Using Fluoridated water in Baby Formula

Detail interior view of Elysian Water Tower in Minnesota, showing fluoride monitor

Everything Birth, of course, advocates breastfeeding. However, for some women that is not always possible. Women who must use formula to feed their babies need to be aware of yet another consideration while prepping their babies’ bottles.

In 2010, a study in the Journal of the American Dental Association found that fluoride intake during a child’s first few years of life is significantly associated with fluorosis. It then warned against using fluoridated water in infant formula. You’ve probably already seen the nursery water for babies that had added fluoride, but some women, unaware of the need to be concerned, may not realize that fluoride is also added to city tap water. Now, just because people sell something doesn’t mean it’s best for the baby. So, after learning about this information, I personally would never purchase the nursery water with added fluoride. City water, boiled or not, though is not suggested to be used to reconstitute dry formula. Even the CDC stated, “Recent evidence suggests that mixing powdered or liquid infant formula concentrate with fluoridated water on a regular basis may increase the chance of a child developing … enamel fluorosis.”

Of course, there are even more health concerns with getting too much fluoride, but that’s another post. Dental fluorosis is a condition in which your tooth enamel becomes progressively discolored and mottled. If progressive enough it can be damaging to teeth in more than just a cosmetic way as well. Regardless of the severity though, new mothers choosing to formula feed need to be aware of the risks involved with using fluoridated city water for their baby bottles. Adding fluoride to tap water is banned in a majority of European nations already. Some cities in the US are now changing their minds about adding fluoride to their water, but most still go out of their way and pay more money to purchase fluoride to be added to their city’s water supply.

In New Hampshire, a bill passed through the house and senate and was adopted this month (May 15th) mandating water bills include a warning stating, “Your public water supply is fluoridated. According to the Centers for Disease Control and Prevention, if your child under the age of 6 months is exclusively consuming infant formula reconstituted with fluoridated water, there may be an increased chance of dental fluorosis. Consult your child’s health care provider for more information.”

As parents we weigh the risks. Currently, the benefits of fluoride are believed to be from topical use only. Given that, there is no real benefit to drinking water that has added fluoride. Given that there appears to be no benefit and some risks to using fluoridated tap water in our bottles, the choice seems pretty clear to me.



  1. Allison

    Can you direct me to some information regarding the statement in your last paragraph that the benefits are believed to be from topical use only? I’m trying to sort out all the information out there so I can make the best decision for us. Thanks!!

    • Dawn

      Featherstone JDB, M.Sc., Ph.D. , Cover Story; J American Dental Association, Vol. 131, July 2000, p. 890.
      “Importantly, this means that fluoride incorporated during tooth mineral development at normal levels of 20 to 100 ppm (even in areas that have fluoridated drinking water or with the use of fluoride supplements) does not measurably alter the acid solubility of the mineral. Even when the outer enamel has higher fluoride levels, such as 1,000 ppm, it does not measurably withstand acid-induced dissolution any better than enamel with lower levels of fluoride. Only when fluoride is concentrated into a new crystal surface during remineralization is it sufficient to beneficially alter enamel solubility. The fluoride incorporated developmentally – that is, systemically into the normal tooth mineral – is insufficient to have a measurable effect on acid solubility.”

      Centers for Disease Control; MMWR Weekly Report. 1999;48:933-940.
      “Fluoride’s caries-preventive properties initially were attributed to changes in enamel during tooth development because of the association between fluoride and cosmetic changes in enamel and a belief that fluoride incorporated into enamel during tooth development would result in a more acid-resistant mineral. However, laboratory and epidemiologic research suggests that fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children.”

      Limeback H. “A re-examination of the pre-eruptive and post-eruptive mechanism of the anti- caries effects of fluoride: is there any anti-caries benefit from swallowing fluoride?” Community Dentistry and Oral Epidemiology 27: 62-71, 1999.
      “Given the widespread use of other fluoride therapies such as topical fluorides (from
      professional treatments and daily use of over-the-counter fluoridated oral care consumer
      products) and the low rate of caries even in non –fluoridated communities of industrialized countries, it is doubtful that the anti-caries effect of fluoride supplement ingestion, if there is one, could even be detected.”

      For a near endless supply of information, go here:

      A few more links I have saved:

      More discussion on risks:
      Kaminsky et. al report: “The available data suggest that some
      individuals may experience hypersensitivity to fluoride-containing
      agents” and ” …individuals with renal insufficiency who consume large
      quantities of fluoridated water are at an increased risk of developing
      skeletal fluorosis.” Research in these two areas were advised but
      never conducted.

      Further, dental fluorosis was reported in diabetics who consume large
      volumes of water containing 0.5 to 1.0 mg fluoride/liter, the latter
      equal to NYS’s fluoridated water supplies.

      Malfunctioning kidneys may not adequately filter fluoride from the
      blood allowing toxic fluoride levels to build up in and damage bones.
      Symptoms of skeletal fluorosis include bone pain, tenderness and
      fractures, according to the EPA.

      The American Dental Association admits in its Fluoridation Facts
      booklet “decreased fluoride removal may occur among persons with
      severely impaired kidney function who may not be on kidney dialysis.”

      The National Kidney Foundation (NKF) withdrew its fluoridation
      endorsement in 2007, with advice that “individuals with CKD [Chronic
      Kidney Disease] should be notified of the potential risk of fluoride

      The landmark 2006 National Research Council fluoride report stated,
      “Early water fluoridation studies did not carefully assess changes in
      renal [kidney] function…Several investigators have shown that
      patients with impaired renal function, or on hemodialysis, tend to
      accumulate fluoride much more quickly than normal.”

      KENS 5 – TV reported “After 9 years and $3 million of adding fluoride, research shows tooth decay hasn’t dropped among the poorest of Bexar County’s children. It has only increased—up 13% in 2010, the latest date that data was available.
      One out of two children in the Head Start program who were checked for cavities had some decay last year.”

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