Health Department Gives Recommendations for Mixing Baby Formula

For Immediate Release: December 8, 2006

Contact: Communication Office
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.

Fluoride plays a key role in reducing tooth decay. However, a slight discoloration of the teeth known as enamel fluorosis may occur when fluoride is consumed above the right amount. Enamel fluorosis is not a disease but it does affect the way teeth look. Most cases of fluorosis result in faint white lines or streaks on tooth surfaces that are usually not noticeable to casual observers.

“I want to assure parents and caregivers that the occasional use of fluoridated water will not harm their baby’s developing teeth in any way,” said Oral Health Director Steve Arthur, DDS, MPH. “The purpose of the new recommendations is to reduce the small possibility of enamel fluorosis, and I agree with this effort.”

The Health Department and the American Dental Association offer the following advice for parents and caregivers:

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.

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, to reduce the risk of fluorosis. The Health Department analyzed several brands of locally available bottled waters for fluoride content and found all brands contained very low or zero amounts.

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 exceed the recommended amount of fluoride.

All water contains some natural fluoride, usually in very low amounts. There are wells in Vermont with levels of natural fluoride that are higher than recommended for drinking. To avoid fluorosis, parents and caregivers who use well water for mixing with infant formula should be aware of the fluoride content of their water. This can be determined by having the well water tested. Fluoride water tests are free from the Vermont Department of Health Laboratory for families with children under age four. Contact your dentist, pediatrician or family physician for information about the fluoride content of your community water, or to get a water test form for your well water.

Drinking community fluoridated water has been proven to be beneficial for the dental health of children and adults. Based on 60 years of research studies, fluoridation at the right level is safe and effective. Research and practical experience show that fluoridation plays a major role in reducing tooth decay for thousands of Vermonters.

For more information about fluoridated water, infant formula and water testing for fluoride, contact the Office of Oral Health, Vermont Department of Health at 1-800-464-4343 (in Vermont only) or 1-802-863-7341. Read about water fluoridation on the Health Department website at:

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