2020年8月4日 星期二

“Can I Breastfeed After Being Teargassed?”: Medical Advice for the Protesting Mom

Some Portland moms line up outside the Mark O. Hatfield Federal Courthouse on July 29. Alisha Jucevic/AFP via Getty Images

A few short weeks ago, unidentified federal agents descended onto Portland, Oregon, attacking and kidnapping young Black Lives Matter protestors in clear violation of their constitutional rights. I’d like to say I couldn’t believe something like that could happen in my supposedly liberal, albeit whitewashed, American city. But after just seven months of the year 2020, I don’t think much really surprises me anymore.

Although what I call my “constant citizen’s outrage scale” shot way up when I first saw the coverage, I was afraid to go down to the volatile late-night protests because I have two young kids to care for. But if you’ve seen any of the emotionally rousing footage of the now-infamous “Wall of Moms” using their privilege to stand between BIPOC kids and their federal attackers, you won’t be surprised that my excuses quickly turned to vapor. If they could handle it, so could I. But wait, my mom brain raced, if I was about to get tear-gassed or shot with pepper rounds (and yes, it turns out, I was), what was I supposed to do about things like breastfeeding? How would I decontaminate before touching my kids? 

Although Black and brown women on the frontlines of civil rights protests have been dealing, unflappably, with mom-specific protest hazards for generations without fanfare, these questions were new and alarming to me. Although I’m an experienced researcher, my initial Google searches turned up mixed messages from mostly dubious sources. And that includes a sweetly earnest but medically iffy info sheet shared via the moms’ Facebook group.

Moms protesting on the frontlines—whether as part of Moms United for Black Lives or any protest—could use some certainty and clarity. So, over several days of protesting, I gathered some questions from them. I then spoke with multiple doctors, two lactation consultants, and waded through what little hard data there is to collect these answers.

Can I breastfeed after being hit by teargas? Do I need to wait? Should I “pump and dump?”

Blessedly, I can give you a short answer: Yes, you can go ahead and breastfeed after a teargas attack, with no pumping and dumping required, as long as you’ve left the contaminated area and have showered.

I have a ravenous 5-month-old at home, so this was the first question I found myself frantically Googling on my way downtown to the Wall of Moms that first night. I couldn’t find a clear answer as I grabbed my bike helmet, snorkel goggles, and a ventilator mask I bought when I thought we might have bed bugs and needed to spray the living hell out of the guest room.

Now, after speaking with Dr. Matthew Riddle, an emergency physician and medical toxicologist, I know that “when your skin has been thoroughly cleaned and feels completely normal, you should be good to go… Tear gas stays on exposed surfaces where it causes irritation and doesn’t get absorbed into the body,” he told me. “So it shouldn’t end up in breast milk. No need to “pump and dump.”

If you are of the extra-cautious persuasion, you may want to follow this 2019 advice from La Leche League, an international community education and support group for breastfeeding mother. They say moms who have been teargassed could choose to wait one hour after decontaminating to breastfeed. However, both sources agree that the main risk to your baby comes from skin-to-skin transfer, with minimal risk from the milk itself.

How do I decontaminate before touching my kids? Will I harm them by coming back into the house after being gassed or hit by pepper rounds?

Riddle recommends removing contaminated clothes and shoes before entering your living space and keeping them inside a plastic bag until they can be washed. Then, a simple shower (no baths) with soap and cold water will do the trick. There’s also some evidence, according to Riddle, that using vegetable oil will soothe skin and help remove capsaicin, which is a main ingredient in pepper ball rounds, pepper spray, and a few teargas varieties. For the other, more common ingredient in tear gasses, o-chlorobenzylidene malononitrile (CS for short), Riddle and the CDC recommend simple soap and cold water.

After being engulfed by tear gas several times now, I’ve taken to following the same basic routine my husband, a hospital physician who sometimes treats COVID-19 patients, follows when coming home. I enter through the basement, strip and put all garments directly into the washing machine, then slink up the stairs without waking or attracting attention from the kids or touching anything until after I disinfect in the shower for at least 10 minutes. Basically, you might not want to hang out in my basement right now.

What if I’m detained by police or agents and need to pump?

This question may sound like a deep dive into the pool of “what ifs.” But if you’ve ever gone too long between pumping or feeding, you get it.

When lactating breasts go too long without being emptied, more than just discomfort is at stake. A build-up of milk can result in blocked ducts and even mastitis, which, according to the Mayo Clinic, can cause serious local and systemic health issues in the mother. Bad news, American moms. There are currently no laws supporting breastfeeding moms who need to pump while they are being detained by police or federal agents. There is a sort of “best practices guide” by the National Commission for Correctional Healthcare about lactating moms who are incarcerated long-term, but still: No law, so no real protection.

Can I participate in the Wall of Moms if I’m pregnant?

There have been reports floating around for years that tear gas exposure may cause birth defects and even miscarriage. And here is the unsatisfying answer: This may or may not be the case. There’s simply not enough hard evidence to really know. Many people would advise an abundance of caution in the case of pregnancy and protest. But it’s a very thorny, very personal issue.

As with many potential hazards to the safety of a pregnancy, there’s simply no ethical way to conduct adequate testing. The FDA is not about to approve a study testing tear gas on pregnant moms. That means the only information scientists can draw on is from field data or anecdotal evidence.

A paper from the Physicians for Human Rights group documented some pregnancy loss following mass civilian teargassing in Bahrain in 2012. Other field documentation by University of California researchers has noted high incidents of miscarriage in Palestinian refugee camps that were repeatedly exposed to tear gas in 2017. But none of these data sets comes from randomized, double-blind, placebo-control trials, which are the gold standard in developing a scientific consensus.

On the other hand, Riddle says that in what little testing there is, he’s seen results that showed no significant increase in birth defects in humans and animals after exposure to CS. He also points to “a report looking at CS exposure in pregnant women [that] found no major increases in miscarriages, stillbirths, or birth defects.” Still, he laments that we have limited data in this instance. We can hope that the potential risks are enough to curb tear gas use in a more hopeful future.

How can I protect or treat myself from tear gas exposure if I’m pregnant, nursing, or recently postpartum?

Riddle, as well as a San Diego pediatrician I consulted, said that the treatment for tear-gas exposure is the same for pretty much anybody. You can fight the gas best by protecting yourself in the first place by wearing long sleeves and pants and protective eyes, nose, and mouth gear.

Then, the best way to clean out affected eyes is to use clean, cool water or medical grade saline. So no, those homemade tear gas wipes soaked in sugar, citric acid, water, and baby shampoo that a well-meaning mom passed me the first time I got gassed might not have been a good idea, according to the docs (they were horrified I’d put them near my eyes actually). Finally, once you’ve been exposed, you’ll want to decontaminate. But first, try to get away from the gas. Moving to higher ground can work. Or, if you’re in downtown Portland, all you need to do is wait for the Dads with Leafblowers.



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