Are you pregnant or thinking of becoming pregnant? If you’re health conscious, there’s a good chance you’ve read up on foods and supplements to optimize your health in pregnancy, but have you thought about exposure to toxins?
It turns out that there are numerous toxins present in our everyday life that can impact fertility, the risk of complications in pregnancy, and even your baby’s development. The chemicals found in the coatings on non-stick cookware are one source of toxin exposure you especially want to avoid.
Most non-stick cookware uses a Teflon coating, which is made from a class of chemicals called perfluorinated compounds or PFCs for short. You may have heard of certain PFCs, such as PFOA (perfluorooctanoate aka C-8) or PFTE (polytetrafluoroethylene).
Chemically speaking, PFCs are made by bonding fluorine and carbon together, a combination that is not found anywhere in nature. They have some pretty remarkable properties, which have made them invaluable to the chemical industry, namely nothing sticks to them.
The problem is that these chemicals are incredibly resistant to breakdown. Once they get in your body, they are there to stay for quite a while. It’s estimated that it can take up to 4-5 years for your body to metabolize and excrete PFCs.
PFCs are one of the most biopersistent chemicals in our environment; there’s virtually no place on earth that is 100% free of them. Researchers can’t even find human blood samples without PFCs, even from people living in extremely remote places and even from newborn babies. It’s frightening, really.
“Human biomonitoring of the general population in various countries has shown that, in addition to the near ubiquitous presence of PFOA in blood, these may also be present in breast milk, liver, seminal fluid, and umbilical cord blood.” (NHANES, 2010)
So, why are we using these chemicals?
Why is Non-Stick Cookware so Popular?
PFCs have a huge array of industrial uses, but one of the most popular (and relevant to your everyday life) is in non-stick cookware.
Original ads for non-stick pans focused on their ease of use, touting how “almost nothing sticks to Teflon” and thus, they require no scouring. For the home chef, this convenience was a huge selling point. Decades later when fat was (unfairly) demonized by the 1980’s dietary guidelines, non-stick cookware suddenly had another selling point: you didn’t need to cook with much—or any—fat.
There’s a great documentary on Netflix called The Devil We Know that explores the history of PFCs, how they became so popular, and the industry cover-up on their toxicity. It’s a must-watch.
(For what it’s worth, I had already extensively researched PFCs when writing Ch 10 of Real Food for Pregnancy and gone to print before this documentary aired, but it added so much context. It’s really an excellent film!)
The documentary starts with an interview with a mother and her grown son. His mother worked closely with the chemicals used to make Teflon at the DuPont plant before and during her pregnancy.
Her son was born with serious problems: half of a nose, one nostril, and severe eye deformities. Another woman who worked in the plant during her pregnancy had a baby with similar deformities. Farmers near the chemical plant, which were exposed to PFCs via wastewater, observed that their cattle had similar deformities.
The Devil We Know goes on to show the massive industry coverup over the toxicity of PFCs, especially PFOA or C-8, that spans decades. Chemical companies had been studying the toxicity of perfluorinated chemicals since the 1950s and ‘60s showing serious health problems in lab animals, including cancer, liver toxicity, pancreatic abnormalities, immune dysfunction, DNA damage, and much more.
As I mentioned earlier, PFCs are highly biopersistent, which means they don’t break down. Once they get in your system, they remain in your blood. In fact, it’s so persistent that the man with facial deformities born to the former DuPont employee had serum concentrations of PFOA higher than his mother, even as a fully grown adult. This supports animal data showing preferential transfer of perfluorinated chemicals from mother to fetus during pregnancy.
Is Non-stick Cookware Harmful in Pregnancy?
Now, I know what you’re probably thinking. “Certainly, low dose exposure to PFCs is harmless, right? My non-stick cookware should be totally safe. It’s not like I’m working in a Teflon factory!”
The coating on non-stick cookware is made of a chemical called polytetrafluoroethylene (PTFE) that, when heated beyond 325 degrees F or when scratched, begins to release another chemical called perfluorooctanoate (PFOA). If you’re searing a steak, for example, your frying pan will easily reach 500 degrees F, practically guaranteeing the release of chemicals into your food and into the air you breathe, even if your non-stick pan is in perfect condition.
