Tag Archives: medical

Lead paint

Jeff and I bought a house recently and are in the process of fixing it up. A few people asked me if we’re concerned about lead paint when moving to an older (pre-1978) house. Unlike a lot of things that could arguably be good for kids (e.g. germs), lead is unambiguously bad.

I looked into this a lot last year. Here’s what I found.

Wood:

Chewing on windowsills is probably rarer than people think. I know someone who does home visits to little kids, and she says she’s only seen kids chew on wood when they don’t have toys to chew. Provide your kids with toys and they will probably have no interest in the woodwork. It seems that some kids do have a thing for woodwork. I’m not really sure what we’ll do if Lily ends up being one of them, but I’d probably start by getting window sill protectors. This seems a lot easier than moving.

Cribs are an exception. I would definitely not use a hand-me-down painted crib or painted toys without checking the paint. You can do that with a kit for a few dollars.

In Massachusetts, the letter of the law is that all dwellings must be deleaded if a child under 6 lives there. In practice, deleading is dangerous (if the child is living there during or shortly after the process, because it creates lots of lead dust) and hugely expensive. In practice, only rental buildings are deleaded because nobody deleads their own home. While the law also says landlords can’t discriminate against families with children, I heard from a realtor that it’s not even worth showing leaded apartments to families with kids because the landlords are afraid the families will sue them if the kids get lead poisoning.

I’m not clear that encapsulating paint is very useful. It’s special paint that bonds to the lead, but it only works on intact paint (if it’s chipping, it’s still going to chip and is still dangerous). And it won’t deter a kid who’s going to gnaw on windowsills or banisters.

Household dust:

The main source of lead poisoning to children is lead dust. The dust comes from old paint inside the house, or from dirt tracked in from outdoors.

Any kind of renovation that disturbs the walls or woodwork of an old house will release lead paint. We discovered this when my in-laws had their house painted, which involved scraping the paint off the shingles, causing a cloud of paint particles to settle all over the yard and blowing in through the windows. In retrospect, not a good thing to do with a baby in the house (or at least not during hot weather with the windows open). I also know someone who got acute lead poisoning as a two-year-old because his parents built an addition to their house. I would never do that kind of work with a young child in the house; if it had to be done, I would go stay with relatives or something until the dust could be cleaned up.

Lead paint will wear off surfaces inside the house where paint is chipping or peeling. If it’s physically coming off the wall, I would scrape it and re-paint. In my state it’s technically illegal to do so unless you’re licensed to handle lead paint, but I’ve never heard of this being enforced. In any case, I would block off the area during work and clean it up well.

Surfaces with moving parts, like old windowframes or doorframes, may create paint dust. We realized those coat racks that hang over the top of the door were scraping against the doorframes, so we took those down.

Some people recommend special detergents to clean lead dust, but they apparently don’t work better than regular detergent.

Some measures to reduce dust tracked into the house: One study found the highest concentration of lead dust was under the doormat. So you should have and use a doormat, because that’s presumably what’s collecting the dust there rather than letting you track it everywhere. This study found a slight benefit to walk-off mats (which I think are the big black kind like in stores, big enough that you definitely step on it as you enter even if you’re not trying to.)

It’s hard to find kits to test the dust on your floors. The commercial kit you can buy online isn’t EPA-approved, so I don’t know if it’s any good. After much searching, I found that the state of Maine provides EPA-approved mail-order test kits. I believe it’s free if you live in Maine, but otherwise it’s a reasonable cost ($20 per swab, including lab testing) and comes with everything you need to collect the samples. They don’t have it on their website, but you can order the kit by calling this guy, who was very competent and helpful:

Michael Bourdon
Maine Health and Environmental Testing Laboratory
207-287-1715

Also, unrelated to lead but related to old houses: before messing with old tile or insulation, test it for asbestos. The mail-away kit you can buy costs more and is slower than some of the labs. I recommend this lab, which has the same level of certification as any other and is faster and cheaper (results by email within a day or two of them getting your sample).

Soil

The fact that lead poisoning peaks during summer indicates soil is a major source of lead. (Although I imagine people are also more likely to renovate their houses in summer).

