Intended for healthcare professionals


China’s tainted milk scandal spreads around world

BMJ 2008; 337 doi: (Published 01 October 2008) Cite this as: BMJ 2008;337:a1890
  1. Jane Parry
  1. 1Hong Kong

    Dozens of countries have banned the sale or imports of dairy products from China. Melamine tainted milk has killed four infants in China and hospitalised tens of thousands of infants and children with kidney problems.

    The European Union has banned all baby food containing Chinese milk; France has gone further by banning all foods containing Chinese milk as a precautionary measure. Altogether 24 other countries in Asia, Africa, and South America have imposed bans on some or all Chinese milk products.

    The World Health Organization has called on countries to be alert to possible melamine contamination of dairy products sourced in China.

    “While breast feeding is the ideal way of providing infants with the nutrients they need for healthy growth and development, it is also critical to ensure that there is an adequate supply of safe powdered infant formula to meet the needs of infants who are not breast fed,” said Jørgen Schlundt, [OK] director of WHO’s Food Safety Department.

    Melamine, which was added to make the protein content of cow’s milk seem higher when it was tested before it was sold to milk product manufacturers, has been found in infant formula from 22 of China’s 109 dairy manufacturers’ brands.

    So far seven Asian countries and territories—Hong Kong, Japan, Macau, New Zealand, Singapore, South Korea, and Taiwan—have found food imported from China or manufactured using Chinese milk to be tainted with the industrial chemical melamine.

    Apart from infant formula, products recalled in the region include milk drinks, one type of Heinz baby cereal, chewy sweets, chocolate biscuits, bakery goods, and powdered cheese.

    The reported number of Chinese babies and children with kidney stones as a result of being fed on tainted infant formula has risen to more than 52 000. Although China’s Ministry of Health has not updated the toll since it reported on 21 September that more than 39 965 children had been treated and discharged, 12 892 remained in hospital, and 104 had acute kidney failure, reports from individual provinces have since added another 9959 cases to the tally.

    The China Daily newspaper quoted Shanghai authorities as saying that an estimated 5% of the city’s children under the age of 3 years have been given a diagnosis of kidney problems related to melamine contamination.

    So far four children in China have died as a result of drinking tainted infant formula, but the death toll is not expected to rise dramatically.

    “We don’t expect a large increase in the number of deaths, because we have to remember that a child usually doesn’t die from a kidney stone itself but from its complications,” Reuters reported Hans Troedsson, [OK] WHO’s representative in China, as saying. “The treatment has been shown to be effective [in China],” he said.

    The recalls of products and bans on imports of other milk products apart from baby formula have been largely precautionary, and no reports have been received of adults falling ill as a result of the tainted milk. However, little research has been done into the effects of long term exposure to low doses of melamine, said Daniel Tak-Mao Chan, [OK] at the University of Hong Kong’s Department of Medicine.

    “It’s not possible to ensure zero exposure to melamine, because in one way or the other it’s part of the food chain; it’s present in animal feed and is widely used for food preparation and containers,” he said.

    “It appears that by itself melamine does not have a significant effect on genetic make-up, but the studies were done long ago in animals, over a relatively short period of time, in an artificial environment.”


    Cite this as: BMJ 2008;337:a1890

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