FLUORIDE AND BABIES ON THE BOTTLE
(written August 2008, for use by communities exploring their response to proposed or enforced water fluoridation)
There used to be fluoride in some infant formulas, and manufacturers were asked to take it out because formula
was being made up with fluoridated water and excess intakes resulted. It is widely stated that now there is no
fluoride in any formula in
up formula with fluoridated water is said to be OK. Is it?
Formula products come from many different countries and contain ingredients that come from many more.
Who tests them to ascertain whether the water used in producing their many components is fluoride free, and
how long will it remain so if community water supplies are fluoridated in the areas of origin? I imagine that –
like much else - this is left to industry to police. There are on record problems relating to the water used by the
manufacturers of infant formula, so that recalls have had to be done, wells closed off, etc. Before this,
companies have marketed in
standards: iron was a classic example, and there were no penalties for doing so. In fact it was only picked up
because another manufacturer dobbed a competitor in, not because our regulatory agencies regularly test infant
formula to see it meets regulatory standards for every ingredient. (They don't.) And look how long it took
industry to get rid of lead in infant formula, or reduce aluminium levels. (With lead, even after it was agreed to
be a serious problem, companies were given another 10 years to swap over to non-lead-soldered cans.)
Are we relying on having a rule and expecting industry to abide by it universally? Or has anyone actually
analysed all the products on the Australian market? If so, where are the results published?
I am shocked by
the clear misuse of the independent and reputable
circulating to all households.
Those researchers stated categorically on the
being misinterpreted, that their results are consistent with anything from mild dysbenefit to mild benefit where
teeth are concerned. And York did not address the broader issue of safety in infancy. I would like some
more references to follow this up. It seems reasonable to assume that if the breast permits very little fluoride
to reach an infant, there is a need to prove overall safety, not assume it after looking only at teeth. Interestingly,
while it is (mis)quoted in the Vic pamphlet, no website is given in the references, so that readers cannot look it
up for themselves. An oversight? I think not. Go to this page - http://www.york.ac.uk/inst/crd/fluoridnew.htm
- for what the review really said.
I note that the Victorian Government website shows that infants' desirable upper limit of intake is 0.7mg/day,
and they calculate that bottle-fed infants exceed this intake only slightly - by using average intake data
(780ml) for breastfed infants. But the problem is, we know that bottle fed infants at 4 months consume an
average additional 200mls over the breastfed infant, and many exceed 1 litre per day even younger than that.
In addition, there is huge variability of intakes at every age: some breastfed infants consume a litre, others
500ml. Formula labels - read them - can suggest up to 1250 ml per day of formula or follow on products.
This excess over the acceptable upper limit of intake may indeed result in moderate fluorosis, but why is no
other potential adverse outcome ever discussed? I am more interested in seeing results of research into what
an imbalance like this might mean for developing brains, nerves and bones, not whether unsightly mottling and
greater susceptibility to decay occurs (yes, I followed current dental advice in the 1970s, and my children pay
the price.) Why is there no research on bottle-fed infants despite the evidence that they are a higher risk group
than breastfed infants? Fluoride is a powerful enzyme inhibitor, while breastmilk contains hundreds of bioactive
factors that assist the growing body.
Why is it just assumed that what applies to one group applies to the other, even in intakes, and despite
bothering to look at what's on the cans? Because no one wants to know the answers? So on the Victorian
Government's own data, bottle-fed babies given formula made up with fluoridated water will be getting more
than the upper limit of fluoride,
day in day out for at least 4 months, and perhaps much longer.
Until I read more impressive work, I will continue to advise, as the American Dental Association does,
that bottle fed infants be fed on
non-fluoridated water. And the
another expense for families, many of whom cannot afford it. Does our government have no responsibility to
provide safe water for our babies?
* Maureen Minchin is a medical historian who studied at
extensively in the area of infant health and nutrition, including being involved in founding the International
Lactation Consultant Association (ILCA), and the Australian Lactation Consultants' Association (ALCA).
She has been
employed as a temporary consultant for UNICEF New York and World Health Organisation,
as well as contracted by USAID to write a review. She was influential in the creation of the International Board of
Lactation Consultant Examiners (IBLCE), whose examination is the Gold Standard for Lactation Consultant
accreditation globally. She has written three books: Revolutions and Rosewater - the evolution of nurse registration
in Victoria, Food for Thought: A Parent's Guide to Food Intolerance, and Breastfeeding Matters; what parents need
to know about infant feeding. Her writing has been described as a milestone in the history of breastfeeding
advocacy and clinical knowledge.
Maureen's interest in infant nutrition began with the 1976 birth of her first child, who developed colic as
a result of in-hospital exposure to cows' milk artificial formula, and later dental fluorosis as a result of following
then-standard recommendations for fluoride tablets. Her concern for optimal infant nutrition makes her an outspoken
advocate of breastfeeding and a critic of the many avoidable practices and pressures that make this impossible
for so many women. She has spoken on radio and television and to many parent and professional audiences, both
allergy and intolerance. Much of what she first described in the 1980s as the clinical experience of Australian
families has since been validated by medical research, although many health professionals resisted this information,
and others are obviously still unaware of it or the research. She opposed then, and still opposes, fluoridation of water
supplies, even while accepting that the topical application of fluoride may be of some dental benefit (probably minor
compared with the benefits of good dental hygiene and diet). It is a basic medical principle that new ideas should be
proven safe before widespread application, and Maureen considers that water fluoridation, like artificial feeding of
infants, is an experiment which has not been proven safe, and likely never will be.