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Contamination of baby milk" The Chinese story" Mohammed Jawad Musmar, Ph.D,R.Ph, Dean, College of Pharmacy An-Najah National University.

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Presentation on theme: "Contamination of baby milk" The Chinese story" Mohammed Jawad Musmar, Ph.D,R.Ph, Dean, College of Pharmacy An-Najah National University."— Presentation transcript:

1 Contamination of baby milk" The Chinese story" Mohammed Jawad Musmar, Ph.D,R.Ph, Dean, College of Pharmacy An-Najah National University

2 Formula feeding risk Infant formula industry is an $8 billion per year business. Infant formula industry is an $8 billion per year business. Risks of infant formula feeding accounts for : Risks of infant formula feeding accounts for : 1. up to 26% of Insulin DDM in children 2. higher Otitis media infections. 3. Infants having 10- fold risk of being hospitalized 4. contaminant in powdered formula i.e. melamine and neurotoxins. 5. There may be a connection between glutamate – heavy foods and Alzheimer ’ s disease 6. glutamate is also a factor in other neurodegenerative diseases such as Parkinson ’ s, MS, Fibromyalgia and Huntington ’ s.

3 What does Infant formula contain? Water – high levels of Fluoride, Nitrates, Metals i.e. lead, Cd. etc. Water – high levels of Fluoride, Nitrates, Metals i.e. lead, Cd. etc. Corn syrup – contains glucose (Mother ’ s milk contains lactose) Corn syrup – contains glucose (Mother ’ s milk contains lactose) Sucrose – wrong sugar for babies. Sucrose – wrong sugar for babies. Soy oil – processed using high temp. and chemicals i.e. bleached & deodorized Soy oil – processed using high temp. and chemicals i.e. bleached & deodorized Whey protein – processed using high temp. likely to destroy fragile whey proteins. Whey protein – processed using high temp. likely to destroy fragile whey proteins. Soy protein isolate contains phytoestrogens Soy protein isolate contains phytoestrogens Carrageenan – hard to digest in infants Carrageenan – hard to digest in infants Soy Lecithin – high in pesticides Soy Lecithin – high in pesticides

4 Cont. Synthetic Vitamins – often have the opposite effect of “ Natural ” vitamins Synthetic Vitamins – often have the opposite effect of “ Natural ” vitamins free glutamic acid (MSG) and aspartic acid – neurotoxins free glutamic acid (MSG) and aspartic acid – neurotoxins Concerning phytoestrogens infant fed soy formula may have concentrations higher than 20,000 times the normal levels in early life. Soy formula has been linked to premature thelarche (breast development in infants and girls under “ 8 ” years of age Concerning phytoestrogens infant fed soy formula may have concentrations higher than 20,000 times the normal levels in early life. Soy formula has been linked to premature thelarche (breast development in infants and girls under “ 8 ” years of age “ It is true that infant formula contains far lower quantities of dioxins, PCB ’ s and Organochlorine pesticides than breast milk. However formula has serious drawbacks that tip the scale against it ” “ It is true that infant formula contains far lower quantities of dioxins, PCB ’ s and Organochlorine pesticides than breast milk. However formula has serious drawbacks that tip the scale against it ”

5 What about the plastic bottles? The “ Plastic World ” has a broader social impact and raises awareness of increasingly important issues. The “ Plastic World ” has a broader social impact and raises awareness of increasingly important issues. Plastic identification symbol and abbreviations. Plastic identification symbol and abbreviations. PET or PETE HDPE PVC PET or PETE HDPE PVC LDPE PP PS LDPE PP PS PC or Others i.e. acrylnitnile, butadiene styrene acrylic PC or Others i.e. acrylnitnile, butadiene styrene acrylic 123 4 5 6 7

6 Use # ’ s 1, 2, 4, 5 plastic and avoid plastic that contain PVC, polyvinylchloride; (note Vinyl chloide is carcinogen). Contains phthalates. PVC, polyvinylchloride; (note Vinyl chloide is carcinogen). Contains phthalates. Phthalates – block production of male sex, hormone Phthalates – block production of male sex, hormone Bisphenol-A or BPA used in polycarbonate plastic #7 = mimic the action of estrogen. Bisphenol-A or BPA used in polycarbonate plastic #7 = mimic the action of estrogen. PBDE ’ s used in several plastics = interfere with thyroid hormone “ fetal rat exposure to BPA or PBDE ’ s disrupts normal development of the brain and behavior in rats and perhaps in humans ”. PBDE ’ s used in several plastics = interfere with thyroid hormone “ fetal rat exposure to BPA or PBDE ’ s disrupts normal development of the brain and behavior in rats and perhaps in humans ”. We see massive contamination of the oceans, in biology known as “ phthalate syndrome ”. We see massive contamination of the oceans, in biology known as “ phthalate syndrome ”. 10 billion pounds of PVC resin produced annually in the USA alone 10 billion pounds of PVC resin produced annually in the USA alone PVC, the most dangerous plastic and NOT recyclable. PVC, the most dangerous plastic and NOT recyclable.

