the same, like brown rice tends to take up more arsenic than like, say, white sushi rice or white Basmati rice tend to take up less arsenic. Where it's grown actually does make a difference. You know, the rice that's grown in the Southeast of the United States does tend to be higher in arsenic because of the history of what was farmed there and the kind of pesticides that were used. And then also I say rinse the rice, cook it with a little extra water. And then again, try a variety of grains, good benefits to that anyway, for dietary reasons. So, even if it is an important part of our culture, it can be healthy for us to try different grains.

So, I get into that level of detail for parents who have a lot of questions about that, or who again, have this strong cultural tradition of rice at the center of the plate. The other thing I want to say about infant cereals is that they are fortified with vitamins, which can make them a healthy choice as one of our first food for babies. However, it is not a necessary first food. In many sort of families or in many traditions, like we just learn that we have to give rice cereal as a first food. It can be a fine first food. It's fortified. It’s a good source of iron. All of those infant cereals that are fortified are. If we're making our own cereals at home, they're not going to be fortified. They're not going to be an iron source. So, it can be a really good source of iron and other vitamins for children. But just changing it up and not feeling like you have to sort of follow this dogma that you must use infant cereals. You must use this particular infant cereal. Those things are not true. We have more flexibility than I think sometimes parents realize.

Macie Jepson

Doctor, what would you say to the parents who decide that they just want to skip all of the roadblocks and buy organic? I mean, that can be confusing as well. It's not always as advertised, right?

Dr. Aparna Bole

Yes. I think that can be confusing. The organic label doesn't really tell us about heavy metal content. Heavy metal, testing for heavy metal content is not part of the organic certification. There are some growing standards, right, that are required for organic certification that include things like no pesticide use. So, there are potentially other benefits, if we know that there were no pesticides, for example, used in the growing of those foods. And so we can, we definitely can get into that. I think whether you're buying processed food or making your own, a lot of families have questions about that choice to buy organic. Whatever type of produce you're buying, when you prepare it, wash it in cool water first. It's a good idea. Some families are making tough choices about like, can I afford to buy organic or not? Which are the items I should buy organic or not?

One helpful resource is from the Environmental Working Group. It's called the Dirty Dozen and Clean 15 List. I often refer parents to that list if they're wondering, are there particular things I might want to focus on when buying organic or things I should be focusing on and thinking about how I prepare my produce. That Dirty Dozen and Clean 15 List is a list of the kinds of fruits and vegetables that either tend to hold on to pesticide residues more or don't. So, the Dirty Dozen are the top 12 and the degree to which they tend to hold on to pesticide residues. And then the Clean 15 are less likely to hold onto those pesticide residues. So, if you're making choices about which foods to purchase organic, that might be one way to think about it. The foods that are on the Dirty Dozen List, you might want to think about purchasing organic or maybe from a local farmer's market where there's no certification, but you can speak to the farmer and you know they're not using pesticides. Or those are just items that you want to pay a little more attention to in how carefully you wash them if you don't purchase those items organic. So, I think that the concept of organic food becomes more relevant when we think about pesticide residue. And also many families are concerned about responsible land use. And so there's some ecological issues in our food purchasing options, but it's a little bit less relevant when it comes to heavy metals.

Pete Kenworthy

I want to get into the homemade foods a little bit more, but before we leave jarred foods, I do have one final question for you. And it's really that if we're in the store shopping for baby food for our babies, is there something on the label that we can look for and feel confident that we're not doing a disservice to the health of our baby?

Dr. Aparna Bole

There is no label that will tell you about heavy metal content right now, both as it pertains to heavy metals and really other aspects of food safety. I think we have an opportunity from a regulatory and policy standpoint in this country to take a more proactive approach to things like testing, setting limits and then creating transparency for the consumer about what that looks like. Unfortunately, we don't have that framework in place for a lot of questions that parents might have about, you know, potential contaminants in foods. And as I mentioned, in addition to heavy metals, you know, we read about pesticides. We wonder about, you know, could there be, you know, certain kinds of plastics or phthalates or other kinds of packaging that could result in contaminants. So, I think parents can feel like it's this minefield when they're shopping. So, what I say to parents is the most important thing to care about is the variety of ingredients. That is, it’s simple. It's just turning it over and looking and making sure that you don't accidentally have the same first ingredient every time. Avoiding fruit juices. And then, you know, if parents have questions about the kinds of packaging or those kinds of things, I do tell parents, you know, it's a good idea, if you can, to avoid heating food in plastic. I would rather you heat in glass. It's just more inert. If you can, run your plastic food containers through the dishwater or washer, you know, high heat and plastic can result in some leaching from the plastic. And again, preferring fresh or frozen produce if you are preparing at home.

