500 millirems, yet the people of Goldsboro were being exposed to 480 millirems every 24 hours! Low—level radiation (and these levels from this accident are not so low—level) is generally agreed to be much more dangerous than originally thought. In addition to the risks of cancer and leukemia, particular hazards to the pregnant woman and her unborn fetus concern me as a pediatrician. The link between radiation to pregnant women and later mental retardation in their offspring, first proposed by Dr. Ernest J. Sternglass, professor of radiological physics at the University of Pittsburgh, leads me to predict that 20 years from now, Goldsboro and Harrisburg will be fertile areas for scientists doing research on intelligence tests. But why wait for these retrospective studies? Why not adopt the prudent approach, as in other emergencies threatening health and life, of ordering (or at least recommending) immediate evacuation?

In future similar accidents, we must regard those invisible radiation particles as being as capable of causing disease as we now regard the epidemics caused by invisible viruses and bacteria. This is the lesson I think we can learn for the future.

Previously, I gave my recommendation for the first line of

defense against radiation damage from future nuclear plant accidents.

I advised the prudent approach of immediate evacuation. At that time (March 29, 1979), it took government officials an additional 48 hours before they counseled even the halfway measure of removing pregnant

women and preschool age children from a five mile area surrounding the Three Mile Island plant. Even as I write today (April 2, 1979), no further evacuation, even of adult women who might unknowingly be pregnant, has been suggested.

Although many statements, often conflicting, have been heard from physicists and other scientists, to date there has been an almost total silence on the part of physicians. The Department of Health, Education, and Welfare, so outraged by cigarette smoking and saccharin, has voiced not a peep about radiation-induced leukemia and cancer. The health officials of the State of Pennsylvania have said nothing about radiation—caused fetal malformations.

Seeing this vacuum of medical leadership at the highest levels, I will humbly offer my own prescription for the second line of defense (under no circumstances any less important than the first line of defense), namely breastfeeding rather than bottlefeeding in areas of high radiation.

Appearing on television on the east coast following the nuclear accident, La Leche League International president Marian Tompson cited evidence from the British medical journal, Lancet ("Absorption,

Excretion, and Retention of Strontium by Breastfed and Bottlefed Babies," Elsie M. Widdowson, et al, University of Cambridge, October 29, 1960) that breastfed babies excrete more strontium (a radioactive substance) then they ingest. If born with five milligrams of strontium (or strontium 90) a breastfed baby would be free of the material within three months. However, the bottlefed baby would have twice as much strontium as he was born with after about one month. The difference was attributed to the high content of strontium in cows‘ milk and the low phosphorus content

of human milk. When phosphorus was given breastfed babies, the excretion of strontium was reduced. Thus, the likelihood is that strontium would not be retained by babies as long as they are fully breastfed.

Even though strontium may not be yet identified as a significant element in the present Three Mile Island leak, the above scientific finding shows the "survival selectivity" of breast milk. Other pieces of