7 The additives are very dangerous to health because they don ’ t bind with plastic, so it can leach out of the polymer. The additives are very dangerous to health because they don ’ t bind with plastic, so it can leach out of the polymer. The resins are part of the protective lining used in food & beverage cans. The resins are part of the protective lining used in food & beverage cans. Old or scratched plastic leaks more (teethers of infants) Old or scratched plastic leaks more (teethers of infants) Microwave use results in breaking down and leakage of toxic additives. Microwave use results in breaking down and leakage of toxic additives. Toxic chemicals are concentrated in breast milk at very high levels. note that “ the mother is concentrating these poisons and delivering them in high dose to inflants. More mothers are nursing their babies. Toxic chemicals are concentrated in breast milk at very high levels. note that “ the mother is concentrating these poisons and delivering them in high dose to inflants. More mothers are nursing their babies. (in USA: from 25% to 75% in the last 30 years) (in USA: from 25% to 75% in the last 30 years)

8 Very important question to ask? “ Should some women with a genetic history that includes family developmental disorders such as language impairment or dyslexia or with male partner who have a similar genetic background breast – feed her baby? “ Should some women with a genetic history that includes family developmental disorders such as language impairment or dyslexia or with male partner who have a similar genetic background breast – feed her baby? PCB ’ s & PCBS ’ s can scramble a developing brain – and how the varying cognition deficits we know as autism and Asperger ’ s syndrome might be the consequence PCB ’ s & PCBS ’ s can scramble a developing brain – and how the varying cognition deficits we know as autism and Asperger ’ s syndrome might be the consequence Hundreds of thousands of tons of PCBE ’ s accumulating in the environment every year. Hundreds of thousands of tons of PCBE ’ s accumulating in the environment every year. * 93 percent of Americans tested positive for BPC at age 6 years? at age 6 years? What do you do when you have a hot potato like this in your hands? What do you do when you have a hot potato like this in your hands?

9 Other contaminant: Other contaminant: 1- Aluminum 2- Silicon 3- Cadmium 4- genetically engineered corn or soy 5- Bacteria, parasites etc. 6- carrageenan, maltodextrin, soy protein isolate, whey protein concentrate, whey hydrolysate, milk protein isolate, skim milk powder, corn syrup solids, whey powder, citric acid, hydrolyzed casein, corn starch, modified cornstarch. “ Note that glutamate is a by product of hydrolyzing any protein ”

10 Melamine is now in global food chain First it was baby milk formula First it was baby milk formula Then, dairy – based products from yogurt to chocolate Then, dairy – based products from yogurt to chocolate Now chicken eggs have been contaminated with melamine Now chicken eggs have been contaminated with melamine And who knows what else! And who knows what else! Melamine is used to manufacture plastic and fertilizers Melamine is used to manufacture plastic and fertilizers Very rich in Nitrogen (66%), give artificially high protein readings. Very rich in Nitrogen (66%), give artificially high protein readings. Melamine plastic dinnerware may leach the chemical. Melamine plastic dinnerware may leach the chemical. Melamine was DELIBERATELY added. Melamine was DELIBERATELY added. Melamine is NOT metabolized; No studies on humans, Melamine is NOT metabolized; No studies on humans, Melamine LD50 < 3 gram / Kilogram, but with cyanurate forms Melamine LD50 < 3 gram / Kilogram, but with cyanurate forms crystals crystals Melamine FDA limits (2008) is up to 2.5 ppm. Melamine FDA limits (2008) is up to 2.5 ppm. Melamine and related compounds : ammeline, ammelide, melamine cyanurate etc. Melamine and related compounds : ammeline, ammelide, melamine cyanurate etc. No data on prenatal toxicity and No case report or No data on prenatal toxicity and No case report or epidemiological studies on carcinogenetic effects epidemiological studies on carcinogenetic effects

11 What can I do to prevent exposure to BPA derivatives? Don ’ t microwave polycarbonate plastic food containers. Don ’ t microwave polycarbonate plastic food containers. Avoid plastic containers with the #7 on the bottom. Avoid plastic containers with the #7 on the bottom. Avoid using harsh detergent & dishwasher Avoid using harsh detergent & dishwasher Reduce your use of canned food Reduce your use of canned food When possible use glass, porcelain or stainless steel containers When possible use glass, porcelain or stainless steel containers Use BPA-free and PC-free baby bottle, teethers, or toys. Use BPA-free and PC-free baby bottle, teethers, or toys.

