Protecting Children from Environmental Toxins: A Functional Medicine Protocol

Small Bodies, Big Burden

A child is not a small adult. This fact, so obvious in every other domain of medicine, is routinely ignored when it comes to toxicology. The environmental regulations that govern “safe” exposure levels are almost universally based on adult body weight, adult metabolism, and adult exposure patterns. Children violate every one of these assumptions.

Pound for pound, a child breathes more air, drinks more water, and eats more food than an adult. A crawling infant’s face is inches from carpet fibers soaked in flame retardants. A toddler’s hand-to-mouth behavior — touching surfaces 80-100 times per hour and mouthing objects repeatedly — makes them a remarkably efficient delivery system for whatever chemicals coat their environment. Their detoxification pathways are immature, their blood-brain barrier more permeable, their organs still developing, and their cells dividing at rates that make them exquisitely vulnerable to substances that disrupt DNA replication and hormone signaling.

The result: children bear a disproportionate burden of environmental toxin exposure, and the effects ripple across neurodevelopment, immune function, endocrine health, and behavior in ways that may not manifest for years or decades.

Functional medicine takes environmental medicine seriously. Not as alarmism. Not as a luxury concern for affluent families. But as a fundamental pillar of preventive care — because the toxins a child absorbs in the first five years of life may shape their health trajectory for the next eighty.

Lead: The Invisible Thief of IQ

Lead is arguably the most well-studied environmental neurotoxin, and the evidence is unequivocal: there is no safe level of lead exposure for children. The CDC lowered its reference value to 3.5 mcg/dL in 2021, but even levels below this threshold are associated with measurable cognitive and behavioral effects. Dr. Bruce Lanphear’s pooled analysis, published in 2005 in Environmental Health Perspectives, demonstrated that the steepest IQ declines occur at the lowest blood lead levels — the first 10 mcg/dL of exposure causes more IQ loss per unit than subsequent increments.

Sources of lead exposure in children:

• Pre-1978 paint — the primary source. Lead paint in older homes creates dust as it deteriorates, concentrating in windowsills, floors, and soil near foundations.
• Contaminated soil — from historical leaded gasoline, industrial emissions, and deteriorating exterior paint
• Water — lead service lines, brass fixtures, lead solder in pre-1986 plumbing. The Flint, Michigan crisis exposed the systemic failure to protect children from lead in water.
• Imported toys, pottery, jewelry, spices (especially turmeric — lead chromate used as a color adulterant), and traditional remedies (Ayurvedic preparations, traditional Mexican folk remedies like azarcon/greta)
• Shooting ranges — airborne lead from ammunition
• Parental occupational exposure — construction, battery manufacturing, plumbing, painting

Testing:

• Capillary blood lead (fingerstick) for screening — if elevated, confirm with venous blood lead
• The American Academy of Pediatrics recommends testing at ages 1 and 2 for all children, with additional testing for high-risk populations
• Any detectable level warrants source identification and reduction
• Above 3.5 mcg/dL: environmental investigation and nutritional intervention
• Above 45 mcg/dL: chelation therapy considered
• Above 70 mcg/dL: medical emergency — inpatient chelation

Chelation — DMSA (Succimer): DMSA (dimercaptosuccinic acid, brand name Chemet) is the only FDA-approved oral chelator for children with blood lead above 45 mcg/dL. Protocol: 10mg/kg every 8 hours for 5 days, then every 12 hours for 14 days. Must be prescribed and monitored by a physician experienced in chelation.

For lower-level lead exposure where chelation is not indicated, functional medicine emphasizes nutritional protection — nutrients that compete with lead for absorption or support detoxification:

Nutritional lead protection protocol:

• Calcium: 500-1,000mg daily (age-dependent) — calcium and lead compete for the same intestinal transporters. Adequate calcium reduces lead absorption by up to 50%.
• Iron: Maintain ferritin above 40 ng/mL — iron deficiency dramatically increases lead absorption (they share the same divalent metal transporter, DMT1). Iron bisglycinate 1-2mg/kg/day if ferritin is low.
• Vitamin C: 250-500mg daily — enhances lead excretion in urine and reduces oxidative damage from lead exposure
• Zinc: 10-20mg daily — competes with lead at absorption sites and supports metallothionein production (a metal-binding protein)
• Adequate protein intake — amino acids (cysteine, methionine, glycine) support glutathione production, the primary intracellular lead-binding molecule
• Never let a child eat on an empty stomach if lead exposure is suspected — lead absorption increases dramatically during fasting

Pesticides: The Invisible Threat to Developing Brains

Organophosphate pesticides — originally developed as nerve agents in World War II — remain among the most widely used agricultural chemicals in the world. They work by inhibiting acetylcholinesterase, the enzyme that breaks down the neurotransmitter acetylcholine. In insects, this causes paralysis and death. In developing human brains, chronic low-level exposure disrupts the same cholinergic signaling essential for learning, memory, and attention.