And yes, even low level exposure to these chemicals is problematic in pregnancy (and also to non-pregnant people!).
Researchers note that PFCs are detectable in the blood of nearly all pregnant women.
In one study, the levels of 6 PFCs were analyzed in the embryonic and fetal organs from each trimester of pregnancy as well as maternal serum levels. A total of 78 embryos, 225 fetal organs, 71 placentas, and 63 maternal blood samples were analyzed for the 6 PFCs.
EVERY SINGLE SAMPLE—meaning every single embryo, organ, placenta, and blood sample—contained at least one of the 6 PFCs analyzed. Keep in mind that there are well over 100 different PFCs manufactured industrially and this study only looked at 6 of them.
While we can’t avoid all routes of exposure to PFCs, particularly contaminated drinking water, we CAN choose to avoid exposure via non-stick cookware.
Like so many other chemicals, higher levels of exposure increases the odds of certain pregnancy complications.
Non-stick Pans are Linked to Serious Pregnancy Problems
Exposure to PFCs in pregnancy has been linked to:
- Higher risk for having a low birthweight baby
- Impaired bone and organ development, resulting in smaller abdominal circumference, birth length, and head circumference
- Higher rates of preeclampsia
- Elevated markers of inflammation in pregnant women
- Depressed thyroid function—in both mother and baby. Note that impaired thyroid health can interfere with baby’s brain development.
- Endocrine disruption, including changes in levels of reproductive hormones
- Higher risk of atopic dermatitis (eczema) in childhood
- Higher incidence of bronchitis/pneumonia, throat infection, pseudocroup), ear infection and gastric flu/diarrhea in infants
- Higher risk of hyperactivity, particularly in female infants
- Lower childhood visual motor abilities
If this sounds frightening that’s because it is.
The harmful effects of PFCs are not just limited to pregnant women and their infants.
The C8 Health Project, which was a massive medical monitoring effort in response to drinking water contamination with perfluorooctanoic acid (C8) in West Virginia and Ohio (from wastewater disposal from Teflon manufacturing), is the largest study on the health effects of PFCs to date.
The C8 Health Project started in 2005 and published results in 2012, which consisted of a health survey (n = 69,030), blood testing for 10 PFCs, and 50+ lab tests (n = 66,899).
Collectively, the C8 Health Project found that PFCs are linked to:
- Testicular cancer
- Kidney cancer
- Ulcerative colitis
- Thyroid disease
- High cholesterol
Since these results were published, hundreds of additional studies have confirmed these findings, even when the study population lives on the other side of the globe. For example, a study in Swedish women found a link between early pregnancy PFOA serum levels and preeclampsia (quote below). Similar results were shown in a study from China.
The study from Sweden found higher PFOA concentrations significantly increased the risk of preeclampsia:
“A doubling of PFOS and PFNA exposure, corresponding to an inter-quartile increase, was associated with an increased risk for preeclampsia of about 38–53% respectively.” (Scientific Reports, 2019)
Are Newer Non-stick Alternatives Any Safer?
After the C8 Health Project published their results, chemical companies scrambled to find a replacement. This has led DuPont to cease production of C-8 in favor of another perfluorinated compound, which they call GenX (hexafluoropropylene oxide dimer acid or HFPO-DA), which is now the chemical of choice used to manufacture Teflon.
Sadly, since U.S. laws on chemical safety are a joke, GenX is understudied and the health effects are not fully known at this time. Early animal studies have shown that GenX is just as toxic as the chemical it replaced, including to pregnant rats and their fetuses.
As one study explains:
“Due to toxicity concerns, PFOA has been replaced with other chemicals such as GenX, but these new alternatives are also suspected to have similar toxicity. Therefore, more extensive and systematic research efforts are required to respond to the prevailing dogma about human exposure and toxic effects to PTFE, PFOA, and GenX and other alternatives.” (Env Sci & Pollution Res, 2017)
Alas, GenX is already contaminating our environment, with many effects yet to be fully studied:
“Recent environmental monitoring studies in North Carolina and the Netherlands have reported elevated levels of HFPO-DA [GenX], among other PFAS, in air, groundwater, and surface water sampled within the proximity of manufacturing sites and in drinking water originating from contaminated surface sources” (Env Health Perspectives, 2019)
In the film, The Devil We Know, they note that “GenX is just one of 88,000 unregulated chemicals used in everyday products.”
