Lead

• Remove any sources of lead in your home.
  • Use wet methods to clean up dust with lead.
  • Clean often around windows and play areas.
  • Wet mop floors often.
• Wash hands and toys often with soap and water.
• If you have concerns about lead in drinking water, contact your local health department
• Flush water pipes for up to 2 minutes before drinking or drawing water, this is especially important when preparing baby formula.
• Use only the cold water tap for drinking, cooking, and especially for making baby formula.
• Regularly clean faucet aerators to clear out particles of lead trapped in the aerator.
• If lead is a concern in your drinking water, use a faucet filter or pitcher to remove lead from water. Families can find specific water filter products and useful sources of information on filtering drinking water. The NSF International provides voluntary certifications on specific water filter products. http://info.nsf.org/Certified/DWTU
• Purchase lead-free faucets and plumbing parts.
• Reach out to your regional Pediatric Environmental Health Specialty Unit (PEHSU) pediatrician expert with any questions.

Heavy metals can occur naturally in soil used to grow food or can get into food through pesticides, food manufacturing, and packaging. This can lead to small amounts of heavy metals in some baby food products such as rice, rice-based foods (e.g., rice puffs, rice cereal), vegetables (e.g., sweet potatoes), and fruit juices.

Parents can reduce heavy metals in their child’s diet with simple steps such as feeding them a variety of foods and limiting rice-based products and fruit juices. Feed your child healthy meals with foods like milk, cheese, green leafy vegetables, peanut butter, beans, cereals, oranges, and peppers. Foods with vitamin C, iron, and calcium may help keep lead out of the body.

• Baby Food and Heavy Metals: What Parents Should Know
• Heavy Metals in Baby Foods and Fruit Juices Advice for Families from Environmental Pediatricians
• Cinnamon Applesauce Pouches: Elevated Lead and Chromium Exposure

Many young children spend significant time in child care settings and schools. According to the Environmental Protection Agency (EPA), child care facilities, schools, among other types of buildings, may have a higher potential for elevated lead levels in their drinking water because they are closed over weekends, holidays, and extended breaks during which lead in pipes and other fixtures can leach into the water.

There are no federal laws requiring lead testing of drinking water in schools that receive water from public water systems, though the public water systems are regulated by the EPA. If you have concerns about lead at your child’s child care or school, contact your child’s pediatrician, the PEHSU, or your local health department.

Lead alters basic nervous system functions, like calcium-modulated signaling, at very low concentrations in vitro. Lead levels often peak at the age of 2 years, the same age at which a major reduction in dendrite connections occurs, among other events crucial to development. It's possible that lead exposure at that time interferes with a critical development process in the CNS, but what that specific process is has not been clearly identified.

Lead also has important non-neurodevelopmental effects. The kidneys are common targets, and children exposed to lead are at significantly greater risk of becoming hypertensive as adults.

Lead also interferes with the body's ability to use the vital nutrients vitamin D and iron. Exposure has been linked to delayed growth.

The AAP 2016 policy statement, Prevention of Childhood Lead Toxicity provides recommendations for child health professionals. In summary health professionals can:

• Partner with local health departments to conduct periodic surveys of blood lead concentrations in a representative sample in their community.
• Recommend environmental assessments of housing built before 1960.
• Advocate for strict legal standards and enforcement of regulations on allowable lead levels in air, water, soil, house dust, and consumer products.
• Test asymptomatic children for elevated blood lead concentrations according to federal, local, and state requirements. Immigrant, refugee, and internationally adopted children also should be tested for lead when they arrive in the United States because of their increased risk.
• Conduct targeted screening of children for elevated blood lead concentrations if they are 12 to 24 months of age and live in communities or census block groups with ≥25% of housing built before 1960 or a prevalence of children’s blood lead concentrations ≥5 μg/dL (≥50 ppb) of ≥5%.
• For children enrolled in Medicaid, blood lead levels should be taken between 9 to 12 months old and at 2 years of age. Lead risks should be assessed through age 6.
• Advocate for environmental inspections in the housing units of children who have blood lead concentrations ≥5 µg/dL (≥50 ppb)

Immigrant children and adoptees, pregnant people should receive a lead risk assessment and a blood lead test conducted if a risk factor is identified.

​Lead factsheet for health care professionals