Is Baby Powder Safe?

Baby powder has traditionally been used to prevent pesky diaper rash and Johnson & Johnson's white bottle is iconic—it's been around for more than 100 years. But in 2020, the company announced that it was permanently discontinuing the sale of talc-based baby powder in the U.S. and Canada, while cornstarch-based baby powder will continue to be sold. Both types will still be sold in other parts of the world.

The decision came after the company faced thousands of lawsuits from people linking the baby powder to their cancer. This 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 there are a few things parents should know to minimize any potential health risks.

Is Baby Powder Dangerous for Babies?

While many of the lawsuits over baby powder concerned cancer, it's not necessarily a link to cancer that pediatricians are concerned about. (Many of the suspected cancer cases with baby powder were for women who had been using the powder on their genitals for years as adults.)

Instead, for use in infants and young children, it's how powder may affect a child's lungs that has the biggest risk. "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% mortality rate in the 25 cases that had occurred that year.

In the 4th edition of Pediatric Environmental Health, published by the American Academy of Pediatrics Council on Environmental Health in December 2018, the AAP also confirmed that parents should avoid talcum powder in the nursery to prevent talc pneumoconiosis, a lung condition caused by breathing in particles. "[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."

Pediatricians encourage parents to consider alternatives to baby powder, like oil-based lotions or creams. Parents can also opt for cornstarch-based powders, 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.

And when in doubt, the best thing to do to avoid diaper rash or other skin irritations is to just change your baby's diaper often. "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 had sued Johnson & Johnson saying the product caused their cancer. Some of them were diagnosed with mesothelioma, a rare cancer tied to asbestos exposure. In 2018, Reuters reported that 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."

In 2019, Johnson & Johnson, which has had wins, losses, and mistrials in court, issued a voluntary recall for a single lot of baby powder. This was done after the FDA found trace amounts of asbestos in a tested bottle. But, after conducting 15 other tests, 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.

Baby Powder's Link 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, M.D., M.Sc., isn't convinced it is a cause. She does recommend that people with female reproductive tracts stick to 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."

There have been studies in the past showing an increased risk, including a case-control study from 1982 which stated women who regularly used talcum powder on both genitals and sanitary pads more than tripled their chances.

However, research published in the Journal of American Medical Association in January 2020 didn't find strong evidence connecting baby powder to ovarian cancer. It concluded this looking at results from four studies involving more than 250,000 women in the United States.

The problem with case studies is they can "be inaccurate because, at the core of the study, they are relying on what someone remembers," says Dr. Wethington. That brings recall bias into play.

Those with female reproductive organs, she says, should instead focus on genetics and family history. Those are proven risk factors for ovarian cancer, which affects almost 20,000 people in the United States each year, according to the American Cancer Society.

"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," says Dr. Wethington. "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."

How To Safely Use Baby Powder in Babies

For 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!), Dr. Kahan says to pay attention to how you apply it and be sure not to let a lot of baby powder release into the air near their faces.

"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.