12 References M.S. food and Drug Administration = http://www.fda.gov/ M.S. food and Drug Administration = http://www.fda.gov/ http://www.fda.gov/ Center for Disease Control and Prevention = http://www.cdc.gov/ Center for Disease Control and Prevention = http://www.cdc.gov/ M.S. Environmental Protection Agency = http://www.epa.gov/ M.S. Environmental Protection Agency = http://www.epa.gov/ National Toxicology Program = http://www.niesh.nih.gov/ National Toxicology Program = http://www.niesh.nih.gov/ Consumer Product Safety Commission = http://www.cpse.gov/ Consumer Product Safety Commission = http://www.cpse.gov/ Thank You Thank You

13 Recommendations from the Chinese Ministry of Health:

14 Clinical manifestations: 1-Unexplained crying, especially when urinating, possible vomiting 2- Macroscopic or microscopic haematouria 3-Acute obstructive renal failure: oliguria or anuria 4-Stones discharged while passing urine. Forexample, a baby boy With urethral obstruction with stones normally has dysurea With urethral obstruction with stones normally has dysurea 5-High blood pressure, edema, painful when knocked on kidney area.

15 Key diagnostic criteria: 1. Been fed with melamine-contaminated infant milk formula. 2. Having one or more of the above clinical manifestations 3. Laboratory test results: routine urine tests with macroscopic or microscopic haematouria ; blood biochemistry ; liver and kidney function tests; urine calcium/creatinine ratio (usually normal); Urinary blood cell morphology shows normal morphology of red Blood cells ( not glomerular haematauria ); parathyroid hormone test ( usually normal)

16 4- Imaging examination: preferably ultrasound B exam of urinary system. 5- Ultrasound examination features: General features:Bilateral renal enlargement; increased echo on solid tissue General features:Bilateral renal enlargement; increased echo on solid tissue Stone Features; most stones affect the collecting system and ureters on both Stone Features; most stones affect the collecting system and ureters on both Sides. Urinary tract is mostly completely obstructed by the stones. Sides. Urinary tract is mostly completely obstructed by the stones.

17 Differential diagnosis: 1-Haematouria differentiation: need to rule out glomerular haematuria. 2-Stone differentiation: the stones are normally radiolucent and have a Negative image on urinary tract x-ray. This feature differentiates the stones Negative image on urinary tract x-ray. This feature differentiates the stones From those of radiopaque stones of calcium oxalate and calcium phosphate. From those of radiopaque stones of calcium oxalate and calcium phosphate. 3-differentiation of acute renal failure : need to rule out pre-renal and Renal failure Renal failure

18 Clinical treatment: Immediately stop using melamine-contaminated infant formula milk powder. Medical treatment: use infusion and urine alkalinization to dispel the stones. Correct the water, electrolyte and acid-base imbalance. Closely monitor routine urine tests, blood biochemistry, renal functions, ultrasound findings (with particular Correct the water, electrolyte and acid-base imbalance. Closely monitor routine urine tests, blood biochemistry, renal functions, ultrasound findings (with particular Attention to the renal pelvis, ureter expansion, and the change of stones in shape and location ). Treatment of complicated acute renal failure : priority should be given to the treatment of life-threatening complications such as hyperkalemia. If, possible blood dialysis and peritoneal dialysis can be used early. Surgical measures can be taken to remove the Obstruction if necessary.

19 Follow-up: Once the urinary obstruction is relieved, and the general condition is good, the children Once the urinary obstruction is relieved, and the general condition is good, the children Can be discharged. Can be discharged. Key issues to follow-up: Key issues to follow-up: Urine routine tests ;ultrasound of urinary system ; renal function tests ; Urine routine tests ;ultrasound of urinary system ; renal function tests ; IVP ( intravenous pyelogram ) if necessary. IVP ( intravenous pyelogram ) if necessary.


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