Lead Safe from the Start

The most common way children are exposed is from lead paint in older homes (built before 1978). Paint can chip or turn into dust, which children may breathe in or swallow.

Other sources may include:

• Contaminated soil
• Imported products such as spices or candies
• Certain imported cookware made of aluminum, brass, or ceramic
• Traditional medicines, remedies, or cosmetics
• Residue from jobs or hobbies involving lead
• Older or imported toys, jewelry, or furniture 
• Contaminated water (less common)

Learn more about sources and simple steps family can take to avoid lead.

Most children with lead exposure do not show symptoms right away. They may look and act healthy.

Even without symptoms, lead can affect:

• Learning and development
• Behavior and attention
• Long-term health

Symptoms are more likely at higher lead levels and may include:

• Stomach pain or constipation
• Tiredness or irritability
• Difficulty concentrating or learning
• Anemia

Severe lead exposure can cause confusion or seizures and can be life-threatening, but this is rare in the U.S.

Children under age 6
Young children are most at risk because their brains are rapidly developing. Even small amounts of lead can be harmful.

Medicaid (Apple Health in Washington State) requires doctors to offer blood lead testing to enrolled children at ages 12 and 24 months, or before age 6 if they have never been tested.  

The American Academy of Pediatrics recommends doctors routinely screen for lead risks for children under 6 and get a blood test if risks are identified. Testing is especially important at 12 and 24 months of age, when children are at highest risk for lead exposure. 

Older children and adults
Routine testing is not recommended or older children or adults, who are generally at lower risk for lead exposure.

But a doctor may recommend lead testing if a person has:

• Had a concerning lead exposure
• Certain behaviors or conditions (such as mouthing or eating non-food items)
• Work or hobbies involving lead
• Signs and symptoms of possible lead poisoning

Your doctor can help you decide when a blood test is needed.

Pregnant and breastfeeding individuals
Lead can pass to a baby during pregnancy and through breast milk. Screening helps identify risks early and protects both parent and baby.

The American College of Obstetricians and Gynecologists recommends that healthcare providers screen pregnant and breastfeeding individuals for lead risks and get a blood test if risks are identified.

A lead test is a simple and safe blood test that checks for lead in the body.

Two common methods:

Venous blood draw (from the arm)

A healthcare professional uses a small needle to take blood from a vein. The needle poke may be uncomfortable for a moment, but it is a safe and routine part of care. The sample is sent to a lab.

This is the most common and accurate test for lead.

Capillary test (finger or heel prick)

A healthcare professional makes a quick, small prick on a finger or heel to collect a few drops of blood. Results are often ready within minutes if the testing machine is in office.

This test is fast and may be less uncomfortable for some children. However, it is not as precise. If a high lead level is found, a venous blood draw is needed to confirm the result. Not all clinics or labs offer this type of blood test.

If lead is detected in a blood test, your doctor will explain the results and work with you to help identify and stop possible sources of exposure. Local health departments may also be able to help depending on what services are available in your area.

Additional follow-up may include:

• Repeat lead testing
• Checking iron levels
• Nutrition guidance
• Referrals to support services

Very high lead levels are uncommon in the U.S. If they occur, more specialized care in a hospital may be needed to safely lower lead levels. 

During pregnancy
During pregnancy, lead can cross the placenta and affect your developing baby. Lead can also increase your risk for certain complications. Identifying and reducing exposure is important to prevent potential harm to you and your baby. 

A blood lead test is the best way to know if you have been exposed.  

The most common way adults are exposed is from certain jobs or hobbies. During pregnancy, some people may have lead risks from behaviors like eating non‑food items (such as clay or soil) or using imported supplements or traditional remedies that may contain lead.

People who had very high or long‑term lead exposure in the past can store lead in their bones, which may be released into the blood during pregnancy. This is uncommon for most pregnant people in the U.S.

If you are pregnant and have lead in your blood, your doctor can help you to find and address the exposure source.

Additional follow-up may include:

• Repeat testing
• Dietary counseling and supplements
• Referrals to support services and resources

After birth, your baby’s provider may recommend lead testing.

Learn more about sources and simple steps you can take to avoid lead from the WA State Department of Health.

Learn more about lead and pregnancy from the American Academy of Pediatrics.

During breastfeeding
Only small amounts of lead usually pass into breast milk, and breastfeeding is generally encouraged with monitoring. However, taking steps to find and reduce lead exposure can help keep a baby’s exposure as low as possible.

In rare cases of very high lead levels, a provider may recommend temporary adjustments to breastfeeding until blood levels go down. Talk with your doctor before making any changes to breastfeeding so you can decide what’s best together.

Learn more about lead and breastfeeding from the American Academy of Pediatrics.

If you have concerns, talk to your pediatrician or a specialist with your regional Pediatric Environmental Health Specialty Unit.

• Lead 101 for Families with Young Children (3 min. video; Northwest PEHSU)
• Practical Tips to Prevent Exposure (3 min. video; Northwest PEHSU)
• Common Sources of Lead Exposure (WA State Department of Health)
• Washington Dirt Alert Map (State of WA Department of Ecology)
• Lead in Drinking Water (U.S. Environmental Protection Agency)
• Leave Lead at Work (U.S. Centers for Disease Control and Prevention)
• Stop Take-home Lead Contamination (WA State Department of Labor & Industries)
• Lead Recalls and Product Safety Warnings (U.S. Consumer Product Safety Commission)
• Lead Renovation, Repair, and Painting (U.S. Environmental Protection Agency)
• Blood Lead Levels in Pregnant & Breastfeeding Moms (American Academy of Pediatrics)
• Lead Screening during Pregnancy and Lactation (American College of Obstetricians and Gynecologists)