This past week, Consumer Reports came out with a report indicating that there were concerning levels of heavy metals in baby formula. Predictably, parents panicked, especially those who had used formulas that had been found to have arsenic. Have I ruined things for my child? — a common refrain in my inbox. At the same time, the FDA announced a new formula initiative.
A casual read of the narrative about formula is: Consumer Reports found evidence of concerning levels of heavy metals in formula, and the FDA launched an investigation.
This read is, however, false. So what is really going on?
Are there heavy metals in formula?
Consumer Reports tested 41 formulas for heavy metals, notably arsenic, lead, mercury, and cadmium. None of the formulas they tested had mercury or cadmium, so we’ll put those aside. Their headline findings are twofold.
First, in 7 of the 41 formulas, Consumer Reports indicated they found levels of arsenic that were above levels they thought were concerning. Two of the formulas had higher levels — EleCare Hypoallergenic and Similac Alimentum.
Second, in nearly all the formulas, they found evidence of lead. In 18 of the 41, they found levels that were between 50% and 100% of the “maximum allowable dose level” (MADL) set by the state of California.
On its face, this seems very scary. At high levels, arsenic can be very dangerous, causing cancer, reproductive issues, and other complications. We know that, also at high levels, lead exposure in childhood is associated with developmental delays.
However, the fact is that the levels of exposure we are talking about in these formulas are extremely low — lower than safe limits set by governments. There is simply no reason to think that there would be any meaningful effects of exposure at these levels.
To slightly elaborate, let’s begin with lead. I have written about this before, but the MADL set by California is one-thousandth the level at which any negative impacts have been seen. In other words, saying that something has “50% of the MADL” is the same as saying it is one two-thousandth of the level that has been shown to have negative effects.
In the case of arsenic, again the levels here are very different from those in many of the studies of concern. In Latin America, levels of arsenic in the water can rise as high as 2,000 parts per billion. Similar levels are seen in parts of West Bengal, India. Obviously, negative impacts can occur at lower levels than this — but it is worth keeping in mind that these levels are perhaps 100 times as high as those seen in the formulas tested and this is exposure in water, a much larger part of consumption.
The simplest way to express this point about arsenic may be to note that the EU limit on arsenic in formula is 20 parts per billion. All of the formulas tested were below this.
I want to be clear: neither lead nor arsenic are adding anything to formula that babies need, so certainly less is more in this case. But both of these metals are present in our environment — in our food and our water, simply because they are found in nature. Breast milk has arsenic and lead, too, sometimes even at higher levels. And we, as humans and even babies, are able to process some of these metals.
The FDA has stated a goal of getting “Closer to Zero” on these exposures. That’s a great goal, but we shouldn’t conclude from it that the only safe level is zero.
In reality, a better headline summary of these findings is this: Consumer Reports tested 41 formulas for heavy metals. None of them had mercury or cadmium. Lead was present, but in all cases below even the conservative standard set by California. Arsenic was present in 7 formulas. Though in all cases this was below the government levels for safety, in two cases the detected amounts approached those levels, and more testing may be warranted.
There, I fixed it.
What is going on with the FDA?
Completely separate from this testing, the FDA has announced an initiative called “Operation Stork Speed” (yes, I also hate the name). This initiative will do a review of the nutrition requirements for formulas, increase testing and labeling, and fund research on formula and health. This is all very reasonable, especially in light of the issues with formulas (shortages, contamination) over the past few years.
This initiative was not motivated by any particular immediate issue with formula safety. The nutrition guidelines have not been reviewed in a couple of decades, and it’s reasonable to do so.
Why are we hearing so much about this now?
Well … you clicked on it, didn’t you? I’m not blaming you, but the reality is that panic sells. With my totally cynical hat on, the California MADL rulings around lead are a gift to the panic headline industry. Since lead is present in our environment everywhere at low levels, if you test basically any food, you’ll find it. And since these California limits are so low, even trace amounts can be cast as “20% of the maximum daily allowable limit!” which is terrifying if you have no context.
A second issue is that this testing has become easier and more sensitive, making it possible to detect levels that would have been harder to see before.
When should I worry?
This is a great question.
First: Is there anyone who should be worried about these particular heavy metal results? I would argue no. Even if you have been giving your baby one of the two formulas that have higher arsenic levels, there is still good evidence of safety. This is important in part because these are products that are often used by families without good alternatives (since they are used for babies with dairy allergies).
Second: Are there any results like this that we should worry about? Of course. We’ve had episodes, even recently, in which there were very high levels of heavy metals in food. These prompted recalls (in the case of applesauce pouches) and a need for testing of children. In that situation, it was absolutely appropriate to worry and to have your child tested for lead if they were consuming a lot of this product.
The other time to worry — especially with lead — is if your child has a high level. This is tested a couple of times in childhood, and if the levels are high, then it is important to look at the environment and ask where exposure might be coming from. The likely answer in nearly all cases is either water or something in the house (a lead bathtub or lead paint). Fixing those issues can fix the problem.
In summary: reserve your worry for cases of actual concern.
The bottom line
- Despite the alarmist headlines, the Consumer Reports testing is largely reassuring about formula safety, and in no case should it prompt consumer panic.
- The FDA initiative to review formula safety and transparency is in no way related to this latest testing or any immediate concerns.
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