Q&A: Baby bottles and bisphenol A

I’ve read so much about bisphenol A and baby bottles lately. Glass or plastic? Which one is safer for my 2 month old?

To avoid bisphenol A (or BPA, as it’s often called) in baby bottles, use glass (handle with care because they can break and cause cuts) or BPA-free plastics such as polyethylene, as Consumer Reports has advised in the past.

There's been a lot of buzz lately about BPA, which is used to make polycarbonate, a clear and rigid plastic. Health concerns about BPA relate to its ability to mimic the hormone estrogen. During such “endocrine disruption,” chemicals can interfere with or mimic the action of hormones, in ways that can upset normal development. Hundreds of studies published over the past decade suggest a connection between exposure to BPA at levels typical in the U.S. and increased rates of breast and prostate cancer, reproductive abnormalities, and—for infants exposed in the womb—problems such as attention deficit hyperactivity disorder, obesity, and diabetes.

When we published our tests of baby bottles in 1999, we found that polycarbonate bottles can leach small amounts of BPA into formula. We calculated that a typical baby who drank formula sterilized by heating the bottle would be exposed to a BPA dose of about 4 percent of an amount that has adversely affected test animals in studies by Dr. Frederick vom Saal, professor of biological science at the University of Missouri-Columbia. Such exposure may initially sound very low. However, safety limits for infant exposure are set as low as 0.1 percent of the level that has adversely affected animals. Babies who used the bottles we tested could be exposed to a BPA dose 40 times higher than that conservative definition of safety. A recent report sponsored by the Work Group for Safe Markets, a coalition of more than a dozen environmental and public health organizations such as the Center for Health, Environment and Justice based in Falls Church, Virginia, and co-authored by nine researchers including Dr. vom Saal, came to a similar conclusion. The report determined that polycarbonate plastic can degrade over time when it’s heated or washed with hot water, causing significant leaching of BPA. As a result, the Work Group for Safe Markets is calling for a moratorium and immediate phase out of the use of BPA in baby bottles and other food and beverage containers.

Nonetheless, the U.S. Food and Drug Administration (FDA) stands by its decades-old approval of polycarbonate bottles as safe, which they say is based on two studies, both funded by the plastics industry. As in 1999, we think the FDA needs to re-examine the issue immediately, as well as the growing body of research that links developmental and reproductive problems with exposure to estrogen-like compounds such as BPA. We will continue to investigate. In the meantime, if you are concerned about the presence of BPA, look for unbreakable BPA-free plastic, such as polyethylene, an opaque, less-shiny plastic (sometimes marked with recycling code 1 and/or the abbreviation PET) that does not leach BPA. Other plastics not made with BPA are high density polyethylene (2, HDPE), low density polyethylene (4, LDPE), or polypropylene (5, PP). Avoid those marked with recycling code 7, which includes polycarbonate, or the abbreviation PC. Glass is another option, but use with care to avoid breakage. If you’re making a switch and your baby misses his old polycarbonate bottle—babies are picky about which bottle they’ll take to—experiment with a different brand of bottle or nipple. That might just do the trick.

Get the lead out: Beware of kids’ metal jewelry

The Senate has passed the Consumer Product Safety Commission (CPSC) Reform Act, which is intended to bolster the safety of millions of products sold in the U.S., particularly goods used by children. Specifically, the Senate-approved bill bans all but trace amounts of lead in all children’s products and also requires third party pre-market testing for children's products. For all products, the measure creates a public database of complaints so that information on potentially unsafe products can be shared more quickly. The House of Representatives passed a similar bill late last year. Now Congress needs to iron out the differences between the two bills and present a strong final version to the President to be signed into law.

Over the past several years, there have been about 170 million pieces of lead-laden jewelry recalled by the CPSC. Lead is highly toxic and can cause a range of adverse health effects in children, including learning and behavioral disorders, if they ingest it. Some small items like charms and rings can contain enough lead to cause death if swallowed. One small study conducted by the CPSC found that 20 percent of children's jewelry in the marketplace has high levels of lead.

