Aluminum as cause for alarm?
“Doctor, what do you know about the risks of using antiperspirant?” asked my 26-week pregnant patient, “Should I be worried?”
Feeling pretty uninformed, I told her, “if it makes you feel better, switch to a natural deodorant instead”.
I also told her she just gave me my next homework assignment.
The natural next question that my pregnant patient is going to ask is what my thoughts are on using antiperspirants while breastfeeding. No need to review all the basics, which if you want to read them are contained in my prior post (12.22.11 – Aluminum in Antiperspirant). In sum, after all my reading and research, I still continue to use my antiperspirant that contains aluminum. I wonder however if we have another child if I’d continue to use it during breast-feeding.
However, because I am on obstetrician-gynecologist and I guarantee somewhere down the line, if not this patient, then another one, is going to ask if there is any danger to using aluminum containing antiperspirants while breastfeeding. As the self-appointed Breastfeeding champion at my work, I better have an educated answer to this question.
How much of absorbed aluminum through the skin actually then goes on to get into breast milk, if any?
What effects does aluminum have on developing human neuro- and skeletal system?
How equipped is an infant to process and rid the body of aluminum?
How much aluminum is absorbed via the skin? ~
If you look at the back of any antiperspirant, an aluminum-based compound is the main/active ingredient. This ingredient functions to clog the sweat glands to reduce the amount of sweating that occurs.
Based on a small radioactive isotope tagging study, only 0.012% of applied aluminum is absorbed through the skin, a very minute amount compared to the amount we absorb in our digestive system.
The study authors concluded that a single use of aluminum applied to the skin does not appear a significant contribution to the body burden of aluminum (Flarend et al, 2001). However, another case report found individual differences might vary in ability to absorb and eliminate aluminum. There is the case report a 43-year-old woman applied around 1-gram of an aluminum chlorohydrate-containing cream on each underarm daily for four years and experienced bone pain and fatigue without another identified cause. After a couple months of stopping the antiperspirant use, the aluminum levels in her blood plasma and urine had decreased and at eight months her symptoms resolved. The authors of this study suggest that, “although individual variations in aluminum absorption are likely, one should apply aluminum containing antiperspirants with caution” (Guillard et al, 2004). Concluding, in essence, different people may have different abilities to eliminate aluminum. We know, those individuals with renal problems and on dialysis are more subject to the toxic build-up effects of aluminum.
Does aluminum absorbed from the skin show up in breast milk? ~
From the prior study, we know that there is a small increase in the amount of aluminum when it is applied to the skin. However, it is so minute, I imagine the amount that enters the breast milk to be a percentage less. For the answer to this question I looked into research articles that may’ve been published on this topic and searched through a “Drugs on Pregnancy and Lactation” text.
Sadly, I couldn’t find one research article that looked at application of antiperspirant and subsequent aluminum amount found in breast milk. Neither could I find anything in the textbooks that I looked through. So, if anyone knows of a research or textbook discussing this topic, please let me know!
Since aluminum is a highly reactive element and it can cross the blood brain barrier, I’d have to assume it also gets in breast milk. The amount is likely miniscule and an infant with well-functioning kidneys should have no problem eliminating this digested amount. However, I can’t determine to what degree since no actual studies have been done.
What effect does aluminum have on the developing infant’s systems? ~
Because infants are much smaller, the amount required for toxicity is much less and their system is not fully developed in its ability to rid the body of waste as readily. As demonstrated by studies in adults, different individuals process aluminum differently. These differences could also be found in infants. Additionally, given their size and immaturity of organs, the ability to process and eliminate the aluminum may be less efficient than adults.
If one is strictly breastfeeding, which the World Health Organization and the American Academy of Pediatrics recommends in most individuals for a minimum of 6 months, the amount of aluminum an infant is exposed to is minimal since the bulk of normal exposure comes from oral intake. However, if formula feeding, the amount infants are exposed to is likely much higher from water sources and from the formula itself.
As mentioned before, the main risks of elevated aluminum levels are that they displace similarly sized elements that have physiologic purpose in our bodies. It therefore, can do this to infant’s bodies’ causing injury to developing brains and bones.
What will I tell my patients? ~
As always it is a risk/benefit evaluation. If social isolation would be the result of not using antiperspirants, I’d say use the antiperspirant. Because the amount transmitted to the breast milk from use of antiperspirants would likely barely be detected and in individuals with normally functioning kidneys oral intake of aluminum can be easily eliminated, the risk of toxicity to an infant is so low, especially if only breastfeeding.
Otherwise, if it makes you feel better using natural deodorants and it works for you; by all means make the switch. As for me, if the time comes to breast-feed again I’ll likely make the switch when I can to natural deodorant but not hesitate to use my aluminum chlorohydrate filled antiperspirant on days I need something stronger.
Flarend R, Bin T, Elmore D, Hem SL (2001). A preliminary study of the dermal absorption of aluminum for antiperspirants using aluminum-26. Food Chemical Toxicology; 39(2):163-8.
Guillard O, Fauconneau B, Olichon D, Dedieu G, Deloncle R (2004). Hyperaluminemia in a woman using an aluminum-containing antiperspirant for 4 years. American Journal of Medicine; 117(12): 969-70.