1. Morin, Karen H. DSN, RN

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Ever heard of a chemical called bisphenol A? If not, I can assure you that your patients have. A quick scan of the Web will tell you that this chemical is a hot topic. For example, on December 10, 2007, ABC News had an item titled, "Chemical in Infant Formula Cans Sparks Concern" ( The Milwaukee Journal Sentinel posted two articles addressing the safety of the chemical. The first, dated December 2, 2007, was titled, "WARNING: The Chemical Bisphenol A Has Been Known to Pose Severe Health Risks to Laboratory Animals. AND THE CHEMICAL IS IN YOU" ( It was followed by another on December 5, 2007, titled, "Formula Concerns Arise" ( If parents were concerned about what and how they were feeding their infants previously, such headlines did nothing to allay their worries. Consequently, this month's column sheds light on the discussion currently occurring in the scientific community.

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Just What Is Bisphenol A?

Also known as BPA, bisphenol A is a molecule that is used to make plastic bottles and line cans (DeNoon, 2007). It is used "to coat metal products such as food cans, bottle tops, and water supply pipes" (National Toxicology Program, 2007). Cans that contain infant formula are coated with the chemical. It also is used in dental sealants and has multiple uses in everyday life. In addition, it is everywhere: in the air, water, and earth (vom Saal et al., 2007)


Why Be Concerned About Bisphenol A?

Bisphenol A is considered an estrogenic environmental chemical because it was associated with reproductive system stimulation in rats as early as 1936 (vom Saal et al., 2007). These experts indicate that even in low doses, bisphenol A alters "endogenous hormone synthesis, hormone metabolism and hormone concentrations in blood" (p. 132) and may be reflected in reproductive disorders. Evidence indicates that the chemical leaches into the liquid in the can. Moreover, leaching accelerates when liquids are heated. Consequently, the amount of chemical available for consumption can vary.


While animal studies support health hazards associated with low-dose bisphenol A-that is, a level less than 50 ug /kg/d (vom Saal et al., 2007)-results are conflicting based on the methodology used to evaluate the evidence. For example, the report issued by the National Toxicology Program (2007) concluded that evidence supported some concern that exposure of infants and children to the chemical could contribute to behavioral and neural sequelae. Conversely, vom Saal et al. (2007) concluded "prenatal and/or neonatal exposure to low doses of BP results in organizational changes in the prostate, breast, testis, mammary glands, body size, brain structure and chemistry, and behavior in laboratory animals" (p.143). When independent investigators evaluated ready-to-eat and concentrated formulas for the presence of the chemical, several formula preparations contained bisphenol A amounts that were close to or more than levels that resulted in harm effects in animal studies.


What Advice Can You, the Nurse, Offer Parents?

DeNoon (2007) offers the following strategies. You can suggest that parents take the following precautions:


* Use glass baby bottles or those made from polyethylene or polypropylene


* Switch to powdered formula preparations


* Don't use plastic containers in the microwave


* Don't use scratched plastic bottles


* Choose plastics numbered 1, 2, and 4


* Avoid plastics numbered 7



The preceding information barely skimmed the surface of the scholarly dialogue that is present in the literature. Become familiar with the issues, because parents will continue to need the most current and sound information.




DeNoon, D. J. (2007). Jury still out on BPA/plastics risk. WebMD Medical News. Retrieved December 24, 2007, from[Context Link]


National Toxicology Program. (2007). Center for the evaluation of risks to human reproduction: Expert panel evaluation of bisphenol A, August 6-8. 2007. Retrieved December 24, 2007, from[Context Link]


vom Saal, F. S., Akingbemi, B. T., Belcher, S. M., Birnbaum, L. S., Crain, D. A., Eriksen, M., et al. (2007). Chapel Hill bisphenol A expert panel consensus statement: Integration of mechanisms, effects on animals and potential to impact human health at current levels of exposure. Reproductive Toxicology, 24, 131-138. [Context Link]