I’m a bit sleep deprived these last few days, so please forgive me if I start to ramble. Everyone warned me that becoming a father would permanently destroy my eight hour sleep routine, and they were right. As a new parent of the world’s cutest boy (of course), I am now driven with every parent’s natural instinct while living here in China: protecting my family from a toxic environment. There are so many environmental concerns here in China, but which one is the most important to protect my new baby? Air pollution is always the top concern on my blog and in my family medicine clinic, and my previous New York Times article (Chinese version here) touched on air pollution’s health risks to children as well as ways to help.
But food safety is close behind as a major health concern, and in some Chinese polls is the #1 concern. How could it not be? Every few weeks it seems we read about a new scandal, or even worse, the recurrence of an old scandal. It might be yet another “gutter oil” crackdown; exploding watermelons; illegal clenbuterol again found in pork; on and on. As Adidas says, in China “impossible is nothing” and you can even find 100% artificially created eggs and wine. I would almost admire their creators’ creativity and ingenuity, if I weren’t so disgusted with their lack of a moral core.
Given the tough reality of our environment, where should a new parent focus? I like to simplify this overwhelming task with this one commandment: take control of your family’s exposure to all environmental toxins. That includes everything: the air we breathe, the foods we eat — even noise and light pollution have major health effects on our immune system and mental health. Empower yourself! Don’t assume anything you eat or drink is healthy; try to know everything you can about the source of your food and drink. This advice isn’t specific to China at all, but it certainly is much more of an everyday dilemma here compared to my more benign choices back in San Francisco. My typical California food dilemma involved wandering the Saturday market and deciding if I want regular tomatoes or should I splurge on the multicolored heirlooms. It wasn’t exactly a cause for panic attacks, not when compared to my wandering our local Beijing market, wondering just how and why those piles of carrots are as thick as my wrist and glowing orange.
At least it’s much easier to plan a meal for a newborn: today would you like milk, milk, or milk? Easy choices here, with only two options: breast or bottle. The healthiest milk, of course, forever will be mother’s breast milk. Breast milk also gives mom complete control over toxin exposure, besides all the health benefits from mom’s antibodies, DHA and other nutrients. But like many working parents, we decided to use infant formula for our baby, which brings us to the next major choice: which formula brand and type is best for our little emperor? This should be relatively easy, but here in China all parents also have a couple of stressful extra questions: which formula won’t cause kidney failure in my baby? And which store do we trust? This awful state of affairs exploded in 2008, with the infamous melamine scandal. This unhealthy protein substitute found its way into much locally produced infant formula and caused serious kidney problems in hundreds of thousands of Chinese newborns, killing six.
This melamine scandal remains the most concerning public health scandal, by far, during my six years in China. And I completely understand why many parents in China — including myself — now would only use imported milk formula for our precious newborns. There’s no way that I would risk the health of my only child on a locally made infant formula, and no amount of PR or advertising is going to get me to make my son a test subject. Sorry, but that’s the hard fact with the dairy industry right now. That’s why we hear crazy reports of mainland Chinese flying to Hong Kong and stocking up on imported formula, forcing the government to limit purchases. I was in Hong Kong over the Christmas holiday and was amazed that almost every street corner market had piles of infant formula displayed. China’s insatiable appetite apparently has spread to Europe, where Dutch moms suddenly were not finding their usual formula on the shelves, now being bought up and shipped to China to feed all the new Dragon babies.
So with our imported organic formula shipped directly from Europe, we have complete control over his toxin exposure, at least for his crucial first four months — assuming our supply from Europe doesn’t sell out first. We then faced the next new parent problem: which water to use for his formula? We’re following the American Academy of Pediatric’s recommendations to use distilled, bottled or boiled water. Back in San Francisco I may have considered just installing a filter on the tap water, but here in Beijing we had to decide what’s the safest way. As the father, I did a lot of internet research on water filters, especially reverse osmosis, which filters out all minerals and germs. But we decided to do what many of our friends do: use Watson’s distilled water. Then you have to ensure that your Watson’s isn’t fake, which apparently isn’t such a small problem. My wife and I decided that our local Jenny Lou’s market had a good enough reputation to buy their Watsons bottles. Does this guarantee it is not fake? No, of course not, but on this issue, we find this an acceptable risk.
On to the next new parent issue, this time a bit more subtle: should his bottles be made of plastic, glass, or stainless steel? Many readers may think we are just over-worrying first-time parents, and they’d be correct — on some fronts (I’ve already started to email his doctor with photos of baby’s poop and rashes). But regarding plastics, I do think there is a legitimate concern, especially for babies. Again, this goes back to my main commandment to take control of your family’s exposure — and that definitely includes all plastics. I’ve discussed this issue a couple of times on my blog, highlighting the many Chinese news stories about plastic safety, from cheaply made takeaway boxes at restaurants to high levels of “endocrine disruptors” such as Bisphenol A (BPA) in children’s drinking cups, bottles and plates. My New York Times colleague Nicholas D. Kristof has published a series of columns raising the alarm about plastics, mostly focusing on a powerful position paper in 2009 by the U.S. Endocrine Society which reviewed the literature on “endocrine-disrupting chemicals”, which include plastics and other chemicals. Here’s a bullet point from their key points:
The evidence for adverse reproductive outcomes (infertility, cancers, malformations) from exposure to endocrine disrupting chemicals is strong, and there is mounting evidence for effects on other endocrine systems, including thyroid, neuroendocrine, obesity and metabolism, and insulin and glucose homeostasis.
In other words, plastics may be one of the major causes of obesity, diabetes, infertility, and some cancers. This developing research really got me to look closely at my environment, and my family changed a lot of our daily practices. With our new baby, our choice to avoid plastic completely and to use glass bottles was an easy and logical next step. Many countries already have phased out BPA from plastic baby bottles, but why take chances at all with plastic bottles when you could just use glass or stainless steel?
I think we’ve completely covered our boy’s food exposure during his first crucial months of life. We think we’ve covered most bases: nothing touches his skin except natural cotton and fragrance-free lotions; he breathes toxin-free air from our imported air purifier, which also nicely provides some relaxing white noise; no hand touches him that isn’t disinfected with soap and water or Purell hand sanitizer.
Many pediatricians, including my son’s, think that over protecting a child and attempting to avoid all germs and toxins may actually be harmful, long-term, for a baby. And there actually is some evidence that newborns can be too clean: super clean newborns, not exposed to the usual germs and thus not activating their immune system, may develop more allergic diseases later, such as eczema, allergies and asthma. Even having a dog early on seems to be more helpful than harmful. This theory is called the hygiene hypothesis. But I think this is more relevant when discussing bacteria and viruses; my more pressing concern now is avoiding harmful chemicals. I’m not so worried about avoiding his first cold, which is inevitable and no big deal; I’m worried about long term body damage, both physical and mental, from food pesticides, heavy metals, hormones and chemicals.
So for now, we first-time parents love keeping him in his toxin-free bubble, fighting off as long as possible his inevitable entry into the big bad world.
This is my latest article to be translated into Chinese and printed in the New York Times China edition here at 将我们的新生儿放在无毒“泡沫”里, where I have a regular health column called 北京健康札记. You can read my previous New York Times articles here in English and in Chinese.
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