Consumer Reports recommends against buying any metal jewelry for children. Don't allow your child to wear any such jewelry that he or she has received as a gift. Recalled items, ranging from fake pearls to heavy metallic rings, chains and charms, were most often manufactured in China, and sold for around $1 to $15 at various discount and dollar stores, as well as department, gift shops and specialty stores. Jewelry from vending machines and jewelry used as part of school fundraisers and special promotional items have also been recalled due to lead levels. Not all inexpensive children’s jewelry contains lead, but it’s tough to tell the lead jewelry from the non-lead stuff. So why risk it? Your safest bet is to avoid bejeweling your child or buying jewelry as presents for other children, unless you know the metal content of the jewelry, such as sterling silver or 14K gold, and that it came from a reputable source. To see pictures of items that have been recalled, check the U.S. Government’s recall Web site, www.recalls.gov. (Even better, sign up for free e-mail notices of future recalls at the CPSC’s Web site, www.cpsc.gov/cpsclist.aspx so you can easily stay up to date.) Also check our online photo gallery of recalled jewelry. If you have a recalled item, take it away from your child and consult the CPSC recall notice for further details. In many cases, full refunds are being offered. 

Q&A: Are pre-owned toys safe?

 Do you recommend shopping at thrift stores or buying second-hand toys?

Used toys, especially solid, molded-plastic ones, can be a great buy, but you need to be aware of potential safety issues. Thrift stores, consignment shops, and yard and garage sales often have toys in excellent condition. But carefully check every toy to make sure that it's well made (i.e. not flimsy or sloppily constructed, with no rough edges or slipshod finishing) and there are no loose or missing parts. Wash it before giving it to your child. Avoid buying used toys that have no packaging or that are missing some type of label or brand identification, without which it might be difficult or impossible to tell if the toy has been recalled.

When you’re buying for a baby or an older child who has a baby or toddler sibling, think about whether that toy could be potentially dangerous for the baby. Toys for kids age 3 and up can have small parts and other hazards that are dangerous for little ones. Babies experience much of their world through sucking, so expect that most toys will go straight to their mouths. If you are not sure if the toy you are considering for a toddler is designed for kids under 3, don't buy it.

Lots of toys have been recalled in recent years. To avoid buying toys that may have been recalled, check the government’s recall site, www.recalls.gov, before you buy. You should also sign up for free e-mail alerts of recalls at the U.S. Consumer Product Safety Commission’s Web site. Staying up-to-date can keep you from buying recalled products and help you remedy the situation if you already have one. If you’ve had a bad experience with a toy, call the CPSC at 800-638-2772 or log on. Your call could lead to a recall.

For more information, see our report on toys for toddler and preschoolers. Also see what to do about recalls, and be sure to check out our Safety Blog, too.

The well-stocked diaper bag

When you’re traveling with your baby, one school of thought is to pack light, since lugging around your baby and probably a stroller is enough already. Another, more practical approach, though, is to pack like your life depends on it. Don’t worry. It will. When you’re on the go with a little one, you want to be ready for everything and anything. Your diaper bag can help get any job done. Consider it your changing table away from home as well as a baby entertainment center and portable food court. Here, some packing pointers:

•    Start with a diaper backpack or messenger-style diaper bag that you can wear diagonally across your body. Either is awesome for traveling because they keep your arms free. They’re great for everyday, too.

•    Assign each diaper bag compartment to a specific item so you don't have to go digging for things. Spending time trying to find your baby's pacifier, for instance, can quickly escalate into a crying crisis.

•    Plan for unexpected layovers by packing extra diapers, a change of clothes, extra baby wipes, diaper ointment, medication your baby may be taking, baby pain reliever and a small first-aid kit, snacks, a bib or two, extra formula and sterilized water if you're formula feeding, plastic bags for disposing of soiled disposable diapers or compartmentalizing clothes that get wet, baby books, toys, your baby's favorite blanket, extra pacifiers in case you lose one (don't assume you'll find the exact one your baby prefers in the airport's newsstand), hand sanitizer, and sunscreen, if necessary.

•    Pack bottles and perishable food like yogurt in freezer/fridge packs. Throw anything out that’s been sitting without a cold pack for more than two hours.

