Protecting children from exposure to lead is important for lifelong good health. No safe blood lead level has been identified. Even low levels of lead in blood have been shown to affect IQ, ability to pay attention, and academic achievement. The effects of lead exposure cannot be corrected.
Women who have been or are currently exposed to lead can expose their fetus or infant to lead during pregnancy and lactation through blood and breast milk, which can have long-term effects on the neurodevelopment of their child. During pregnancy and lactation, mothers can have lead in their blood or breast milk for two reasons:
- They have been directly exposed to lead during pregnancy or lactation.
- Lead that is stored in a woman’s bones and teeth from a prior exposure to lead can be released during pregnancy or lactation.
If a pregnant or lactating woman has blood lead levels (BLLs) ≥5 μg/dL, the health care provider should attempt to determine the source(s) of lead exposure, working with the local health department and occupational medicine specialists as needed for environmental assessment and case management.
It is recommended that mothers with BLLs <40 μg/dL should breastfeed, but it is important to note:
- Infant BLLs should be monitored if his or her mother’s BLLs are between 5 and 39 μg/dL. Breastfeeding should continue for all infants with BLLs below 5 μg/dL.
- If infant BLLs are rising or failing to decline by 5 μg/dL or more, the healthcare provider should contact the local health department for environmental sampling. If no external source is identified, and maternal BLLs are ≥20 μg/dL and infant BLLs are ≥5 μg/dL, then breast milk may be the source of lead exposure. Mothers should consider temporarily pumping and discarding their breast milk until maternal BLLs are lower.
Mothers with BLLs ≥40 μg/dL are encouraged to pump and discard their milk until their BLLs drop below 40 µg/dL.
- Testing breast milk for lead is not recommended.
What Are Some Kinds of Lead Hazards Breastfeeding Women Might Be Exposed To? How Can They Protect Themselves and Their Infants?
Breastfeeding women should be aware of or avoid the following:
- Lead-based paint (typically found in homes built before 1978). Stay away from repair, repainting, renovation, and remodeling work. Test paint before starting home improvements that disturb paint. If hiring someone else to perform work, make sure they follow lead paint repair rules from the Environmental Protection Agency (EPAExternal).
- Pica. Never eat or mouth clay, soil, pottery, or paint chips because they may be contaminated with lead.
- Tainted food. Use caution when eating candies, spices, food additives, and other foods from abroad, especially if they appear to be noncommercial products of unknown safety. Limit eating game meat—such as deer—that have been hunted with lead ammunition.
- Tainted foodware. Avoid using imported lead-glazed ceramic pottery and pewter or brass containers or utensils to cook, serve, or store food. Avoid using leaded crystal to serve or store beverages. Do not use dishes that are chipped or cracked.
- Tainted medicine or personal care products. Avoid imported medicines and herbal remedies (azarcon, Ayurvedics); cosmetics and ceremonial powders (tiro, kohl, kajal, surma); and personal care products (litargirio) that may contain lead.
- Water with lead levels exceeding 15 parts per billion (ppb). If water lead levels exceed EPA’s action level of 15 ppb, use bottled water or water from a filtration system certified by an independent testing organization to reduce or eliminate lead for cooking and drinking.
- Some occupations or hobbies that may involve lead exposure. These include construction or home renovation/repair in pre-1978 homes; firing ranges and military or police work; battery or electronics manufacturing or recycling; soldering or casting metal; oil field work; mining; and aviation gas used in small planes. If a household member works with lead, take precautions to avoid taking home lead dust in cars or on clothing, skin, hair, and shoes.
- Prior exposure. Prior significant exposure such as childhood environmental exposure or previous occupational exposure could lead to large stores of lead in bone which can become mobilized during pregnancy.
- Recent immigration. Recent immigration to the United States from countries where relatively high lead exposure is endemic, such as countries where leaded gasoline is still used or where use of consumer products containing lead is widespread.
- Angelon-Gaetz KA, Klaus C, Chaudhry EA, et al. (2018) Lead in Spices, Herbal Remedies, and Ceremonial Powders Sampled from Home Investigations for Children with Elevated Blood Lead Levels — North Carolina, 2011–2018. MMWR, 67(46):1290–1294. Cdc-pdf[PDF-131KB]
- Guidelines for the Identification and Management of Lead Exposure in Pregnant and Lactating Women Cdc-pdf[PDF-3.67MB]
- Resources for Workers with Lead Exposure
- Prevention Tips for Pregnant Women
- What Do Parents Need to Know to Protect Their Children?
- Lead Screening During Pregnancy and LactationExternal – American College of Obstetricians and Gynecologists
- Prevention of Childhood Lead ToxicityExternal – American Academy of Pediatrics
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