Dr. Brenda Eskenazi’s CHAMACOS study (Center for the Health Assessment of Mothers and Children of Salinas) — a longitudinal birth cohort in California’s agricultural Salinas Valley — demonstrated that prenatal organophosphate exposure, measured by maternal urinary DAP (dialkylphosphate) metabolites, was associated with lower IQ, impaired working memory, and increased ADHD symptoms in children at age 7.

Dr. Maryse Bouchard’s 2010 study, published in Pediatrics, extended these findings to the general US population using NHANES data. Children with detectable urinary DAP metabolites — reflecting dietary pesticide exposure, not agricultural proximity — had significantly increased odds of ADHD diagnosis. The association showed a dose-response relationship: higher metabolite levels correlated with greater ADHD risk.

Reducing pesticide exposure:

The Dirty Dozen and Clean Fifteen: The Environmental Working Group’s (EWG) annual Shopper’s Guide identifies the most and least contaminated conventional produce. The Dirty Dozen — consistently including strawberries, spinach, kale, nectarines, apples, grapes, bell peppers, cherries, peaches, pears, celery, and tomatoes — should be purchased organic whenever possible. The Clean Fifteen — avocados, sweet corn, pineapple, onions, papaya, sweet peas, asparagus, honeydew, kiwi, cabbage, mushrooms, mangoes, watermelon, sweet potatoes, and carrots — have lower pesticide residues even when conventionally grown.

Organic priorities for children:

• Dairy and meat — these bio-concentrate pesticides, hormones, and antibiotics up the food chain
• The Dirty Dozen fruits and vegetables
• Wheat/grains — glyphosate (Roundup) is used as a pre-harvest desiccant on conventional wheat, oats, and lentils
• Baby food — infants are disproportionately vulnerable; organic baby food is not a luxury but a reasonable precaution

Additional strategies:

• Wash all produce thoroughly — a solution of baking soda in water (1 tsp per 2 cups water, soak 12-15 minutes) removes more pesticide residue than water alone
• Peel conventionally grown apples, pears, and cucumbers if organic is unavailable
• Grow what you can — even a small container garden with herbs and tomatoes reduces exposure
• Avoid lawn and garden pesticides — children play on grass, dogs walk through it and bring it inside

Plastics and Endocrine Disruption

Plastics are the defining material of modern childhood — bottles, sippy cups, food containers, toys, teething rings, pacifiers. And plastics leach. The two most studied endocrine-disrupting chemicals from plastics are BPA (bisphenol A) and phthalates.

BPA (Bisphenol A): BPA mimics estrogen. It binds estrogen receptors and disrupts hormonal signaling at concentrations far below those deemed “safe” by regulatory agencies. In children, BPA exposure is associated with early puberty, obesity, behavioral changes, and altered immune function. CDC biomonitoring data shows detectable BPA in over 90% of Americans tested.

“BPA-free” is not necessarily safe — many replacement chemicals (BPS, BPF) show similar endocrine-disrupting properties. Dr. Patricia Hunt’s research at Washington State University demonstrated that BPS is as potent as BPA in disrupting oocyte development in mice.

Phthalates: Phthalates are plasticizers — chemicals that make plastic flexible. They are found in vinyl flooring, food packaging, personal care products (fragrance, shampoo, lotion), and medical tubing. Dr. Shanna Swan’s research, culminating in her 2021 book Count Down, documents the profound reproductive effects of phthalate exposure. Her studies showed that prenatal phthalate exposure correlates with decreased anogenital distance in male infants — a marker of reduced androgen exposure during critical developmental windows. This has implications for fertility, genital development, and potentially gender-typical behavior.

In children, phthalate exposure is associated with:

• Early puberty in girls
• Altered neurodevelopment and increased ADHD risk
• Asthma and allergic disease
• Obesity and insulin resistance

Practical plastic reduction for families:

• Never microwave food in plastic — heat dramatically increases chemical leaching
• Replace plastic food storage with glass or stainless steel
• Use stainless steel or glass water bottles
• Avoid canned food when possible (cans are lined with BPA or BPA-substitute resins) — choose fresh, frozen, or glass-jarred
• Choose fragrance-free personal care products for children — “fragrance” on a label can hide dozens of phthalates
• Avoid vinyl (PVC) toys, shower curtains, and flooring
• Don’t handle thermal receipt paper — BPA-coated; especially don’t let children play with receipts
• Choose wooden, silicone, or natural rubber toys over plastic

Heavy Metals in Baby Food

In 2021, the Healthy Babies Bright Futures (HBBF) report — based on testing of over 168 baby foods from major US brands — found detectable levels of at least one heavy metal (arsenic, lead, cadmium, mercury) in 95% of products tested. One in four contained all four metals. Rice-based products had the highest concentrations.

