Dr. Howard Koh, Assistant Secretary for Health, US Department of Health and Human Services (HHS) in a video commentary published on Medscape.com, March 8, 2011.

Koh says, “…tooth enamel formation occurs from birth until about 8 years old. This is also the time when dental fluorosis may occur with excess fluoride consumption.”

Koh advises low-fluoride bottled water be used for routinely reconstituting infant formula.

Reference: Government Perspectives on Healthcare;HHS: Proposed Guidelines on Fluoride in Drinking Water,A Commentary By Howard K. Koh, MD, MPH

http://www.medscape.com/viewarticle/738322

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From the Centers for Disease Control

http://www.cdc.gov/FLUORIDATION/safety/infant_formula.htm#1

“Recent evidence suggests that mixing powdered or liquid infant formula concentrate with fluoridated water on a regular basis may increase the chance of a child developing the faint, white markings of very mild or mild enamel fluorosis.”

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Academy of General Dentistry

http://www.agd.org/public/oralhealth/Default.asp?IssID=303&Topic=F&ArtID=1247#body

“If you add fluoridated water to your infant’s baby formula, you may be putting your child at risk of developing dental fluorosis…”

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Mayo Clinic

“Regularly mixing a baby’s formula with fluoridated tap water can provide enough fluoride to cause fluorosis — mild white streaks on the teeth or more severe pitting or staining of tooth enamel. Fluorosis can affect both baby teeth and permanent teeth.”

http://www.mayoclinic.com/health/infant-formula/MY00193/NSECTIONGROUP=2

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Vermont Department of Health

“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.”

http://healthvermont.gov/news/2006/120806fluoride.aspx

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New York State Department of Health

Parents who are concerned about the risk of enamel fluorosis, can mix liquid concentrate or powdered infant formula with water that is fluoride free or contains low levels of fluoride. Examples are water that is labeled purified, demineralized, deionized, distilled or reverse osmosis filtered water.

http://www.health.ny.gov/prevention/dental/fluoride_guidance_during_infancy.htm

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California Dental Association

“…mixing powdered or liquid infant formula concentrate with fluoridated water on a regular basis for infants primarily fed in this way may increase the chance of a child’s developing enamel fluorosis,” according to the CDA’s Feb 2010 Report, Oral Health During Pregnancy and Early Childhood: Evidence-Based Guidelines for Health Professionals.  http://www.cdafoundation.org/library/docs/poh_guidelines.pdf (Page 12)

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  National Research Council In March 2006, the National Research Council (NRC) cautioned that infants can fluoride-overdose via reconstituted baby formula. (2) The
American Dental Association (ADA) passed this information on to its members in a November 2006 e-gram.

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American Dental Association_Evidence-based_Infant_Formula_Chairside_Guide.

Recommendations for infants who consume reconstituted infant formula as the main source of nutrition: • Continue use of liquid or powdered concentrate infant formulas reconstituted with optimally fluoridated drinking water while being cognizant of the potential risk for enamel fluorosis.  • Use ready-to-feed formula or liquid or powdered concentrate formula reconstituted with water that is either fluoride-free or has low concentrations of fluoride when the potential risk for enamel fluorosis is a concern.  http://ebd.ada.org/contentdocs/ADA_Evidence-based_Infant_Formula_Chairside_Guide.pdf

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Delta Dental

http://oralhealth.deltadental.com/Children/Infant/22,DD63

The American Dental Association expert panel concluded that for infants from birth to age 12 months who consume reconstituted infant formula as the main source of nutrition, the continued use of powdered or liquid concentrate formulas reconstituted with optimally fluoridated drinking water is appropriate, as long as the parent or caregiver is cognizant of the potential risk for enamel fluorosis. If parents and caregivers are concerned about the potential for increasing a child’s risk of developing enamel fluorosis, breast feeding, ready-to-feed formula or powdered or liquid concentrate formula reconstituted with water that either is fluoride free or contains low concentrations of fluoride are an alternative. This type of water is often labeled “purified,” “demineralized,” “deionized,” “distilled” or “produced through reverse-osmosis.”

