Why are lead and anemia screening important for children?
1/20/2025 by Meghan Deyo, APRN, C.N.P., M.S.
Have you ever wondered why your child's primary care clinician recommends lab testing for lead or anemia screening if your child appears healthy?
Lead and anemia screening during early childhood allows for early identification and treatment before the risk of poor health outcomes. A child poisoned by lead may not look or act sick and their symptoms may be quite vague. This can lead to lead poisoning, which could be mistaken for other illnesses or can go unrecognized. Similarly, the infant or child with mild anemia does not display obvious clinical signs or symptoms. The risk of exposure to lead and iron deficiency anemia peaks around 12 to 24 months and can extend up to 36 months of age.
The American Academy of Pediatrics (AAP) recommends that all infants be screened for anemia at 12 months of age. Additional screening is recommended for any child with risk factors for anemia (feeding problems, prematurity, poor growth, inadequate dietary iron intake). Other risk factors during early childhood include excessive cow's milk, chronic conditions, lead exposure and obesity.
As of 2022, Minnesota Public Health has recommended that all children receive a lead blood test at 12 months of age with a second lead test at 24 months of age. There is no safe lead level for children. Low levels of exposure can contribute to behavioral problems, learning difficulties (lower IQ scores, academic underachievement) and slowed growth and development. As blood levels increase symptoms may include abdominal pain, loss of appetite, constipation, irritability, headaches, encephalopathy, seizures and even death.
What you need to know
- Every child should be evaluated at 12 and 24 months of age, sometimes later depending on environmental factors.
- The only way to screen for lead exposure and anemia is with a blood test.
- In the state of Minnesota, the Women, Infant and Child program does not evaluate your child's lead level. Please arrange to have this done with your child's healthcare clinician.
- Lead exposure increases in your child's environment at 6 months of age and peaks at 2 years due to increasing mobility and developmental behaviors, such as increased hand-to-mouth activities.
- How to prevent iron deficiency:
- If your baby is formula-fed, iron-fortified formula will provide your infant with the recommended amounts.
- If your baby receives breastmilk, start an iron supplement. You can talk to your child's healthcare clinician about when to start this (typically at 4 to 6 months of age).
- Limit cow's milk consumption to approximately 20 ounces per day for children 1 to 5 years of age.
- Offer iron-rich foods such as red meat, fish, beans, spinach, iron-fortified baby cereal, pureed meats and pureed beans.
Meghan Deyo, APRN, C.N.P., M.S., is a pediatric nurse practitioner in Primary Care in Rochester and Kasson's Division of Community and Pediatric and Adolescent Medicine. She has worked in pediatrics since 2011.