Why rice is problematic: Rice is uniquely efficient at absorbing arsenic from soil and water. Inorganic arsenic — the more toxic form — concentrates in rice at levels 10-20 times higher than other grains. For infants, whose body weight is low and whose dietary exposure to rice cereal can be proportionally massive, this is a significant concern.

Practical protocol:

• Skip rice cereal as a first food. It is a nutritionally inferior, arsenic-concentrating product marketed out of tradition, not science. Better first foods: avocado, sweet potato, egg yolk, mashed banana, pureed meat (iron-rich).
• If using rice: Choose white basmati or sushi rice (lower arsenic than brown rice), rinse thoroughly, and cook in excess water (6:1 ratio) then drain — this removes up to 60% of arsenic.
• Limit rice-based snacks (puffs, teething biscuits, rice cakes) — these are disproportionately consumed by toddlers.
• Diversify grains: Oats, quinoa, millet, barley, and buckwheat have far lower arsenic levels.
• Vary fruits and vegetables — carrots and sweet potatoes can concentrate cadmium from soil; rotation prevents excessive exposure to any single contaminant.
• Make your own baby food when possible — blending whole foods gives you control over sourcing.
• Test your water — well water can contain arsenic, lead, and other metals. Municipal water should be tested at the tap, not at the plant.

Flame Retardants and PFAS

Flame retardants (PBDEs, organophosphate flame retardants): Polybrominated diphenyl ethers (PBDEs) were ubiquitous in furniture, mattresses, electronics, and carpeting until being phased out starting in 2004. Their replacements — organophosphate flame retardants — are proving equally concerning. These chemicals migrate out of products as dust, and children ingest them through hand-to-mouth behavior. PBDE exposure in children is associated with lower IQ, impaired attention, and thyroid disruption.

PFAS (Per- and polyfluoroalkyl substances): “Forever chemicals” — so named because they do not break down in the environment or in the body. PFAS are found in nonstick cookware, waterproof clothing, stain-resistant fabrics, food packaging, firefighting foam, and contaminated drinking water near military bases and industrial sites. PFAS accumulate in the body with a half-life measured in years.

In children, PFAS exposure is associated with:

• Immune suppression — reduced vaccine antibody response (Grandjean 2012, JAMA)
• Thyroid disruption
• Increased cholesterol
• Potential developmental effects

Exposure reduction:

• Flame retardants: Vacuum frequently with a HEPA filter vacuum. Wash children’s hands frequently. Replace old foam furniture (pre-2005 couches are PBDE reservoirs). Choose flame-retardant-free furniture and mattresses (many manufacturers now offer these).
• PFAS: Avoid nonstick cookware — use cast iron, stainless steel, or ceramic. Avoid stain-resistant treatments on furniture and carpet. Don’t use microwave popcorn bags (PFAS-coated). Choose PFAS-free waterproof clothing. Test your drinking water for PFAS if you live near a military base, airport, or industrial site. Invest in a reverse osmosis or activated carbon block water filter — these remove the majority of PFAS.

Mold in Schools and Homes

Mold exposure is an underrecognized driver of chronic illness in children. Water-damaged buildings — homes, schools, daycare centers — harbor mold species that produce mycotoxins: toxic secondary metabolites that can cause neurological, immunological, and respiratory damage.

Symptoms of mold exposure in children:

• Chronic congestion and sinusitis that doesn’t respond to typical treatment
• Recurrent respiratory infections
• Asthma — new onset or worsening
• Fatigue and malaise — the child who is always tired
• Headaches
• Cognitive difficulties — “brain fog,” difficulty concentrating, declining school performance
• Skin rashes
• Abdominal pain and nausea
• Mood changes — anxiety, depression, irritability
• Joint pain

The challenge: These symptoms are nonspecific and overlap with dozens of other conditions. Mold is frequently missed because nobody asks about the environment.

Critical questions to ask:

• Is there visible mold anywhere in the home?
• Has there been water damage — roof leak, plumbing leak, flooding, basement moisture?
• Does the child’s bedroom smell musty?
• Do symptoms improve when the child is away from home or school for extended periods (vacation)?
• Is the school in an older building with known water intrusion issues?

