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Pediatricians and Pesticides- AAP Provides Guidance and Opens Door for New Conversations

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Ever since my first child was born nearly 14 years ago, I have diligently brought information and articles to well child visits about all kinds of environmental health issues. Shouldn’t you be telling us about mercury in tuna, I would ask the doctor? What about BPA in baby bottles? Alas, our otherwise sage pediatrician stuck to the traditional topics of immunizations, car seat safety, and bike helmets.

But my 3rd child’s 5 year old visit may be different than his brother and sister’s have been. It is the dawning of a new day here at the Annual Conference of the American Academy of Pediatrics in New Orleans, where a new report examines the health implications of eating organic foods.

What did they find? The answer may depend on which news story you read, hear or watch. Headlines picking up this story have suggested completely different views on the benefits if eating organic. For the real answer you need to read the paper and hear from the authors of the paper directly. While the article acknowledges that there is no direct evidence that organic foods are nutritionally superior, it clearly states that organic foods do have lower levels of pesticides, which may be significant for children. Joel Forman, MD, FAAP, a member of the AAP Council on Environmental Health and one of the lead authors of the AAP clinical report, points out that while the scientific evidence does not exist to predict the impact over a lifetime, we do know that a child’s developing brain is uniquely vulnerable. The authors also point out that organic meats reduce antibiotic resistance bacteria because organic farming rules prohibit the non-therapeutic use of antibiotics.

As to higher cost, the authors suggest choosing organic produce selectively based on items that tend to have the highest pesticide residues per information from Consumer Reports and the Environmental Working Group. Janet Silverstein, MD, FAAP, a member of the AAP Committee on Nutrition and the other lead author of the report, stressed that most importantly, children should eat diets rich in fruits and vegetables, whole grains, and low-fat or fat-free dairy products.

In a session at the AAP conference on Food Matters, Joel Forman provided the context and framing that is impossible to do in quick sound bites and press releases. He talked about the impact of pesticides on farmworkers and new evidence that organic farming can actually provide as much food efficiently and cost effectively as conventional agriculture. As one pediatrician said after the presentation “This talk has expanded my understanding of organics which I always thought were too expensive. Now I understand that there are all these hidden costs that need to be taken into account”. So when NBC reports that docs say “don’t recommend organics for kids”, they are not reporting the whole story.

It is encouraging that the AAP has taken the bold step to suggest that pediatric providers begin discussing these issues with their patients and families. But now the real work needs to begin…the upstream changes that will allow families to afford purchasing organic foods, to have the option to make good precautionary decisions about their children’s health. Healthcare providers can play an important role in advocating for healthier food systems in their hospitals and in their communities. .

Hospitals can also play an important role in changing the landscape so that the healthier organic choice, is also an easy and affordable choice. As large institutional purchasers, the healthcare sector can influence the supply chain, just as a group of hospitals has done in the Bay Area.

But today, on the verge of the 2nd Annual Food Day, where people around the country are recognizing the need for a healthy, sustainable food system, let’s celebrate that an association which guides the everyday practice of more than 50,000 pediatric providers around the country, may encourage more and more pediatricians to begin the discussion about the risks of pesticides and antobiotics in our food system. I know I will have this conversation next time I bring my little guy to get his immunizations. Or perhaps his doctor will start the conversation first….

Heath Care without Harm, an international coalition of more than 500 organizations in 53 countries, is working to transform the health care sector, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment. To learn more about HCWH's work, visit our website at www.noharm.org, our YouTube channel at HCwithoutharm, and our twitter feed at hcwithoutharm.