Reply to Telephone Query

Can You Work With Lead and Breast Feed?

A community nurse asked how she should advise a woman who works with lead powder, about breast feeding her baby. 20 Aug 93

Dear Madam,

I have sought some advice by telephone from a couple of our technical consultants. Clearly it would be better for you to speak with these experts yourself or even for the woman to speak directly with them.

They would need to know what is done with the lead powder, where it is used (in the home, at work), what precautions are taken and whether its use really needs to continue. Without knowing these details, Dr. Garth Alperstein says:

•  the information on how much lead actually gets into the breast milk is scant, however it has been reported that very small amounts of lead come through the breast milk. This amount is highly unlikely to be significant in women not occupationally exposed to lead.

• in most cases, mothers who are breastfeeding should be encouraged to continue to do so in view of the advantages of breast feeding.

• for a definitive answer, the breast milk of occupationally exposed women should be assessed for its lead content, for comparison with the lead content of breast milk substitutes.

• the mother could certainly have a blood lead estimate done for herself. If the' mother's blood lead is high, the baby could have a blood lead estimate done.

Volunteers Wanted

Graeme Waller says:

• breast milk can be tested if we have controls, I am trying to organise 10-20 volunteers who can hand express breast milk to fill 2 x 10 ml containers which Graeme can provide (lead-free containers only can be used as the amount we're expecting to find is quite small); these samples will be the controls and your client could be one of them if she uses the containers supplied.

• generally, anyone who works with lead should shower, wash hair, scrub hands and nails and put on clean clothes (which have not been laundered with the work clothes) before handling a child. Utmost hygiene is essential.

• even without knowing the rate of transfer of lead via breast milk, it is not advisable to continue to work with lead whilst breast feeding.

• no matter what lead compounds the parent is exposed to, clothes should be left at work and laundered at work.

• children should also be kept away from workplaces where lead is used, from the kitbag, shoes, car etc of a lead worker.

Please keep in touch. Elizabeth O'Brien