If you want to learn more about GenX, I recommend listening to this podcast interview on The Researcher’s Perspective, which explains:
“DuPont introduced GenX almost 10 years ago as a chemical substitute for perfluorooctanoic acid (PFOA). Although GenX was intended to be less environmentally persistent than PFOA, it has turned out to be what is known as a “regrettable substitute,” whose effects may be as bad as or even worse than the chemical it replaced.”
How to Minimize Your Exposure to Non-stick Chemicals in Pregnancy
If you already avoid the use of non-stick pans, you may assume you’re ok. But, it turns out that PFCs are used in a wide range of products including stain-resistant and water-resistant coatings (for carpets, clothing, and upholstery), paint, and even food packaging (to keep food from sticking to the container).
Needless to say, we’re in contact with a lot of PFCs, most often from food, contaminated water, or consumer products.
Of all food products, PFCs are particularly high in microwave popcorn because they are transferred from the coating on the popcorn bag into the corn kernels upon heating. Other common dietary sources are canned meat, hot dogs, chicken nuggets, French fries, and chips.
Clearly, limiting exposure to PFCs is wise during pregnancy—and for all of us. Here are some practical ways to do it.
Tips to minimize PFC exposure:
- Avoid the use of non-stick pans and kitchen utensils (opt for cast iron, stainless steel, glass, or ceramic cookware). Remember to check bake ware as well, such as cookie sheets and muffin tins. Consider that most air fryers, rice cookers, and waffle irons have non-stick coatings. Strictly avoid Teflon® cookware. See my note below on “ceramic non-stick” pans.
- Eat less microwave popcorn, prepackaged food, microwave dinners, and fast food, as the packaging often transfers PFCs into the food.
- Avoid the use of stain-resistant or water-repellent sprays (decline optional stain treatment on new carpets and furniture).
- Buy clothing without the Teflon®, Scotchgard™ or Gore-Tex® tags. (If you live in a rainy climate, this may simply be unavoidable. Pick your battles.)
- Don’t use household chemicals or personal care products with the words “fluoro” or “perfluoro” or “PTFE” in the ingredients list. Computer cleaners are common offenders (which often use 1,1-difluoroethane).
- Check with your local water source to ask about contamination with PFCs. Some water filters, like BerkeyⓇ filters, can remove PFCs, but many other brands do not. Always check with the manufacturer before you purchase a water filter to see which chemicals it removes.
What About Ceramic Non-stick Pans?
Inevitably when I talk about non-stick cookware, I get questions about the novel ceramic non-stick cookware, such as The Green Pan.
What’s frustrating in trying to research this type of pan is that the company does not disclose the full list of ingredients used in manufacturing the coating, just that it’s manufactured without PFOA.
From their website, they explain that the coating on Green Pan is made of Thermolon:
“Thermolon is the ceramic non-stick coating used on all GreenPan non-stick cookware. It is a coating that is manufactured without PFAS, or PFOA, and does not contain any lead or cadmium. It is made from Silicon (not to be confused with silicone), basically sand, that has been transformed into a spray-able solution and then cured onto the pan in the oven.”
That’s great, but it doesn’t tell me what chemicals were actually used in the manufacturing process, which could be any number of other PFCs. If it’s entirely free of PFCs, I’d expect them to advertise this. I’ve even scoured the scientific literature to try to learn about the coating on these pans and haven’t found much of anything.
Without knowing the full story here, I can’t recommend for or against their use based on claims of being non toxic.
Personally, I have a number of friends who have found the coating to chip or crack over time OR have found the non-stick properties to decline with prolonged use.
