Fluoridated Water and Infant Formula
The Vermont Department of Health recommends mixing powdered or concentrated baby formula with water that is fluoride-free, or contains very low levels of fluoride, for feeding infants under 12 months of age. Recent studies have discovered the possibility that infants in this age group may be consuming more fluoride than necessary.
- Mixing baby formula with fluoridated water
- Recommended amount of fluoride for children under 12 months of age
- What happens if I continue to mix fluoridated water with infant formula?
- What is fluorosis?
- What can I do instead of using fluoridated water to mix baby formula?
- How do I know if my town water is fluoridated?
- Should I be concerned about my well water?
- Will WIC provide ready-to-feed formula or bottled water?
- Resources
Mixing baby formula with fluoridated water
The Vermont Department of Health and American Dental Association offer these recommendations for parents and caregivers of infants:
- When liquid concentrate or powdered infant formula is the primary source of nutrition, it can be mixed with bottled water that is fluoride-free or contains low levels of fluoride to reduce the risk of fluorosis. The Health Department Laboratory analyzed several brands of locally available bottled waters for fluoride content and found all contained very low or zero amounts of fluoride.
- For infants who get most of their nutrition from formula during the first 12 months, using ready-to-feed formula can help ensure that infants do not get more than the recommended amount of fluoride intake.
- Consider breastfeeding your child. Breast milk is the most complete form of nutrition for infants. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months for almost all infants.
Recommended amount of fluoride for children under 12 months of age
Infants from 0-6 months should not receive any fluoride. Infants from 6-12 months could receive a small amount (0.25 mg/l).
What happens if I continue to mix fluoridated water with infant formula?
There is a small possibility that your child’s teeth (baby teeth and permanent teeth) will have very mild to mild fluorosis.
What is fluorosis?
Fluorosis is not a disease. Fluorosis affects the way teeth look.
From left to right: Very mild, mild, and moderate fluorosis of teeth.
- In its mild form, teeth will have faint white lines or streaks that are not readily visible to most parents.
- In the more moderate form, the teeth begin to show more visible white spots.
- Only severe fluorosis, where teeth have brown stains and pits, is serious.
In 2002, the Vermont Department of Health conducted a survey of 3rd graders showing that 95 percent of all 3rd graders had no fluorosis, 3.5 percent had mild fluorosis and less than one percent had moderate fluorosis. There were no cases of severe fluorosis.
What can I do instead of using fluoridated water to mix baby formula?
- Switch to ready-to-feed formula in cans or bottles.
- Use non-fluoridated bottled water to mix with the formula. Check the labels on the many brands of water available at the grocery stores.
If you can't switch to ready-to-feed formula or use bottled water, don’t worry. Continuing to mix infant formula with fluoridated water will only result in a slight chance of mild fluorosis, and it is not a serious health problem. Remember, the whole purpose of fluoride is to strengthen teeth and reduce the possibility of tooth decay.
The Health Department also uges women to consider breastfeeding their babies. Breast milk is a natural and a complete form of infant nutrition and provides antibodies that protects infants and helps fight off infection and disease. For more information on the benefits of breastfeeding and local resources for nursing mothers, visit our Breastfeeding Web page.
How do I know if my town water is fluoridated?
Contact your family dentist, doctor, the Office of Oral Health ( 802-863-7341 or toll free at 1-800-464-4343, ext. 7341), or your town's public works department. They canwill be able to tell you whether or not your town has fluoridated water.
Should I be concerned about my well water?
If your family is on a well and you are feeding your infant formula mixed with well water, you should know the fluoride content of your well water.
All water has some level of natural fluoride. In most cases, the fluoride level in well water will be very low. However, there are a few areas in Vermont where the fluoride content of well water is quite high. Have your well water tested if you are mixing it with infant formula.
Fluoride water tests from the Department of Health Laboratory are available at no charge to families with children under age four. Your dentist, pediatrician or family physician has a water test order form that you will need to fill out for the test.
The Vermont Department of Health also offers a screening test (Kit C) for wells that includes fluoride, arsenic, chloride, copper, hardness, iron, lead, manganese, nitrate, sodium and uranium.
A water test kit order form is available on the Health Department website at: http://healthvermont.gov/enviro/ph_lab/water_test.aspx.
Will WIC provide ready-to-feed formula or bottled water?
No. WIC cannot distribute ready-to-feed infant formula or bottled water.