Analysis of fluoride concentration in mother's milk substitutes

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.

Fluoride concentrations of milk, infant formulae, and soy-based products commercially available in Brazil

OBJECTIVES

To assess the fluoride (F) content in commercially available milk formulae in Brazil and to estimate the F intake in children from this source in the first year of life.

METHODS

Samples of cow's milk (n = 51), infant formulae (n = 15), powdered milk (n = 13), and soy-based products (n = 4) purchased in Araçatuba (Brazil) had their F content measured using an ion-specific electrode, after hexamethyldisiloxane-facilitated diffusion. Powdered milk and infant formulae were reconstituted with deionized water, while ready-to-drink products were analyzed without any dilution. Using average infant body masses and suggested volumes of formula consumption for infants 1-12 months of age, possible F ingestion per body mass was estimated. Data were analyzed by descriptive analysis.

RESULTS

Mean F content ranged from 0.02 to 2.52 mg/L in all samples. None of the cow's milk provided F intake higher than 0.07 mg/kg. However, two infant formulae, one powdered milk, and one soy-milk led to a daily F intake above the suggested threshold for fluorosis when reconstituted with deionized water. Assuming reconstitution of products with tap water at 0.7 ppm F, two infant formulae, five powdered milk, and four soymilks led to daily F intake ranging from 0.108 to 0.851 mg/kg.

CONCLUSIONS

The results suggest that the consumption of some brands of infant formulae, powdered milk, and soy-based milk in the first year of age could increase the risk of dental fluorosis, reinforcing the need for periodic surveillance of the F content of foods and beverages typically consumed by young children.

Dental fluorosis in the primary dentition and intake of manufactured soy-based foods with fluoride

BACKGROUND & AIMS

To identify manufactured soy-based products more recommended by pediatricians and nutritionists; to determine fluoride concentrations in these products; to evaluate children concerning fluorosis in primary teeth and its association with the consumption of soy-based products.

METHODS

Pediatricians and Nutritionists answered a questionnaire about soy-based products they most recommended to children. Fluoride concentrations of the 10 products more cited were analyzed with the ion-specific electrode. Dental fluorosis exams were performed in 315 4-6-year-old children. Dean's Index was used to assess fluorosis. Among the children examined, 26 had lactose intolerance. Their parents answered a questionnaire about children's and family's profile, besides permitting the identification of soy-based products use. Chi-squared and Multivariable Logistic Regression tests were used (p < 0.05).

RESULTS

Fluoride content in the analyzed products ranged from 0.03 to 0.50 μg F(-)/mL. Dental fluorosis was detected in 11% of the children, with very mild and mild degrees. Dental fluorosis in primary teeth was associated with lactose intolerance (p < 0.05), but there was no significant association with the use of manufactured soy-based products.

CONCLUSIONS

Isolated consumption of soy-based products recommended by health professionals to children do not offer risk of dental fluorosis in primary teeth, which had a low prevalence and severity.

Fluoride content of bottled drinking waters available in Riyadh, Saudi Arabia

AIMS

This study aimed to examine the fluoride concentration of commercially available bottled water products in Riyadh, Saudi Arabia, and to assess the accuracy of the labeling of fluoride concentration on the tested brands.

METHODS

Fifteen randomly selected commercial brands of bottled water were obtained from supermarkets in Riyadh, Saudi Arabia. Three bottles of each brand were purchased, and fluoride content was measured using a combination fluoride-ion-selective electrode. The average reading for each brand was estimated and also compared with the fluoride content printed on the label.

RESULTS

The mean (±SD) fluoride content of the 12 local bottled water samples was 0.79 (±0.09) mg/L with a range from 0.5 to 0.83 mg/L. The mean fluoride concentration of the three imported brands was 0.67 (±0.02) mg/L with a narrow range of fluoride content (0.65-0.69). All tested samples mention the fluoride content on the label except two imported brands. Five samples showed a significant difference between our evaluation and stated content of fluoride that ranged between +0.46 and -0.2 mg/L.

CONCLUSIONS

Bottled drinking waters available in Riyadh, Saudi Arabia contain differing concentration of fluoride, but within a safe range for use as a source of systemic fluoride. In addition, the manufactures' labeling of fluoride content may be inaccurate.