In one review article on the performance of various “green” pans, the authors conclude:
“While a range of “green” non-stick pans are available to consumers today, including the Classicor Go Green, the Cuisinart GreenGourmet, the EarthPan and the GreenPan. All of these products fail to meet standards required by the laboratory, the consumer kitchen, or both… A truly “green” Teflon® substitute has yet to be developed to fill this need. Likewise, the notion of being able to remove excess fats from daily food consumption is a worthy pursuit, but cooking in a vessel free of any lubrication or medium would appear as impossible as it sounds.”
This may be a separate issue from toxicity, but from an environmental standpoint, I’d rather purchase and use cookware that lasts a lifetime than contribute to landfills when the latest kitchen fad disappoints.
Note on “ceramic non-stick” vs. traditional ceramics:
Keep in mind that “ceramic non-stick” cookware is not the same as traditional glazed ceramics, like you might find as an insert for your slow cooker. Generally speaking, as long as a food-grade glaze was used on ceramic cooking vessels, they’re perfectly safe. The only consideration, if you’re not sure on the food-grade issue, is that some glazes can contain lead. The FDA advises using lead-testing kits (check online or at a hardware store) to ensure your ceramic cooking vessels or dishes are food-safe.
What Cookware is Safe in Pregnancy?
Think about the cookware your great grandma would have used and start there.
The entirety of my cookware collection is cast iron, stainless steel, enameled cast iron (such as Le Creuset), and glass. I also have a slow cooker with a ceramic insert, though these days, I mostly use my Instant Pot, which has a stainless steel insert. These are non-toxic and aside from enameled cast iron (which can get scratched) or glass (which can break), are essentially a one time purchase.
A properly seasoned cast iron skillet with a good flat-edged metal spatula, sufficient use of fat during cooking, and pre-heating the pan before you put your ingredients in negates the need for a non-stick pan entirely.
And hey, if something sticks, wash it!
Don’t be afraid of using some old fashioned elbow grease to clean your pans. Since I have never known any different (grew up without the use of non-stick pans and have never personally owned one), I’m accustomed to scrubbing cookware after use. Since there are no delicate non-stick coatings to risk damaging, there’s no fear of scrubbing and no fear of scratching if you use the “wrong” utensil.
If you need to heavily scour your cast iron pan (rare if it’s properly seasoned), then you simply re-season it when you’re done. They’re practically indestructible.
UPDATE: Recommended Cookware
So many of you have emailed or messaged me asking for specific brands of cookware that I consider safe. Here are a few links to start your research.
I personally have a mix of old and new cookware (like hand-me-down and vintage cast iron, glass pyrex pans from thrift stores, a few nice pieces of All Clad, etc.), but since you asked, here are some Amazon affiliate links (meaning you don’t pay any extra, but I get a small commission for recommending the product):
All Clad 12-Inch Stainless Steel Frying Pan — 12 inches and has a lid. If you opt for recipes that require searing followed by a quick steam (such as my green beans with macadamia nuts and thyme or baby broccoli with bacon, you’ll want a lid). Bonus points that you and use this lid on a 12 inch cast iron skillet as well. I love the ease of cleaning and even heating that you get from really high-end, heavy guage stainless steel, but it is definitely an investment. Thankfully, it’s a one time purchase!
Cuisinart 5-1/2-Quart Saute Pan w/ Lid — If All Clad is out of budget (I get it; I only have 2 pieces of All Clad in my house!), Cuisinart is just fine. It generally runs about ¼ of the price of All Clad. I have a saucepan from them and although the sides are a bit thin in comparison to All Clad, it gets the job done. This pan is a large skillet with straight sides, which some find more versatile than a typical frying pan with curved sides; it also has a larger capacity, which is helpful when making a large stir fry.
Solidteknics 12″ Wrought Iron Skillet — This USA-made pan cooks and seasons like cast iron at only half the weight. It’s made of heavy-metal-free USA sheet iron and caries a multi-century warranty. I can attest that it cooks just as well (if not better) than cast iron. Keep in mind that you’ll need to season it upon purchase. It arrives looking like stainless steel with instructions for seasoning (so, it will turn a darker color and develop a non-toxic, non-stick finish similar to cast iron). The same company also manufactures a nickel-free stainless steel line of cookware (called Noni), which comes at a higher price point, but if you’re in need of stainless cookware, this is a great small company to support. I love that all of their pans are free of rivets, which makes for super easy cleaning!
