Lead poisoning and lactation: An integrative review

Problem: In recent years, there has been an increase in research studying the effects of elemental lead on women during lactation. In order to enhance the clinical utility of the findings from the individual studies, they must be integrated.

Method: The following terms or combination of terms were used to conduct the article search: lead poisoning, plumbism, lactation, and breastfeeding. The computerized databases of MEDLINE and CINAHL were used to conduct the search.

Findings: Sixteen articles were included in this review. Findings revealed there were significantly larger increases in the mobilization of skeletal lead during the postpartum period than during pregnancy. The major sources of lead in breast milk were found to be from maternal bone and maternal diet. Breast milk lead levels were noted to significantly decrease over the course of lactation. Breast milk lead levels were shown to have a strong influence on infant blood levels over and above the influence of maternal blood lead levels.

Summary: Public health workers that work with lactating women must educate them about the effects of lead poisoning for themselves and their infants. Lactating mothers should be screened for lead poisoning using the risk assessment questions provided by the Centers for Disease Control and Prevention (CDC). If mothers answer “yes” to any of the risk assessment questions, she and her breastfeeding child should be considered for blood lead screening. Early intervention with lead hazards may prevent blood lead levels from rising and causing irreversible damage to the neurodevelopmental status of the infant.