Bottle fed infants: fluoridated water not a problem

Parents need no longer be concerned about using fluoridated water for baby formula. Photo credit: Life insurance for your heirs

New recommended fluoride dietary intakes by infants and young children in Australia and New Zealand were recently published. The updated values are available online at Nutrient Reference Values for Australia and New Zealand.

This is a regular update – the Australian National Health and Medical research council advises these recommendations be reviewed every 5 years. But the new recommendations are interesting because the upper limit for fluoride intake for infants and young children is substantially higher than the previously recommended upper limit.

Public health policy in Australia and New Zealand aims to adjust fluoride intake at the population level to be high enough to prevent dental caries but low enough not to cause moderate or severe dental fluorosis or other adverse effects. But health professionals have noted an anomaly in recent years.  Dietary intake of fluoride by children may exceed the previously recommended upper levels – even when community water fluoridation levels are within the recommended targets. Despite this the occurrence of moderate or severe dental fluorosis in Australia and New Zealand was rare.

This led to health authorities acknowledging that, for example, bottle-fed infants may sometimes exceed the upper limits for dietary fluoride intake – but still recommending this was harmless. Anti-fluoride activists misrepresented this advice by claiming health authorities were recommending that fluoridated water not be used for preparing formula for bottle feeding. Their claims are incorrect and alarmist. The “warning” simply provided advice that there was no risk of harm but the if parents were concerned they should occasionally use non-fluoridated water to make up baby formula.

In part, this current report is a response to that conundrum.

Why the change?

Anti-fluoride propagandists will no doubt attack this change. They have made capital out of the situation in the past by claiming that infants and young children are getting dangerous levels of fluoride in their diet. They, of course, ignore or hide the fact that despite this, levels of moderate and severe dental fluorosis have not been a problem. They, also misrepresent the situation regarding dental fluorosis and its causes – see Dental fluorosis: badly misrepresented by FANNZ and Water fluoridation and dental fluorosis – debunking some myths.

However, the expert working group who reviewed the literature and came up with the new recommendations did have their reasons. And these were more than just the absence of moderate and severe dental fluorosis.

They also concluded the previous recommendation was not consistent. This is because it was based on the US Environmental Protection Agency’s use of mean dietary intake and not the higher percentile fluoride intake which should have been used for the upper limit.

Consequently, their recommendation for the upper limit of fluoride intake for children up to 8 years of age is 0.20 mg F/kg bw/day (kg bw = kg body weight). The previous limit was 0.1 F/kg/ bw/day. This produces the following upper limits for children of different ages.

In Australia and New Zealand, the estimated upper range of total daily fluoride intake for different age groups ranges from 0.09to 0.16 mg F/kg bw/day – considerably lower than the new recommended upper limit of 0.2 mg F/kg bw/day.


Will anti-fluoride campaigners top claiming that bottle-fed infants consume dangerous levels of fluoride if their formula is made with fluoridated water?

And the rest of us should not longer make the concession that intake levels are above the recommended upper limits – because they aren’t.

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7 responses to “Bottle fed infants: fluoridated water not a problem

  1. soundhill1

    Ken it should be noted that that only is supposed to work if the infant formula itself is not supplemented with fluoride.

    And what government levels mean is not always good,
    for example in noise damage to hearing. A level is set that is supposed to be safe for an eight hour working day. Then what about recreation?

    And what is said to be safe I think is what will leave 90% of the population able to hear speech without a hearing aid. Yes, only speech, not the finer qualities of bird song.


  2. Brian – infant formula is not supplemented with fluoride. In fact:

    “Infant formula in New Zealand is regulated under Standard 2.9.1 of the Australia New Zealand Food Standards Code. Under this standard, fluoride is not permitted to be added to infant formula during the manufacturing process.”


  3. soundhill1

    Ken my point is you should have advised people to read the labels.

    Attachment A – Approved draft variations to the Australia
    New Zealand Food Standards Code
    Australia New Zealand Food Standards Code
    Food Standards Australia New Zealand Act 1991
    This Code consists of standards made under the Food Standards Australia New Zealand
    Act 1991.
    As in effect on 1 March 2016.”

    “2.9.1—23 Statements of protein source and dental fluorosis
    (1) For the labelling provisions, the required statements are:
    (a) a statement of the specific source, or sources, of protein in the product,
    immediately adjacent to the name of the product; and
    (b) if the infant formula product is one to which subsection (2) applies:
    (i) a statement to the effect that consumption of the formula has the
    potential to cause dental fluorosis; and
    (ii) a statement recommending that the risk of dental fluorosis should
    be discussed with a medical practitioner or other health
    Note The labelling provisions are set out in Standard 1.2.1.
    (2) This subsection applies to an infant formula product that contains:
    (a) for a powdered or concentrated infant formula product—more than 17 μg
    of fluoride/100 kJ prior to reconstitution; or
    (b) for a ready-to-drink formula—more than 0.15 mg of fluoride/100 mL”


  4. soundhill1

    Ken quoted: “Under this standard, fluoride is not permitted to be added to infant formula during the manufacturing process.”

    That it is not permitted to be added does not guarantee it to be low.


  5. soundhill1

    A similar adjustment of allowable levels has followed the GMO foods since there is a lot more glyphosate in them and under the old allowable limits they were illegal.


  6. soundhill1

    “The “warning” simply provided advice that there was no risk of harm but the if parents were concerned they should occasionally use non-fluoridated water to make up baby formula.”

    In other words the fluoride-caused damage to the ameloblasts (which produce tooth enamel) sufficient to produce regions of mild opacity in the enamel is not regarded as “harm.”


  7. soundhill1

    Sorry not regions of mild opacity, rather a mild display of regions of opacity.


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