Baby powder is traditionally used to prevent a pesky diaper rash, and Johnson & Johnson's white bottle is iconic—it's been around more than 100 years. But there have been several recent headlines questioning baby powder's link to cancer. Plus, Johnson & Johnson Consumer Inc. issued a voluntary recall for a single lot of baby powder in October 2019, after the FDA found trace amounts of asbestos in a tested bottle. These stories might leave you wondering: is talc-based baby powder actually safe to use?
The short answer is yes—baby powder is now generally safe to use. But when it comes to any product you put on your baby, it's a good idea to be very vigilant. Pediatricians urge parents to be cautious when applying talc-based baby powder on their young ones.
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Protecting Baby's Lungs
It's not necessarily a link to cancer that pediatricians are concerned about. Rather how inhaling the powder may affect a child's lungs. "People who are using these large amounts of baby powder, particularly around the baby's face, run the risk of the child inhaling this very fine particulate matter into the lungs," says Joel Kahan, M.D., director of pediatrics at Syosset Hospital in New York. "If there's a big enough load, it can really be very harmful to the child."
This concern isn't new. In 1981, the American Academy of Pediatrics released a report about the potential hazards of talcum powder aspiration. The report called these incidences "grossly underestimated" and tied them to a 20 percent mortality rate.
In the 4th edition of Pediatric Environmental Health, published by the American Academy of Pediatrics Council on Environmental Health in December 2018, the AAP confirmed that parents should avoid talcum powder in the nursery to prevent talc pneumoconiosis. "[This] can result from accidental inhalation of bulk powder if a can should tip over into a baby’s face," the AAP wrote. "Talc pneumoconiosis has been associated with several infant fatalities."
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Pediatricians encourage parents to consider alternatives to powder, like oil-based lotions or creams. Parents can also opt for cornstarch, which is comprised of larger particles than talcum powder making it less of a threat to the airway. These products are equally effective at making sure babies stay dry.
"The most important thing you can do is change your baby frequently and keep them out of wet or soiled diapers," says Dr. Kahan.
Baby Powder and Asbestos
If you're concerned about baby powder being linked to cancer, let's break down the news: More than 13,000 people have sued Johnson & Johnson saying the product caused their cancer. Some of them were diagnosed with mesothelioma, a rare cancer tied to asbestos exposure. According to Reuters, the company concealed the fact its talcum powder sometimes contained small levels of asbestos between 1971 and the early 2000s. Talcum powder is made of talc, a naturally occurring mineral used in many consumer products, including makeup, because of its ability to absorb moisture. It's found in underground deposits that often also contain asbestos, a known carcinogen, making contamination possible.
A representative from Johnson & Johnson confirmed to Parents.com that the talc used in Johnson's Baby Powder does not contain asbestos.
"Thousands of tests over decades repeatedly confirm this," says Susan Nicholson, M.D., vice president, women’s health, Johnson & Johnson. "Not only do we and our suppliers routinely test to ensure our talc does not contain asbestos; our talc has also been tested and confirmed to be asbestos-free by a range of independent laboratories and universities, including the FDA, Harvard School of Public Health, and Mount Sinai Hospital."
Even so, Johnson & Johnson issued a voluntary recall in October 2019 for a single lot of baby powder. This was done after the FDA found trace amounts of asbestos in a tested bottle. However, after conducting 15 new tests later that month, Johnson & Johnson says it did not find asbestos in that same bottle of baby powder. Forty-eight other tests of samples from the recalled bottles performed by two third-party labs also didn’t find asbestos.
Johnson & Johnson has had wins, losses, and mistrials in court. In March 2019, a jury in Oakland, California ruled in the favor of one of the plaintiffs who is suffering from terminal mesothelioma, according to the Associated Press. She was awarded about $29 million. The verdict came after a Missouri jury ordered Johnson & Johnson to pay $4.69 billion to 22 women in 2018, while a Los Angeles jury granted $25.7 million to another woman that same year. But in May 2019, a jury in South Carolina concluded the company wasn't to blame for the plaintiff’s disease, becoming the fifth verdict in favor of Johnson & Johnson.
Baby Powder's Connection to Ovarian Cancer
Other plaintiffs, who say they used Johnson & Johnson baby powder for perineal care, believe the talc in the product gave them ovarian cancer.
Dr. Nicholson says that research, clinical evidence, and more than 40 years of studies by medical experts supports the safety of the cosmetic talc found in Johnson's Baby Powder. "Government and non-governmental agencies, such as the U.S. Food and Drug Administration and Cosmetic Ingredient Review Expert Panel have all investigated the potential harmfulness of talc and determined that talc is safe and does not cause ovarian cancer," she says.
Overall, the data connecting talc with ovarian cancer isn't so black and white and gynecologic oncologist Stephanie Wethington isn't convinced it is a cause. She does recommend women use unscented, simple soap products on their perineum instead of baby powder, but that has nothing to do with ovarian cancer risk. Those are just less likely to cause irritation.
"At this point in time, especially with the modern product, current testing, and current attention to the issue, I do think it's safe," adds Dr. Wethington, assistant professor of gynecology and obstetrics for the Johns Hopkins Kimmel Cancer Center in Maryland. "I don't think we have any compelling evidence to indicate that it is unsafe."
Observational studies, such as one in 2014 from the Women's Health Initiative that followed more than 61,000 women for 12 years, didn't find a connection between talc and ovarian cancer. Yet, case-control studies have concluded an increased risk. One such study from 1982 stated women who regularly used talcum powder on both genitals and sanitary pads more than tripled their chances.
The problem with case studies is they can "be inaccurate because, at the core of the study, they are relying on what someone remembers," Dr. Wethington says. That brings recall bias into play.
Women, she says, should instead focus on genetics and family history. Those are proven risk factors for ovarian cancer, which affects about 20,000 women in the United States each year, according to the Centers for Disease Control and Prevention.
"I wish the attention was actually being brought to the ways in which we can intervene and the things that all of us who are gynecologic oncologists wish every patient did know about ovary cancer," Dr. Wethington says. "[That] would get us to a much better and safer place rather than focusing on talc, which it is not clear has any association with ovary cancer."
And to parents who still want to use talc-based baby powder on their tots, or can't find another solution (we know, baby rashes can be brutal!): "You need to be very judicious and careful about how you apply it," says Dr. Kahan. He suggests putting very small amounts of baby powder on your hands before rubbing it on a child's bottom. Keeping babies far from the "plume of talc in the air" is critical.