So, those are really sort of the list. And I think parents can be in a place of just extreme stress if they're feeling like whatever choice I pick, oh my gosh, there's heavy metals in that; there's pesticides in that. It’s not the label. I think it's stressful. You know, everyone wants to do the best for their children. And I think for parents, the best piece of advice is that issue of variety, avoiding fruit juices and some of the other things that we've already talked about. And again, not losing sight of, especially when it comes to heavy metals, like let's not forget that there are other significant sources of heavy metals of concern. And especially here in Cleveland and other cities like us, lead is coming from paint, soil, housing issues by and large. So, the last thing I would want is for people to sort of be super worried about food ingredients and then forget about this other really major source.

The one other thing I'll say is that when it comes to ingredients, we've talked a lot about arsenic and rice. It is true that there are certain ingredients in baby foods where they, not just in baby foods, certain foods that tend to hold on to other heavy metals. And one that parents may have read about or heard about are certain root vegetables like sweet potatoes and carrots. They're grown in the ground. Relatively speaking they tend to be a little bit more likely to hold on to lead from the soil than other kinds of fruits and vegetables. On the other hand, sweet potatoes and carrots have a lot of really good healthy benefits. So, the message is not don't ever eat sweet potatoes and carrots. It is. Just make sure that you're varying. Sweet potatoes and carrots are sweet. Babies like them. Sometimes they're used, like sweet potatoes are often used as sort of like a filler in other multi-ingredient foods. So, the message is eat those things. They're good for you, but don't only eat those things. And don't accidentally buy sort of multi- ingredient foods where the first ingredient is sort of always the same. It's always sweet potatoes. So, I don't want parents to feel like that some of these healthy types of produce and grains should be avoided altogether. That's not the message. It's more about variability. And then some of those sort of special instructions on cooking, if you're a family who does eat a lot of rice.

Macie Jepson

Doctor, can we talk a little more about making our own foods and whether there are any landmines we need to be concerned about if we make that choice? What's the best way to make the best food for our child?

Dr. Aparna Bole

Yeah. I think the most important take home point for parents is not to feel like feeding their children must be sort of regarded as navigating landmines. And I realize why parents feel that way when they see, you know, sort of what's in the news. And we feel sometimes like there's no great choice, or we aren't empowered with the information to make great choices. So, first of all, I think sort of freeing ourselves of that because ultimately there are regulatory solutions that we need to recommend for some of these issues. As far as making our own baby food is concerned, what I would say is prefer fresh or frozen produce if you're making your own baby food. Make sure you wash that fresh produce in cool water before you use it, even if you're going to peel it first and then offer a wide variety of ingredients. And then, you know, you can, you certainly can flavor your children's food, your baby's food. I recommend no added sugar or salt. But otherwise, you know, babies are experiencing, you know, this universe of new tastes and textures. Having them experience a variety of food groups and a lot of different options in each of those food groups, those are the best pieces of advice that I can offer, whether we're making our own baby food or buying it.

The other thing I would say about making your own baby food, just to be aware that things like infant cereals that we buy at the store are fortified with vitamins and iron. When, if we're making our own infant cereals at home, they're not going to be fortified with vitamins and iron. So, if I've got, you know, a baby who's just starting on solid foods, some families, it's convenient to use the fortified baby food as a great source of iron for babies. But if I'm making my own and it's not iron fortified, OK, we just have to be aware of that. What is their iron source? Some babies need supplemented. Some of our breast, you know, our breastfed babies get some extra vitamin D. Eventually they usually get a little extra iron, too. So just things to be aware of that it's not always an apples to apples, so to speak, if we think we're making the equivalent of what's in the store. Our homemade cereal, isn't going to be fortified. There might be some other examples. And I also, a word of caution, I have heard some, you know, definitely hear from parents who think that homemade is always best, and they do things like try to make their own infant formula. I do not advise that. Infant formula is made according to very specific standards. It is tested. The balance of electrolytes and nutrients are what the baby needs. So, you know, definitely, you know, recommend breastfeeding for families who can. If you're switching to formula or using formula, please don't assume that making your own is a safe choice. It isn't. It isn't. So, I just want to make sure parents hear that.

Otherwise, I would just say, you know, have fun with a variety of ingredients, avoid added salt and sugar. Make sure you're offering different food groups. Prefer fresh or frozen. Wash it first, and then have at it. And just make sure it's in a developmentally appropriate form avoiding choking hazards and all those kinds of things, too.

A great resource for parents that I often share is from the American Academy of Pediatrics, healthychildren.org, webpage. There's a lot of great information on there about infant, toddler and childhood nutrition. And there's a specific piece about metals and baby food and metals in food that parents can take a look at.

