This January, California Assembly Bill 899 (AB 899) will go into effect, mandating that baby food manufacturers test for toxic metals such as arsenic, cadmium, lead, and mercury.¹ While this legislation marks an important step toward improving the safety and transparency of baby food, healthcare providers now face a new challenge in addressing parents’ concerns about food safety.

As we gather at the AAP National Conference at the end of the month, it’s crucial that we begin preparing for the implications of this law.² AB 899 will impact baby food production, safety, and transparency standards in California, with a ripple effect across the United States. It is essential that we educate ourselves and each other so that we can help parents make informed decisions regarding their child’s health.

What is AB 899?

California Assembly Bill 899 (AB 899) introduces a new requirement for baby food manufacturers to test their products for four naturally occurring metals: arsenic, cadmium, lead, and mercury. While these metals can be found in the environment and may enter food during production, this legislation is designed to help ensure that baby foods meet higher safety and transparency standards. By staying informed and proactive, we can continue guiding parents in making safe and healthy choices for their children.

AB 899 aims to create a uniform standard for testing and reporting, with the goal of minimizing children’s exposure to these harmful substances. Starting in January 2025, baby food manufacturers producing within or that sell within the state of California will be required to make these test results publicly available, providing greater transparency and accountability in the baby food industry.

Nationwide implications of AB 899

Although AB 899 is a California law, its influence is expected to extend nationwide. Historically, California has led the way in establishing health and safety standards that are later adopted by other states or integrated into federal regulations. Given California’s large market share, most baby food manufacturers are likely to adopt these testing requirements across their entire product lines, simplifying and ensuring uniformity in compliance. This could potentially result in improved transparency and food safety measures across the United States.

Pediatricians nationwide should be ready to address parents' questions and concerns regarding this new law, helping them understand its impact on baby food safety and their children's well-being. By staying informed, we can provide reassurance and guidance, ensuring parents feel confident about the safety of the foods they choose for their children.

Toxic metals and their impact on young children

The presence of trace amounts of metals like arsenic, cadmium, lead, and mercury in baby food has been a topic of discussion for some time. Recent studies have brought more awareness to these concerns, particularly regarding potential long-term health effects. While infants and toddlers are more sensitive to environmental factors due to their developing bodies, it's important to remember that ongoing research and improved regulations, like California's AB 899, are working to ensure that food manufactured and marketed for babies is as safe as possible. As pediatricians, our role is to reassure parents and guide them in making well-informed choices for their child's health.

According to the American Academy of Pediatrics (AAP), exposure to these metals, even in small amounts, can have serious consequences for children’s health, particularly affecting brain development and the nervous system. Lead, for example, has no safe level of exposure and can cause permanent neurological damage, impairing cognitive function and behavior.³ Ingredients that have been flagged as being of elevated heavy metal risk include rice, leafy greens, root vegetables, and certain seafood.

Clean Label Project in partnership with the University of Miami Miller School of Medicine conducted one of the most comprehensive studies on the levels of lead and cadmium in America’s best selling baby food and infant formulas and published it’s findings in the peer-reviewed international multidisciplinary journal, Science of the Total Environment.⁴ While the presence of heavy metals is ubiquitous, through deliberate proactive formulation evaluation and ingredient sampling and testing, many of America’s baby food and infant formula brands have shown a marked decrease in the presence of heavy metals.

As pediatricians, it is essential to guide parents on how to minimize their children’s exposure to these toxic metals. Recommending safer food alternatives, such as offering a variety of grains beyond rice, having their drinking water tested, discussing environmental exposures (like those from lead paint in older homes), and encouraging parents to choose products from companies that test rigorously for toxic metals, can help reduce these risks. Additionally, if concerned about lead exposure, the best screening and confirmatory diagnostic tool for evaluating recent or ongoing lead exposure is the venous blood lead level test, although many pediatricians routinely screen with a capillary sample in office first.⁵

Preparing your practice for parental questions

As awareness grows through social media posts and mainstream news, parents will increasingly seek guidance about AB 899, toxic metals in baby food and the implications of the heavy metal test results in their child’s favorite foods. As pediatricians, we should be prepared to address any of their questions. Offering evidence-based advice and reassurances will be key to helping families navigate these concerns.

1. Stay informed: Familiarize yourself with AB 899, its focus on testing for arsenic, cadmium, lead, and mercury, and the requirements for manufacturers to publicly disclose their test results. CDPH offers FAQs to help stay updated on the law’s scope and implications.⁶

2. Educate and reassure parents: Parents and caregivers have a right to be concerned about the food provided to their families. Discuss the potential health risks associated with toxic metals in baby food. Explain how these metals enter the food chain through environmental contamination, such as from soil and water during cultivation, and how industrial processing can contribute to exposure. While it’s normal to have tiny amounts of heavy metals in food, being aware of them helps parents make more informed choices for their child’s diet.

3. Promote product transparency: Encourage parents to select baby food products from brands that prioritize transparency in their testing processes. Resources like the Clean Label Project can help parents identify products specifically formulated to minimize heavy metal exposure, empowering them to make informed choices for their children. As we get closer to the AAP National Conference, the Clean Label Project will have toolkits available for healthcare providers to navigate the evolving baby food regulations and confidently guide parents through these important changes.

4. The definition of “baby food”: AB 899 applies to all food specifically for babies and young children less than two years old. This includes food packaged in jars, pouches, tubs and boxes. Infant formula is not included in the definition of baby food. For parents with toddlers and infants, this inconsistency may cause confusion or concern as they navigate the web looking at the contents of their families’ favorite foods. If they have concerns, encourage them to reach out to brands directly to ask questions and demand answers.

5. Dilution is NOT the solution: Caution parents that when it comes to looking at heavy metal test results, low levels of heavy metals should not come at the expense of high nutritional density. So don’t just look at the heavy metal test results, read up on the nutritional facts panel. A diet rich in vitamins, nutrients, fats and proteins builds healthy brains and bodies while also keeping children satiated.

Conclusion

AB 899 is a significant advancement in addressing the presence of toxic metals in baby food with an impact expected to extend nationwide. Pediatricians must remain informed and vigilant, offering guidance and advocating for safer food products. By staying educated and providing sound advice, pediatricians can help protect children from toxic exposures and support healthy development.

References:

1. California Legislative Information. Assembly Bill No. 899. 2024. Accessed September 5, 2024. https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB899.

2. American Academy of Pediatrics. AAP National Conference & Exhibition. 2024. Accessed September 7, 2024. https://aapexperience.org.

3. American Academy of Pediatrics. Babies should eat a varied diet to protect against heavy metals in food, experts say. AAP News. August 11, 2022. Accessed September 5, 2024. https://publications.aap.org/aapnews/news/21916/AAP-Babies-should-eat-a-varied-diet-to-protect?autologincheck=redirected.

4. Close J, Roda C, Hsu H, et al. Exposure to toxic metals in baby foods: A comprehensive study. Sci Total Environ. 2019;651(Pt 2):822-829.

5. American Academy of Pediatrics. Detection of lead poisoning. May 1, 2024. Accessed September 7, 2024. https://www.aap.org/en/patient-care/lead-exposure/detection-of-lead-poisoning/?srsltid=AfmBOopMS6lUJuWXZNfA78K6GiF61bigXKIm97Nj52mx1fYdKWhupbfR.

6. California Department of Public Health. AB 899 Frequently Asked Questions. 2024. Accessed September 5, 2024. https://www.cdph.ca.gov/Programs/CEH/DFDCS/CDPH%20Document%20Library/FDB/FoodSafetyProgram/PFR/AB899FrequentlyAskedQuestions.pdf