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Subject:
From:
"Dr. Tom Hale" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 6 Oct 1998 17:14:11 -0400
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To : Barbara
Re : Lead and breastfeeding

The amount of lead that transfers into milk is controversial.  Some papers
say a lot,  one abstract that I know of says minimal levels are transferred
via milk.  The answer lies probably in between.

However, this is not the answer to this problem.  With lead levels of 70,
this woman requires serious treatment, as well as her infant.  No doubt, her
infant will be highly elevated as well.  So both will probably require
treatment, and really soon.

But the most pertinent question is,  should this mom breastfeed while
undergoing chelation therapy, and I suggest no.  Today, we presently use a
medication called Succimer  to chelate and remove lead.  However, succimer
while chelating the lead, also mobilizes vast quantities of lead out of the
bone and into the plasma compartment for excretion via the kidneys. So the
plasma lead levels may rise significantly.  Chelation has always been a "two
edged sword" in that it also carried the possibility that it might
'mobilize' the lead into the brain compartment, where it is most dangerous.
This has happened before and is a known risk.

With this same thought,  does the succimer-chelated lead enter milk in
higher levels?  We do not know with certainty, but it probably does, and
does so with a higher probability than the unchelated lead, as it would be
quite water soluble and low in molecular weight.

So,  if both the mom and infant are undergoing chelation therapy
"simultaneously" you might suggest that it is alright to breastfeed. But
this is a very liberal approach.  If the mom is very insistant on
breastfeeding, then pumping and dumping while undergoing chelation would be
ideal,  but because chelation sometimes requires daily therapy for up to 3
weeks, this might not work well.

Regards

Tom Hale, Ph.D.

PS:  For gosh sakes, make sure the health department inspects this parents
house for lead contamination or chelation will be wasted therapy.

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