Fluoride levels in UK infant milks

Comparison of fluoride level between mother's milk and infant formula milk - a global systematic review and dental fluorosis risk assessment

Dental Fluorosis (DF) is one of the negative outcomes of excessive fluoride (F) intake through food sources. This systematic review aimed to compare F content in two important food sources for infants, Mother's Milk (MoM) and Infant Formula (IF), and then evaluate the risk of DF related to F in those two types of food. For this purpose, 181 studies were initially found by searching the relevant keywords in widely recognized databases, including Google Scholar, Scopus, Science Direct, and PubMed. Then, 29 final studies were selected considering the inclusion and exclusion criteria. The results showed that the F level of MoM in five out of nine (55.5%) studies and its overall average worldwide does not comply with the European Food Safety Authority (EFSA) guideline (100 µg/L). Therefore, MoM's value of F must be continuously monitored, and risk mitigation solutions must be used to reduce F. Accordingly, tracking F in drinking water, tea, and food consumed by lactating mothers (LMs) was the essential measure that could lead to the reduction of F of MoM. The level of F of IF was much lower than its value in MoM. The estimated hazard quotient (HQ) of DF for both types of food was lower than the acceptable level (HQ = 1), but, due to other sources of F intake, it is necessary to use control solutions to reduce the level of F in MoM and IF consumed by infants.

Worldwide Variations in Fluoride Content in Beverages for Infants

In situations where breastfeeding is impractical, milk formulas have emerged as the primary choice for infant nutrition. Numerous global studies have scrutinized the fluoride content in these formulas, uncovering fluctuations in fluoride levels directly associated with the method of preparation. This variability poses a potential risk of elevated fluoride concentrations and, consequently, an increased susceptibility to dental fluorosis in infants. The primary objective of this review is to intricately delineate the fluoride content in dairy formulas and emphasize the variability of these values concerning their reconstitution process. The review's findings reveal that, among the 17 studies assessing fluoride levels in infant formula, milk-based formulas exhibit a range of 0.01-0.92 ppm, with only two studies exceeding 1.30 ppm. Conversely, soy-based formulas demonstrate values ranging from 0.13-1.11 ppm. In conclusion, the observed variability in fluoride levels in infant formulas is ascribed to the choice of the water source employed in the preparation process. This underscores the paramount importance of meticulously adhering to recommendations and guidelines provided by healthcare professionals concerning the utilization of these formulas and their meticulous reconstitution.

A comparative evaluation of the fluoride content in commercially available infant formulae in India: An in vitro study

CONTEXT

The most critical period for enamel fluorosis to develop is during the early years of life when enamel formation occurs. To minimize the risk of dental fluorosis development, monitoring fluoride intake during teeth development has been suggested. As infant formulae are major source of nutrition in infants, it is important to determine the fluoride content in them in order to monitor the fluoride intake in infants.

AIMS

To estimate and comparatively evaluate the fluoride content in different commercially available infant formulae in India.

METHODOLOGY

A total of 16 commercially available infant formulae were collected from local pharma/grocery stores, in which 14 were milk based (Group M) and 2 were soy based (Group S). Fluoride content of the formulae was evaluated using ORION F selective electrode.

STATISTICAL ANALYSIS USED

ANOVA test, t-test.

RESULTS

The mean F values for groups M and S were found to be 0.031 and 0.07 ppm, respectively. Fluoride content of milk-based formulae was significantly lesser (P < 0.001) than soy-based formulae. Daily fluoride intake through the tested formulae was in the range of 0.013 mg and 0.105 mg when calculated following the manufacturer's preparation guidelines.

CONCLUSIONS

Infant formulae alone were unlikely to be a risk factor for dental fluorosis, but when reconstituted with optimally fluoridated water, they can be a risk factor for the development of dental fluorosis.

An Analytical Protocol for the Differentiation and the Potentiometric Determination of Fluorine-Containing Fractions in Bovine Milk

Free fluoride ions are effective in combating caries in children, and their supplementation in milk has been widely used worldwide for this purpose. Furthermore, it is known that ionic fluoride added to milk is distributed among its components, but little is known about their quantitative relationships. This is likely due to the absence of an analytical protocol aimed at differentiating and quantifying the most important forms of fluorine present in milk. For the first time, a comprehensive protocol made up of six potentiometric methods devoted to quantifying the most important fractions of fluorine in milk (i.e., the free inorganic fluoride, the inorganic bonded fluorine, the caseins-bonded fluorine, the whey-bonded fluorine, the lipid-bonded fluorine, and the total fluorine) has been developed and tested on real samples. Four of the six methods of the procedure are original, and all have been validated in terms of limit of detection and quantification, precision, and trueness. The data obtained show that 9% of all fluorine was in ionic form, while 66.3% of total fluorine was bound to proteins and lipids, therefore unavailable for human absorption. Beyond applications in dental research, this protocol could be extended also to other foods, or used in environmental monitoring.

Comparative evaluation of the effects of human breast milk and plain and probiotic-containing infant formulas on enamel mineral content in primary teeth: an in vitro study

AIM

This study quantitatively investigated the changes in enamel mineral content of primary teeth after immersion in human breast milk and plain and probiotic-containing infant formulas.

METHODS

Thirty-six sound primary anterior teeth were collected and assessed for mineral content (calcium and phosphorus content in wt%) using scanning electron microscope attached with energy-dispersive X-ray analyser (SEM-EDXA). In order to create a microbial-induced caries model, the enamel surfaces of the teeth were inoculated with mutans streptococci and then each tooth was randomly assigned to one of three groups: human breast milk, plain infant formula or probiotic-containing infant formula (n = 12) each. Teeth were then soaked in the designated type of milk, and the solutions were replenished every day for 1 week after which the mineral content was measured again using SEM-EDXA. Wilcoxon signed-rank test was used to study the changes by time within each group, and the significance level was set at P ≤ 0.05.

RESULTS

Treatment of enamel surface with breast milk has significantly increased mean Ca wt%, while no significant changes were detected in mean P wt%. On the other hand, when primary teeth were soaked in plain or probiotic-containing infant formulas, both mean values of both Ca and P wt% significantly decreased.

CONCLUSIONS

In conclusion, whereas breast milk might confer some protective effect against enamel demineralisation, infant formulas whether plain or supplemented with some probiotics might promote loss of minerals from enamel surface.