The American Dental Association ADA has issued concerns about water that contains higher concentrations of fluoride greater than 0. Fluoride can be protective for dental health, but higher levels can cause fluorosis on developing teeth. Fluorosis is not a tooth disease. Rather, it appears as discoloration on your baby's developing teeth, which may appear as white spots or streaks on the enamel. This imperfection of coloration develops on your baby's permanent teeth while they are still forming in the gums.
Most powdered infant formulas contain fluoride. The Centers for Disease Control and Prevention CDC recommends that if an infant is exclusively consuming infant formula reconstituted with fluoridated water, parents should use de-fluoridated bottled water part of the time.
This will help reduce the risk of too much fluoride, which can lead to dental fluorosis. If you are using fluoridated water, the ADA suggests checking with your local water company to make sure that the fluoride level in your water is less than 0.
If you are mostly breastfeeding, and only using an occasional bottle that may have a slightly higher concentration of fluoride, ask your pediatrician if the limited exposure is acceptable. If your home is supplied by well water rather than by a public water system, the American Academy of Pediatrics AAP recommends having your water tested for nitrates every 3 months for a year to make sure it is safe for your baby. Nitrates naturally occur in plants and are used in fertilizers.
They can also make their way into the groundwater. When ingested regularly by infants such as through formula nitrates can lead to methemoglobinemia , a dangerous and potentially fatal condition that causes interference with the circulation of oxygen in the blood.
Boiling water will not reduce the nitrate concentration and could even increase it as the water evaporates. Mechanical filters also do not remove nitrates. If you are in a situation where you do not want to or cannot use tap water whether at home or in public , the other option is to buy bottled water.
You'll find some "nursery water" products that are marketed specifically for babies. You can also choose low-fluoride bottled water that's labeled as purified, deionized, demineralized, distilled, or prepared by reverse osmosis. Product packaging used to make clear that all water used to make infant formula should be boiled. However, if you read the label on an infant formula today, you will most likely see a statement urging you to ask your doctor whether or not you should boil the water before preparing formula for your baby.
The AAP instructs parents to use water from a safe source to mix infant formula. If you are concerned about your water source's safety, use bottled water or boil your water for one minute and allow it to cool for up to 30 minutes before using it to make the formula. However, keep in mind that boiling water will only address bacterial contaminants, not chemicals. Powdered infant formula is not sterile and therefore it runs a risk of bacterial contamination.
The World Health Organization WHO guidelines for preparing formula state that all water whether tap or bottled and purified should be boiled before it is used, and mixed with the formula before the temperature drops below 70 degrees C degrees F.
The WHO also states that if boiled water isn't available, a safe water source can be used to mix formula, but the reconstituted formula should be used immediately and not stored. Discuss your plans for making formula with your pediatrician and find out what they recommend as the safest option.
In addition to talking with your baby's doctor, the AAP also recommends checking with your local health department to find out if you can use unboiled tap water in your baby's bottle. Remember that the WHO recommends boiling all water and using the hot water to reconstitute the formula to kill bacteria that could be lurking in the formula itself. Recommendations and water safety vary by location. Carefully measure the amount of water and formula you add. Too much water might cause the formula to fail to meet your baby's nutritional needs.
Too little water might cause your baby to become dehydrated. It's fine to give your baby room temperature or even cold formula. If your baby prefers warm formula, place a filled bottle in a bowl of warm water and let it stand for a few minutes — or warm the bottle under running water. Test the temperature by putting a couple of drops on the back of your hand.
The formula should feel lukewarm — not hot. Don't warm bottles in the microwave. The formula might heat unevenly, creating hot spots that could burn your baby's mouth. Discard remaining formula at the end of each feeding if it has been more than an hour from the start of a feeding. Resist the urge to refrigerate a bottle once you have fed your baby from it, since bacteria from your baby's mouth can still multiply in the refrigerator. If you're using ready-to-use formula, cover and refrigerate any unused formula from a freshly opened container.
Discard any leftover formula that's been in the refrigerator more than 48 hours. If you prepare and fill several bottles of liquid-concentrate or powdered formula at once, do the following:. There is a problem with information submitted for this request. Sign up for free, and stay up-to-date on research advancements, health tips and current health topics, like COVID, plus expert advice on managing your health.
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This content does not have an Arabic version. See more conditions. To lessen this chance, parents may choose to 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 and are without any fluoride added after purification treatment FDA requires the label to indicate when fluoride is added.
Some water companies make available bottled waters marketed for infants and for the purpose of mixing with formula. When water is labeled as intended for infants, the water must meet tap water standards established by the EPA and indicate that the water is not sterile. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Community Water Fluoridation. Section Navigation. Facebook Twitter LinkedIn Syndicate.
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