Cuisinart 8-Quart Stock Pot — Great for bone broth, soup, chili, etc. Since I have a 6-quart Instant Pot, I only use a separate stock pot if I need a larger capacity (hence why I linked to an 8-quart stock pot here), when straining bone broth, or when canning.
Lodge 12-Inch Cast Iron Skillet — Cheap, indestructible, and fortifies your food with iron. This pan has an extra handle at the other end, which is helpful when transferring/pouring food from the pan (cast iron is heavy!). This is my preference for searing on high heat (like steak, pork chops, etc.). If I’m cooking meat in it, I’ll follow up with the vegetables for the meal so I can make use of all the delicious brown bits and flavor left in the pan. The vast majority of my cooking is done in a cast iron skillet. Cleaning instructions and benefits of cast iron are discussed in this post. Beware, the handle will be hot. Get used to having a handle cover or having hot mitts at the ready.
Lodge 8-Inch Cast Iron Skillet — My cast iron skillet of this size lives permanently on our stove top and is used almost exclusively for eggs. Perfect size for 2 fried eggs. By the way, you need a flat-edged METAL spatula when cooking in cast iron. This is my favorite. Remember, when you cook in cast iron, you have to develop better cooking techniques than using a non-stick pan. That means pre-heating the pan before you add your food, using enough fat, waiting to flip your food until it has “released” from the pan (such as when searing meat or flipping an egg), and using the right utensil to get under the food (hence why I’m linking to a good spatula for you!). Don’t worry, your cooking skills will improve with time as will the “non stick” seasoning on your cast iron skillet.
All Clad Stainless Steel Cookie Sheet — If you do a lot of baking, you might want to trade up for a stainless steel cookie sheet. I personally have an All Clad Jelly Roll Pan (sadly, this has been discontinued), which is the size of a half sheet pan with sides and perfect for roasting vegetables. Prior to this, we roasted veggies in large glass Pyrex baking pans (lasagne pans).
Le Creuset Dutch Oven — These iconic, brightly colored enameled cast iron pans are awesome and with a price tag to match. I only have one, but to be honest, I rarely use it now that I make most “slow cooked” meals in the Instant Pot. They’re a bit finicky to clean and you can’t use metal utensils or scouring pans when cleaning it because it can damage the enamel.
Bakeware: You may have to do some extra searching, but you can find cast iron muffin tins, glass baking pans, stainless steel roasting pans, stainless steel cookie sheets (linked above), and much more. If you bake often, replacing your non-stick pans might be a bigger priority than if you only bake during the holidays or for special occasions. Your call.
Cleaning cast iron: see this post.
Cleaning stainless steel: After cooking and emptying the contents of your food to your serving dish, place the skillet/pot in a sink and fill with water. Soak if needed (especially if you have baked-on food). Use a heavy duty scouring pad with dish soap (those dark green ones you get at the grocery store are great for this!). If you have burnt-on food, consider using steel wool for tough spots. Then wash/rinse as usual. That’s it. Note that the higher quality stainless steel cookware you have, the easier it will be to clean. My All Clad cookware is a breeze to clean, but the Cuisinart often takes a bit of extra scrubbing.
Final Thoughts on Non-stick Pans in Pregnancy
Since there are so many non-toxic and viable cookware alternatives available, there is really no need to continue using non-stick cookware.
The PFCs in non-stick cookware are detrimental to your health, your baby’s health, and the environment at large. Let’s quit supporting companies that produce these toxic products and switch to other alternatives.
Cheers to safer cookware and a healthier pregnancy ahead.
Until next week,
PS – You’ll notice aluminum pans are not on my list of recommended cookware. There’s a reason for it. See this post to learn why cooking with aluminum, even aluminum foil, is not a wise choice. For research specific to pregnancy and aluminum exposure, as well as a number of other toxins, see Ch 10 of Real Food for Pregnancy.
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