Lead and Pregnancy

Lead can pass from a pregnant person to their unborn baby.  Preventing lead exposure is the best way to keep your baby safe.  Maternal lead exposure is associated with hypertension, premature birth, decreased fetal growth and miscarriage.  Fetal exposure may adversely affect the baby’s neurodevelopment.  If you are pregnant and think you may have been exposed to lead, talk to your healthcare provider about getting a blood lead test.  A blood test is the only way to determine if you have been exposed to lead.

Lead Risk Assessment for Pregnant Persons by a Healthcare Provider:

Lead Risk Assessment Questions: the following are questions you can ask patients to help assess their risk of lead exposure:

 Have you ever been tested for lead poisoning? If yes, was your blood lead level high?

• Were you born outside of the United States?
• In the past 12 months, have you spent any time outside of the United States?
• In the past 12 months, did you use products from other countries, such as health remedies, spices, foods, ceramics, or cosmetics?
• At any time during your pregnancy, did you eat, chew on, or put in your mouth nonfood items such as clay, pottery, soil, or paint chips?
• In the last 12 months, have there been any renovations/repairs in your home?
• Do you have, or have you ever had, a job or hobby that could expose you to lead? (e.g., bridge repair, home repair and renovation, automotive or electronic repair, working with firearms, etc.)
• Are there other adults in your home that have a job or hobby that could expose you to lead?

If the patient answers “YES” to any of the questions above, test them for lead.

Lead and Breastfeeding:

Mothers who have been exposed to lead can expose their baby to lead during lactation through blood and breast milk.  During lactation, mothers can have lead in their blood or breast milk for two reasons:

1. They have been exposed to lead during pregnancy.
2. Lead that is stored in a woman’s bones and teeth from prior exposure can be released during lactation.

It is recommended that mothers with BLLs < 40 μg/dL should breastfeed, but it is important to note:

• Infant BLLs should be monitored if the mother’s BLLs are between 5 and 39 μg/dL.  Breastfeeding should continue for all infants with BLLs below 5 μg/dL.
• If a mother’s BLL is ≥ 20 μg/dL and infant’s BLLs is ≥ 5 μg/dL, 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.

For more information on the CDC’s “Guidelines for the Identification and Management of Lead Exposure in Pregnant and Lactating Women”, click here. 

Prenatal Lead Exposure Fact Sheets: