The Ministry of Health of China reports that more than 53,000 children have sought medical treatment and have been hospitalised due to powdered infant formula contaminated with melamine, a toxic chemical. There have also been several deaths reported in this connection. In addition, dairy products made in China and exported to other countries have been found to be contaminated with melamine.

The Bangladesh government advised people to avoid buying eight milk powder brands after Dhaka University tests showed they were contaminated. So it is very imperative for us to know the foods with creamer or milk contaminated with melamine and should avoid those.

What is melamine?
Melamine is an organic base chemical most commonly found in the form of white crystals rich in nitrogen, carbon and hydrogen. Melamine is widely used in plastics, adhesives, dishware and whiteboards.

Why is melamine added into milk and powdered infant formula?
There is use of adding water to raw milk to increase its volume. As a result of this dilution, the milk protein concentration becomes lower. Companies using the milk for further production (e.g. of powdered infant formula) normally check the protein level through a test measuring nitrogen content. The addition of melamine increases the nitrogen content of the milk. Addition of melamine into food is not approved by the FAO/WHO Codex Alimentarius (food standard commission) or by any national authorities.

What are the other products made with melamine?
Melamine was used to produce a wide range of brightly colored dishware, bowls and containers. The compound is still used to create utensils and dishware and is used to create a resin coating for wood and textiles to produce laminates, flues, adhesives, moulding compounds. Some flame-retardants, fertilisers and dyes also contain melamine.

What are the health effects of melamine consumption in humans?
Melamine alone causes bladder stones in animal tests. When combined with cyanuric acid, which may also be present in melamine powder, melamine can form crystals that can give rise to kidney stones. These small crystals can also block the small tubes in the kidney potentially stopping the production of urine, causing kidney failure and, in some cases, death.

Chronic exposure to melamine may cause cancer or reproductive damage. Health effects from exposure to melamine vary depending on the amount and duration of exposure. While there is limited evidence to suggest, any group might be more susceptible to melamine.

It is expected that newborns and infants are to be more sensitive to melamine. Milk is the major food of infants. If they are given contaminated milk, they will consume a much higher quantity of melamine in respect of age and body weight. Till date, only babies and young children have been reported to be affected by melamine toxicity.

What are the symptoms and signs of melamine poisoning?
Irritability, blood in urine, little or no urine, signs of kidney infection for example fever, high blood pressure etc.

What are the medical tests to be done if my child is suspected of having melamine ingestion?
The doctor will examine your child, and, depending on the findings, may order urine tests, blood tests and/or ultrasound if necessary.

Is melamine accumulates or easily eliminated from the body?
Low level of melamine ingestion through the diet are not expected to accumulate and would be rapidly removed from the body, even over long term or chronic exposure. Adverse health effects occur as the body attempts to eliminate high levels of melamine such as those associated with contamination.

By Dr Md Abedur Rahman
The writer is a lecturer of Physiology, Dhaka Medical College.