•    Pack a book or your favorite magazine. When your baby dozes, you can catch up on your reading.

For more information, see our report on diaper bags, including features to consider before buying one.

Q&A: Safe antibiotics for nursing moms?

My doctor recommended I not take an antibiotic for an infection I developed because I’m nursing and it may harm my baby. Are any antibiotics safe when nursing?

Some appear safer than others, though the risks haven’t been well studied. There’s concern that ingesting antibiotics through breast milk may cause infants to develop diarrhea, nutritional deficiencies, or other problems. But the amount of antibiotic that passes into breast milk varies by drug, so you can limit your baby’s exposure by using the ones least likely to leach.

The safest appear to be the cephalosporins, such as cefaclor (Ceclor and generic), cephalexin (Keflex and generic), or cefdinir (Omnicef); macrolides, such as clarithromycin (Biaxin and generic), azithromycin (Zithromax and generic), or erythromycin (E-Mycin and generic); and penicillins, such as amoxicillin, ampicillin, and oxacillin. Antibiotics to avoid include metronidazole (Flagyl and generic); quinolones, such as ciprofloxacin (Cipro and generic); and tetracyclines, such as doxycycline (Vibramycin and generic) or minocycline (Minocin and generic).

Taking medication right after nursing may also minimize exposure.

6 big ways to save on infant formula

If your baby is on infant formula exclusively, you’ll shell out about $1,500 by her first birthday on the stuff. Of course, “breast is best” not only because it’s healthier for your baby, it’s also a bargain. But infant formula has its place. Here are six big ways to pay less:

Shop at mass merchandisers. Formula sold by mass merchandisers, such as Wal-Mart, Costco, and Sam’s Club, cost 16 percent less than formula sold in supermarkets, according to a USDA report. And formula sold in drugstores cost 19 percent more than in supermarkets, so shop there only as a last resort. Generally, milk-based formula tends to cost less than soy-based formula, so don’t buy soy or another type of specialized formula unless your pediatrician recommends it.

Join the club. Some formula companies, such as Similac have a membership club you can join for free by filling out an online form. After you enroll, you’re eligible for exclusive offers and savings.

Buy online. Many retailers, including many mass merchandisers, don’t sell formula through their Web site, so you’ll have to go shopping, and then schlep the stuff home. But you can purchase formula online at www.amazon.com. The site offers Enfamil, Similac, and Nestle Good Start, with free shipping on some quantities. The site also has organic formulas from brands such as Baby’s Only and Bright Beginnings. You can also sign up for Amazon Prime, which entitles you to unlimited “free” standard and two-day shipping on eligible items as well as other benefits for an annual membership fee of $79. Another option is to buy formula online from the manufacturer’s Web site. Enfamil (www.enfamil.com) and Similac (www.welcomeaddition.com), for example, offer this convenient method. If you buy three or more cases at a shot from the manufacturer, you may find reduced prices. By checking around online, we found that this option can be a competitive deal, and unlike Amazon, there’s no membership fee.

Prefer powder, if possible. Powdered formulas are the least expensive option in the formula lineup. The USDA reports that liquid concentrate formulas, though more convenient and easier to mix, than powder, tend to cost more.

Buy big. Across brands, larger cans of formula, whether it’s in powder or liquid form, cost less per reconstituted ounce than smaller cans. Buy the largest cans you can find.

Consider a store brand. You’ll find store brands of formula at major retailers such as Kmart and Wal-Mart and the savings can be substantial. We found that the store brand of formula at a local Wal-Mart (Parent’s Choice) cost 50 percent less per ounce than a leading national brand (Enfamil). According to the FDA, all formula marketed in the United States must meet the same nutrient specifications, which are set at levels to fulfill the needs of infants. Although infant-formula manufacturers may have their own proprietary formulations, brand-name and store-brand formula must all contain at least the minimum levels of all nutrients specified in FDA regulations, without exceeding maximum levels, where those are specified. Safety note: Always take special care with baby formulas. Check the “use by” date; follow preparation and storage instructions exactly; and pay attention to recalls. It is generally recommended that parents not switch brands once baby has gotten used to one.

For more information, see our report on baby formula.