Infants, Formula and Fluoride
The ADA offers these recommendations so parents, caregivers and health care professionals have some simple and effective ways to reduce fluoride intake from reconstituted infant formula:
- For infants who get most of their nutrition from formula during their first 12 months, ready-to-feed formula is preferred to help ensure that they do not exceed the optimal amount of fluoride intake.
- 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.
- Breast milk is widely acknowledged as the most complete form of nutrition for infants. The American Academy of Pediatrics recommends human milk for all infants (except for the few for whom breastfeeding is determined to be harmful).
Parents and caregivers should consult with their pediatrician, family physician or dentist on the most appropriate water to use in their area to reconstitute infant formula. Ask your pediatrician or family physician whether water used in infant formula should be sterilized first (sterilization, however, will not remove fluoride).
Other sources of Fluoride for Young Children
Fluoride Toothpaste
Unless advised to do so by a dentist or other health professional, parents should not use fluoride toothpaste for children ages two and younger. Children should use an appropriate size toothbrush with a small brushing surface and only a pea-sized amount of fluoride toothpaste at each brushing. Children should always be supervised while brushing and taught to spit out, rather than swallow, toothpaste. Many children younger than age six have not fully developed their swallowing reflex and may be more likely to inadvertently swallow fluoride toothpaste.
Fluoride Mouthrinse
Fluoride mouthrinses have been shown to help prevent tooth decay for both children and adults. However, the ADA does not recommend use of fluoride mouthrinses for children under age six, unless recommended by a dentist or other health professional. Children under age six may be more likely to inadvertently swallow fluoride mouthrinse.
Dietary Fluoride Supplements
Supplements are not recommended for children under six months of age. Children should only receive dietary supplemental fluoride tablets or drops as prescribed by their physician or dentist based on the dietary fluoride supplement schedule approved by the ADA, the American Academy of Pediatrics and the American Academy of Pediatric Dentistry.
Naturally Occurring Fluoride in Water
The optimal fluoride level in drinking water is 0.7 to 1.2 parts per million, an amount that has been proven beneficial in reducing tooth decay. In some areas, naturally occurring fluoride may be above or below these levels. Under the Safe Drinking Water Act, the U.S. Environmental Protection Agency requires notification by the water supplier if the fluoride level exceeds 2 parts per million. People living in areas where naturally occurring fluoride levels in drinking water exceed 2 parts per million should consider an alternative water source or home water treatments to reduce the risk of fluorosis for young children.
Read More: Fluoride and Infant Formula Frequently Asked Questions (FAQ), Manage Your Oral Health: Life Stages: Parents and A-Z Topic: Fluoride & Fluoridation.
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