Testing:

• Home: ERMI (Environmental Relative Moldiness Index) — dust sample sent to a certified lab. HERTSMI-2 is a simplified version scoring the five most clinically significant mold species. Score above 11 on HERTSMI-2 warrants remediation.
• Urine mycotoxin testing (RealTime Laboratories or Great Plains Laboratory) — detects ochratoxin A, aflatoxins, gliotoxin, mycophenolic acid, and trichothecenes in urine.
• Visual Contrast Sensitivity (VCS) test — a screening tool for biotoxin illness (available online through SurvivingMold.com). Not mold-specific but sensitive for neurological toxin effects.

Remediation principles:

• Fix the water source first — remediation without addressing the moisture problem is futile
• Professional remediation for areas larger than 10 square feet (EPA recommendation)
• HEPA air purifiers in the child’s bedroom and main living areas
• If the school is the source: formal request for indoor air quality assessment; consider temporary homeschooling or school transfer in severe cases
• Binders for mycotoxin clearance (under practitioner guidance): activated charcoal (250-500mg between meals), cholestyramine (prescription — 2-4g daily for older children), modified citrus pectin (1-3g daily)
• Glutathione support: NAC (300-600mg daily), liposomal glutathione (100-200mg daily), or glutathione precursors (glycine, selenium)

The Clean Living Guide for Families

Environmental medicine can feel paralyzing. The toxins are everywhere, the studies are frightening, and the cost of organic food and water filters adds up quickly. Here is a prioritized, practical framework — start with the highest-impact changes and build from there.

Food (Highest Impact)

Tier 1 — Start here:

• Organic dairy and meat
• Organic Dirty Dozen produce
• Eliminate artificial colors, flavors, and preservatives
• No microwave in plastic — ever

Tier 2 — When budget allows:

• All produce organic
• Organic grains (especially wheat, oats, rice)
• Avoid processed food generally — whole foods are inherently lower in contaminants
• Make baby food from whole ingredients

Water

• Filter your drinking water. At minimum: a solid carbon block filter (removes chlorine, many VOCs, lead, some pesticides). Ideal: reverse osmosis system (removes fluoride, arsenic, PFAS, heavy metals, virtually everything).
• Filter bath water too — children absorb chlorine and chloramine through skin during baths. A simple shower/bath filter significantly reduces this.
• Test well water annually for heavy metals, nitrates, and bacteria

Air

• HEPA air purifier in the child’s bedroom — this is where they spend 10-12 hours daily
• No synthetic air fresheners, scented candles, or plug-in fragrances — these release VOCs and phthalates
• Open windows when weather permits — indoor air is typically 2-5 times more polluted than outdoor air
• Vacuum with a HEPA filter vacuum weekly
• Remove shoes at the door — shoes track in pesticides, lead dust, and other contaminants
• No smoking anywhere near children — thirdhand smoke (residue on surfaces) is a real exposure route
• Avoid new carpet smell — off-gas new furniture and carpeting before putting children in the room

Personal Care Products

• Use the EWG’s Skin Deep database (ewg.org/skindeep) to check products
• Choose fragrance-free everything — shampoo, soap, lotion, laundry detergent
• Avoid antibacterial soap (triclosan is an endocrine disruptor — and was banned by the FDA in consumer hand soaps in 2016, but persists in other products)
• Mineral sunscreen (zinc oxide) rather than chemical sunscreen (oxybenzone, octinoxate)
• No talc-based baby powder — contamination risk, respiratory irritation
• Fewer products is better — a child needs soap, occasional moisturizer, and sunscreen. That is it.

Home Environment

• Wet-mop and wet-dust rather than dry-sweep (captures rather than disperses lead and chemical dust)
• Replace nonstick cookware with cast iron, stainless steel, or ceramic
• Choose solid hardwood or tile over wall-to-wall carpet (carpet traps dust, chemicals, mold, allergens)
• Test for radon if you have a basement — radon is the second leading cause of lung cancer
• Address moisture problems immediately — mold grows within 24-48 hours of water intrusion

The 80/20 Rule

Perfection is the enemy of action. No family can eliminate every toxin from every exposure route. The goal is not purity — it is meaningful reduction of the most significant exposures.

Focus on the 20% of changes that address 80% of the risk: clean up the diet (organic when it matters most), filter the water, get a bedroom air purifier, ditch the fragranced products, and replace plastic food containers with glass. These five changes, taken together, dramatically reduce a child’s toxic burden without requiring a complete lifestyle overhaul.

The developing child is a biological masterpiece in progress — 37 trillion cells coordinating a construction project of staggering complexity. Every toxin we keep out of that process is a gift to the blueprint. Every clean meal, every filtered glass of water, every fragrance-free bath is a small act of protection for a system that cannot protect itself.

What is one change you can make this week to lighten your child’s toxic load?