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Minnesota Dental Association

If liquid concentrate or powdered infant formula is the primary source of nutrition, it can be mixed with water that is fluoride free, or contains low levels of fluoride to reduce the risk of fluorosis. Examples are water that is labeled purified, demineralized, deionized, distilled or reverse osmosis filtered water. Many grocery stores sell these types of drinking water for less than $1 per gallon.

http://www.medicalnewstoday.com/releases/57490.php

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Maryland Government Agency

Regularly mixing powdered or liquid infant formula concentrate with fluoridated water may increase your child’s risk of developing faint white markings or streaks on the teeth — a sign of mild enamel fluorosis.If you’re concerned about fluorosis, you can minimize your baby’s exposure to fluoride by using ready-to-feed formula. You can also alternate using tap water and nonfluoridated water for formula preparation, or mix powdered or liquid infant formula concentrate with low-fluoride water most or all of the time. CDC also recommends that parents can use low-fluoride bottled water some of the time to mix infant formula; these bottled waters are labeled as de-ionized, purified, demineralized, or distilled. http://fha.maryland.gov/oralhealth/community-water.cfm#formula

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Chester Water Authority (Chester, Pennsylvania)

Parents should consider preparing powdered or liquid concentrate formulas for infants using water that contains no or low levels of fluoride, if reconstituted formula is the primary source of nutrition for the infant. Other sources of infant nutrition could include breast milk or ready to feed (no-mix) formula, both of which are low in fluoride.Some fluoride is beneficial, but dental fluorosis or mottling of the teeth can occur if an infant receives too much fluoride. Infants are susceptible to receiving too much fluoride due to their low body weight and high fluid intake

http://www.chesterwater.com/fluoridation.htm

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Wisconsin WIC If liquid concentrate or powdered infant formula is the primary source of nutrition, it can be mixed with water that is fluoride free or contains low levels of fluoride to reduce the risk of fluorosis. http://www.dhs.wisconsin.gov/wic/WICPRO/training/fluoride.pdf

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American Public Health Association: Policy Statement Database

Recent evidence suggests that mixing powdered or liquid infant formula concentrate with fluoridated water on a regular basis for infants primarily fed in this way may increase the chance of a child’s developing the faint white markings of very mild or mild enamel fluorosis. Occasional use of water containing optimal levels of fluoride should not appreciably increase a child’s risk for fluorosis. Studies have not shown that teeth are likely to develop more esthetically noticeable forms of fluorosis, even with regular mixing of formula with fluoridated water.

http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1373— —

Des Moines Water Works

Powdered or liquid concentrate infant formula can be mixed with water that is fluoride free or contains low levels of fluoride. These types of water are labeled as purified, demineralized, deionized, distilled or reverse osmosis filtered water http://www.dmww.com/upl/documents/water-quality/lab-reports/fact-sheets/fluoride.pdf

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Smile Florida  SmileFlorida.org is a product of the Florida Dental Association, Inc.,

Some infant formulas may already contain beneficial fluoride levels from water used during the manufacture of the product. If liquid concentrate or powdered infant formula is the primary source of nutrition, it can be mixed with water that is fluoride-free or contains low levels of fluoride to reduce the risk of fluorosis.

These include water labeled as purified, demineralized, deionized or distilled, as well as reverse-osmosis filtered water.

http://smileflorida.org/care/fluoridation.html

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Broomfield, Colorado

The American Dental Association has recommended that for infants being fed primarily reconstituted infant formula, a fluoride-free water source such as demineralized or distilled water be used to reduce fluoride intake. For http://www.broomfield.org/environment/FactSheets/Fact%20Sheet%208.pdf

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Ormond Beach, Florida puts infant warning advisory on Annual Water Quality Report

http://www.ormondbeach.org/DocumentView.aspx?DID=2961

Dental Associations Advise Against Fluoride in Baby Formula

Although the American Dental Association and the Florida Dental Association both endorse fluoridated water as an effective way to prevent tooth decay, they have issued an advisory recommending that non-fluoridated bottled water be used in powdered or liquid-concentrate baby formula for infants.The advisories note that too much fluoride can cause fluorosis, resulting in a discoloration or streaks on teeth.

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Sugarland Texas

However, recent studies revealed infants might receive greater than optimal amounts of fluoride when fed formula mixed with water containing fluoride. The ADA recommends ways to reduce fluoride intake from reconstituted infant formula: • Breast milk is widely acknowledged as the most complete form of nutrition for infants. • Ready-to-feed formula is preferred to help ensure fluoride intake does not exceed optimal amounts. • Liquid concentrate or powdered infant formula mixed with bottled water that is fluoride free or contains low levels of fluoride can reduce the risk of fluorosis. • Occasional use of water containing optimal levels of fluoride should not appreciably increase a child’s risk for fluorosis.

http://www.sugarlandtx.gov/utilities/reports/documents/WaterReportv10.2.pdf

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Thanks to Formula Fluoride.