Pete Kenworthy

We mentioned at the top of the podcast a number of boards on which you serve, including Chair of the American Academy of Pediatrics Council on Environmental Health. And I think we'd be remiss not to talk to you about this as you've referenced policy also throughout some of your answers here. What needs to change here in America?

Dr. Aparna Bole

I think that question gets to issues related to environmental hazards, including from food, but also way beyond that, right? Like we've been much too reactive in this country when it comes to environmental hazards. I'm especially concerned about child health, but in general, much too reactive. What do I mean by that? We wait until we figure out something is toxic because people are suffering from the consequences instead of making sure it's safe first before we're using it. That's sort of the simplest way to think about it. We have an opportunity and an obligation to be more proactive in assuring safety in, for example, chemicals, but also a whole host of other hazards, whether it's air pollution, water pollution, safer chemicals use. We tend to sort of, our standard around chemicals policy has really been historically much, much too reactive.

We assume safety until we learn after people are suffering consequences that it's not safe. Lead is just a perfect example, right? So, we figured out after lead was widely used in gasoline and in paint that it was toxic. We then, it's been since 1978 since leaded paint has been used in housing. However, it's still a problem that plagues children, right? It's now a multi-generational problem that we have children being poisoned by lead with their developing brains, you know, being put at risk by exposure to this known toxin because we sort of put it out there, and now putting Pandora back in the box is really challenging. So, number one, I think whether it's around food safety or environmental hazards in general, a much more proactive, proving safety first and incorporating considerations about children into our policy making, because it's not just about the toxicity of whatever the chemical is we're talking about. It's also about the timing of exposure. What may be safe for an adult may be very, very not safe for either a developing fetus or an infant. Children's organ systems are growing so rapidly in those early years of life. And I think we have underappreciated the importance of considering specifically safety to children when it comes to environmental policy. That's the first piece.

And then even the issue of being reactive. You know, it, is sort of a deep philosophical question. Why is it that we've allowed lead poisoning to be, continue to be the most preventable environmental health hazard probably that, you know, that is, remains out. There's no rational explanation. We know how to fix it. We know it's toxic to children. It's incredibly unjust. It disproportionately impacts Black children. It disproportionately impacts vulnerable populations. It adds to other risk factors for poor developmental health. And we have just lacked the political will to invest in fixing it. It’s a huge return on investment. For every dollar invested in lead poisoning prevention, the return is astronomical. The only thing that even comes close is childhood vaccines, because it results in better school performance, you know, increased productivity, less interaction with the criminal justice system. The list goes on. So, it's a great return on investment. We know how to do it. It's been a multi-generational problem, and we have just failed to muster the political will to fix it.

So, one thing that I, so I, I guess the answer to the question is that it's about political will and it's about our philosophy. And the bottom line is I feel really hopeful that with greater attention to some of these issues from parents, from community leaders, from multiple sectors that we're in a position to start moving in a more healthy and proactive direction.

Macie Jepson

So, to wrap things up, not everyone is going to agree on the best approach. You have to follow your gut and be smart while you're doing it. Dr. Bole, any main takeaways before we wrap up here?

Dr. Aparna Bole

I think the primary takeaway when it comes to feeding our children, is those, the variety of ingredients, whole foods, less, you know, I don't want to say less processed food in terms of less jarred food necessarily, but sort of more recognizable fruits, vegetables, grains and protein that are really representative of those different ingredients, whether we're buying from the store or we're making our own, that's, what's going to really develop a healthy palate for our kids. The other thing to keep in mind is that there's so much that we are doing for our kids that is within our power to really encourage healthy brain development, right? Like I mentioned, exposures are one piece, but everything we're doing in our homes, when we read to our children, when we talk to our children, when we love our children, when we give them the emotional support that they need as infants and young children, all of those things are promoting resilience and healthy brain development. So, I just want parents to feel that they're supported, that they're doing a wonderful job, that these simple sort of wide variety avoid fruit juices kinds of tactics in feeding our kids is absolutely the right thing. And in the meantime, there's so much else we're doing as nurturing, loving parents to promote healthy brain development. And we should feel good about that.

Macie Jepson

So, the takeaway here is we need to train our babies’ palettes to grow into healthy adult palettes. We should all be living by this. Thank you so much for joining us, Dr. Aparna Bole, pediatrician at University Hospitals.

Dr. Aparna Bole

Thank you. It was a pleasure to be with you.

Macie Jepson

And remember, you can find in subscribe to this podcast on iTunes, Google Podcasts, Stitcher, or wherever you get your podcasts. Search University Hospitals, or Healthy@UH, depending on where you subscribe.

Pete Kenworthy

For more health news, advice from medical experts and Healthy@UH podcasts, go to UHHospitals.org/blog.