Ask a Doc: Lead Poisoning

September 23, 2015

“It is easier to build strong children than to repair broken men.” Frederick Douglass

A recent publication ranked, from high to low, the median annual income for recent graduates by college major. It seems Petroleum Engineers make the most at nearly $160,000. The dubious distinction of the lowest annual salary goes to those who graduate with a degree in Early Childhood Education; they can expect to earn about $38,000 annually. When I mentioned this to my friend, Denise, a career childcare social worker, she commented, “Isn’t it a shame that our market based society assigns the lowest salary to the profession that could deliver the best return.” Denise is wise - early childhood is truly life’s “golden hour.”

Early childhood influences are powerful. The positive and negative experiences on early brain development have profound and, in my experience, irreversible effects. Infants and toddlers are in a tremendous state of learning with a very short attention span, they find all that visual and auditory stimuli so unique and interesting! This state of learning actually begins before birth; we know this from the observation that infants preferentially will turn to their mother’s voice rather than another female voice, even in the first weeks of life. Their cry may even have a language accent from hearing their mother talk during the last months of gestation! Learning is happening so fast in young children; each microscopic neuron making neurotransmitter connections with the next; branching, reinforcing, pruning and remodeling based on recognizable patterns and the positive reinforcement of that pattern recognition. At 2 months, the infant smiles and if someone close to their face smiles back, the neurons of smile recognition fire, are reinforced, branch out and are primed to recognize another smile, maybe even a laugh. At 7 months, the infant’s recognition patterns can differentiate love-ones from infrequent or new faces. As such, infants will show “stranger anxiety” often bursting in tears when Mom’s face is replaced by that of the grandma from Florida. By 15 months, infants can perceive gender and racial differences and can correctly use basic names for family members and pets, all learned responses from positive reinforcement and neuronal connections. These progressive personality steps are so predictable that we pediatricians record them as “milestones” and can identify delays fairly accurately. We are not so good at always knowing the cause.

This we know; children who are blessed with loving caregivers, good nutrition and freedom from serious illness or environmental neurotoxins will enjoy optimal milestone progress, as long as they have normal genetic building code for this neuronal connecting program. Children with Autism seem to make quality connections in color, numeric and sound patterns but for some genetic reason, not in interpersonal learning.

The first 36 months are a formative, fragile window and adverse influences can damage and even destroy this process of learning. These negative influences include an absence of love and nurturing, as well as abuse, neglect, toxins and illness. When these adverse forces happen during this critical time, the connections may become miss-wired. Removing the child from the adverse influence can limit further injury but not all the future adaptive challenges caused from this toxic exposure.

This brings me to the topic of Lead, a well-known toxin affecting the developing brain. High blood lead levels can have a profound impact on the developing brain during these fragile months such that the effects will likely become life long and affect the child’s ability to learn, develop resilience and socialize. Even though it was removed from all house paint more than 80 years ago, its adverse effect on the younger child just will not go away. Sadly even today we cannot seem to keep our infants and toddlers free from this toxin. Two year old children with toxic Lead levels are not uncommon in upstate N.Y. The problem is concentrated, but not limited to, families of poverty who are most at risk for other socioeconomic factors affecting brain development.

There are steps families can take to reduce the Lead burden in old homes:

  1. Wet moping window sills and doors, preferably with a high phosphate cleaner such as Spic and Span in homes that are Lead positive.
  2. No child should be allowed to chew on painted surfaces or pick up pieces of paint.
  3. Wash hands prior to eating or drinking.
  4. Get rid of the pacifier.
  5. Ensure a Healthy diet rich in calcium and including iron supplementation with multivitamins with iron.
  6. Identify and treat iron deficiency.
  7. Avoid exposure to recreational hobbies that use lead or old automotive batteries.
  8. Use great caution in an older home with Lead paint when undergoing abatement and remodeling.

My hope is that every home with a resident child will be totally lead free. Perhaps we can finally meet this goal with a public health policy that would motivate landlords to promptly abate when they are notified by public health. Before a home is rented to a family with children it should be certified as “Lead Free.” We need environmental legislation that would publically identify and label houses that are not “Lead Free” including a searchable public database where young families can identify homes where lead exists before they rent or buy them.

A child with a high blood lead is not like an injury or illness from which the child will fully recover. This injury impacts the child for life with a lower IQ, and much higher incidence of learning disabilities and mental health problems. Lead Poisoning in children is really a neurologic brain injury and shamefully it is still a common occurrence.

JordanMichaelMichael Jordan, MD, MS-HQSM, chief of Pediatrics of Newark-Wayne Community Hospital is board-certified in Pediatric Medicine. He attended the College of Human Medicine at Michigan State University and completed his residency training at the University of Rochester. In addition to his leadership role as chief of Pediatrics at Newark-Wayne, he is the medical director of Rochester Regional Medical Group and is also chair of Rochester General Medical Group’s Quality Committee. He works in the Sodus Rochester General Medical Group Pediatric office. To send questions on children’s health, please email Wendy Fisher, Pediatrics’ Practice Manager at and write “Ask a Doc” in the subject line. To schedule an appointment, call (315) 483-3214.


About Rochester Regional Health
Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes and beyond. The system includes 150 locations: five hospitals; more than 100 primary and specialty practices, rehabilitation centers and ambulatory campuses; innovative senior services, facilities and independent housing; a wide range of behavioral health services; and ACM Medical Laboratory, a global leader in patient and clinical trials. Rochester Regional Health, the region’s second-largest employer, was named one of “America’s Best Employers” by Forbes in 2015. Learn more at