Version May 2024
| Key considerations for breastfeeding |
| Human breast milk is specific to the needs of the infant and is the most complete and ideal source for infant nourishment in the first year of life. |
| Key recommendations for initiation of breastfeeding |
| Measurement of levels of lead in breast milk is not recommended. |
| Mothers with BLLs <40 mcg/dL should breastfeed. |
| Mothers with confirmed BLLs ≥40 mcg/dL should begin breastfeeding when their blood lead levels drop below 40 mcg/dL. Until then, they should pump and discard their breast milk. |
| These recommendations are not appropriate in countries where infant mortality from infectious diseases is high (World Health Organization Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality 2000). |
| Key recommendations for continuation of breastfeeding |
| Breastfeeding should continue for all infants with BLLs below 5 mcg/dL. |
| Infants born to mothers with BLL ≥5 mcg/dL can continue to breastfeed unless there are indications that the breast milk is contributing to elevating BLLs. These infants should have blood lead tests at birth and be followed at regular intervals. |
| For infants whose blood lead levels are rising or failing to decline by 5 mcg/dL or more, environmental and other sources of lead exposure should be evaluated. If no external source is identified, and maternal BLLs are >20 mcg/dL and infant BLL ≥5 mcg/dL, then breast milk should be suspected as the source, and temporary interruption of breastfeeding until maternal blood lead levels decline should be considered. |
| Key recommendations for use of reconstituted infant formula |
| Infant formula requiring reconstitution should be made only with water from the cold water tap. Flush the tap for at least three minutes before use and then heat the water or use bottled or filtered tap water known to be free of lead. |
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