Soil can have lead, either from automobile exhaust from before they banned leaded gasoline or from paint chips (for example, paint that was scraped off a building). This study found soil near farmhouses had similar lead levels as urban soil, so it’s not just in cities.

You can test your soil for lead. I did mine by mail order from a local university; I imagine any extension agency has something similar. The test costs $15 per sample and also tells you about your soil pH and nutrients, which could be helpful for gardening. When we move, I’ll probably sample our front and back yards and the nearby park.

Before eating produce from a home garden, I would test the soil. Fruit crops (tomatoes, peppers, etc) have less lead than leaf or root crops. Adding organic matter (compost, dirt from someplace with less lead) will reduce the lead. If your soil has too much lead, I would go with raised beds and get soil from someplace else. More info on minimizing risk from soil.

If your soil has high lead, I’m not really sure what to do about kids playing in it and eating it. It seems better to play on surfaces with grass, gravel, mulch, or sand rather than bare dirt. I have increasingly grandiose plans for a sandbox for Lily.

Other

I’ve heard of kids getting lead poisoning from chewing on jewelry. I wouldn’t let kids mouth metal objects unless they’re spoons or something obviously intended to be food-safe.

A closing note: 

As with anything in parenting, it’s possible to drive yourself crazy about this. After the scraping-the-house episode I spent a few weeks washing everything obsessively and refusing to let Lily touch anything that had touched the floor. While I’m all in favor of preventing brain damage in children, sometimes you have to take a deep breath and recognize that stuff will happen and you can’t prevent it all. And, as a friend pointed out, all the geniuses of world history (and practically everyone raised before the 1980s) were exposed to lead as kids.

Liquid diet for G-tubes

A family member has been on a liquid diet for a few months due to needing a gastronomy venting tube (also called a g-tube).  Food goes in by eating as usual, but must leave via a 4.67mm tube.  In this case, getting enough nutrition is not an issue because the person gets supplemental nutrition through TPN.  Eating is only for pleasure, but how do you make a liquid diet pleasurable?

When we got that news, I couldn’t find good advice for what foods would work.  The hospital dietitian was unhelpful, as was the internet.  The existing advice is usually for weight loss or for people with jaw problems who just can’t chew.

I decided to write up some things that we have found viable.

  • Buy a good blender.  You will use it a lot.  We like our Ninja-brand one.
  • Pasta does not seem to get thin enough no matter how much you blend it (though I think it might if you cooked it a long time first.)
  • You can puree a lot of something and freeze it in ice cube trays.  Keep the cubes in bags in the freezer, then thaw however many you want.
  • Trader Joe’s and Whole Foods sell cartons of good pureed soups.

Foods that work:

  • Whatever other people are having for dinner, pureed (e.g. chicken, rice, and spinach with broth, water, or milk to thin it. )
  • Pureed soups, curries
  • Purees of foods with distinctive spices (falafel, apparently, still tastes falafel-y without the texture)
  • Fruit and vegetable juices
  • Yogurt
  • Flan/creme caramel
  • Pudding
  • Ice cream/sorbet/Italian ice
  • Popsicles
  • Smoothies/milkshakes
  • Coffee/tea
  • Alcohol (drains out quickly enough that it doesn’t have much effect, but check with doctor about liver function first)

Foods that are not liquid, but seem to work okay if you chew a lot and drink fluid with them:

  • Avocado
  • White bread/toast
  • Cheese
  • Hummus
  • Baba ganoush
  • Soft cookies and cakes
  • Saltines

Birthday cake ideas (again, chew a lot and drink a lot of fluid):

  • Tiramisu
  • Icebox cake
  • Cheesecake
  • Soft regular cake
  • Ice cream sundaes with whipped cream, syrups/sauces, fruit purees

Passover on a liquid diet:

  • Matzo ball soup, pureed
  • Gefilte fish, pureed with broth
  • Charoset, pureed with apple juice or water
  • Borsht

Thanksgiving/Christmas:

  • Mashed potatoes, thinned with milk
  • Turkey, pureed with broth or gravy
  • Gravy
  • Cranberry jelly
  • Stuffing would probably work if you chew it well

A pinterest board with more ideas.