Dietary fluoride intake from infant and toddler formulas in Poland

Risk of enamel fluorosis associated with excessive fluoride intake during infancy and early childhood has been widely reported in literature. Results of several studies indicate that infant formula consumption, especially in the form of powdered concentrate, may appreciably increase children’s fluoride exposure in optimally fluoridated communities. The aim of the study was to measure fluoride content of infant and toddler formulas available in Poland and to discuss implications of the results. Twenty nine brands of powdered formulas were evaluated. Analyzes were performed with the use of ionselective fluoride electrode (09-37 type) and a RAE 111 chloride-silver reference electrode (MARAT). Results revealed that concentration of fluoride in all products was low (mean 29.0 μg/100 g), and that the formula itself is not a significant source of fluoride exposure. However, when reconstituted with water containing more than 0.5 ppm of fluoride, starting formulas and follow-on formulas may provide a daily fluoride intake of above the suggested threshold for fluorosis. Thus, fully formula-fed infants consuming mother milk substitutes prepared with optimally fluoridated water may be at increased risk of dental fluorosis.