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Toddlers are explorers, using all of their senses to learn about the world—and they tend to put just about everything in their mouths. Unfortunately, this puts them at risk. Substances that contain even trace amounts of lead can be very harmful to a child’s development. That’s why MCHC Health Centers medical providers test every child at 1 and 2 years old for the buildup of lead in their blood. Lead was once found in paint, on toys, in gasoline, and even painted on dishware. Better  regulations are now in place, but it is still possible to come into contact with lead. When lead enters the system, it has serious impacts. For children, these include developmental and intellectual delays, inattention and difficulty learning, chronic abdominal pain, loss of appetite, and fatigue. No amount of lead exposure is considered safe for children. According to the Centers for Disease Control (CDC), children most at-risk for lead poisoning are those who live in or spend time in buildings constructed before 1978; are from low-income households; are immigrants or refugees; or live with someone who works with lead or has hobbies that expose them to lead. Because these risk factors are fairly common, and because risk factors are not always identifiable, many pediatric clinics, including MCHC, routinely screen all children for lead poisoning at 1 and 2 years old. Lead screening is a quick process that takes place during a well-child check. The medical provider collects a drop of blood with a finger prick, and families usually have the results before they go home. If any lead is detected in the blood, the next step is to have results confirmed with blood drawn from a vein in a medical lab and then tested. If lead is detected in a child’s blood, the first thing to do is to find and remove the source of lead in the child’s environment. Potential sources include paint in homes built before 1978, older cookware, and antique toys. Certain foods and spices from other countries are not tested for lead, and some tamarind candy and imported medical remedies contain lead. Kids can also come into contact with lead through water runoff or playing in the dirt around an auto shop or construction site. Parents and caregivers sometimes bring lead home on their clothing. For adults working in fields with potential lead exposure, such as auto mechanics, welders, and construction workers, the best practice is to change clothes before entering the home. I worked with a family whose child had lead exposure that was eventually traced back to tiny amounts on his parent’s clothing. Once that parent began changing prior to coming home, the child’s blood lead levels dropped. In another case, lead poisoning was traced to antique dishware, the outsides of which were decorated with lead paint. Because the bowls were stored in a stack, paint on the outside of one bowl contaminated the inside of the bowl beneath it. Again, once the source of lead was removed, the child’s blood lead levels dropped. Lead poisoning does occur and it can be serious, but increased regulations have made it rare. Nowadays, it’s not acceptable to find any lead in a child’s blood. For both children and adults, average blood lead levels have dropped 80% since the late 1970s, a huge improvement (and one that many in the past considered impossible). Though lead poisoning is not common, when it does occur, recognizing it quickly is crucial to a child’s health and development. Identifying lead poisoning through routine screenings often benefits the whole family, since other household members may have also been exposed. Sometimes, routine lead screening identifies urgent problems affecting entire communities. In Flint, Michigan, a team led by a local pediatrician sounded the alarm when blood lead levels in children rose significantly after the community changed water sources. All times in a child’s development are crucial, but the toddler years are particularly important. Lead screening at 1 and 2 years old is an important part of routine care and can result in the quick detection and removal of harmful lead in the child’s environment, leading to a healthier future. By Dr. Casey Johnston, Pediatrics Team