Fluoride exposure in infants

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Fluoride Exposure in Infants: Sources and Intake Levels

Infants are exposed to fluoride from several sources, including drinking water, infant formula, foods, and dental products. The use of fluoridated water in preparing infant formula or in the processing of commercial baby foods can significantly increase an infant's total daily fluoride intake, especially in communities with fluoridated water supplies 1568. Formula-fed infants, particularly those in fluoridated areas, tend to have higher fluoride intake and retention compared to breastfed infants or those in non-fluoridated areas 68. The estimated maximum daily fluoride intake for infants up to 6 months can reach 0.127 mg/kg of body weight, with some scenarios exceeding the upper tolerable intake limit, raising concerns about potential health risks 15.

Health Risks: Dental Fluorosis and Neurodevelopmental Effects

Dental Fluorosis in Infants

Dental fluorosis, a condition caused by excessive fluoride intake during tooth development, has become more prevalent in recent decades, even in areas with non-fluoridated water 58. The risk is closely linked to the amount of fluoride consumed during infancy, particularly from formula prepared with fluoridated water and inadvertent swallowing of toothpaste 58. Recommendations to reduce risk include using low-fluoride water for formula preparation and supervising young children during toothbrushing .

Neurodevelopmental and Cognitive Concerns

Recent research has raised concerns about the potential neurodevelopmental effects of fluoride exposure during pregnancy and infancy. Studies have found that higher prenatal and early-life fluoride exposure is associated with lower cognitive scores, including reduced IQ and poorer performance in non-verbal intelligence tasks in children 247910. Specifically, prenatal fluoride exposure has been linked to lower mental and psychomotor development scores in infants, as well as reduced visual acuity and altered cardiac autonomic function at 6 months of age 24. These effects appear to be more pronounced in formula-fed infants and may persist into later childhood 710.

Balancing Benefits and Risks of Fluoride in Infancy

While fluoride is effective in preventing dental caries, especially when applied topically, the benefits of systemic fluoride exposure (such as through drinking water or formula) for infants are less clear . Excessive fluoride intake during infancy can lead to dental fluorosis and may pose risks to neurodevelopment 247910. Experts suggest that in environments where fluoride is available from multiple sources, the risk-benefit balance of community water fluoridation for infants and pregnant women may be unfavorable .

Conclusion

Infants are particularly sensitive to fluoride exposure, with formula-fed infants in fluoridated areas at greatest risk for excessive intake. Excessive fluoride during infancy is linked to dental fluorosis and emerging evidence suggests potential neurodevelopmental risks. To minimize harm, it is recommended to use low-fluoride water for infant formula, supervise dental hygiene practices, and reconsider the need for systemic fluoride exposure in early life.

Sources and full results

Most relevant research papers on this topic

Total fluoride intake of infants.

Infants up to 6 months of age should not exceed 0.127 mg of fluoride per kilogram of body weight per day, regardless of whether they consume human milk or cow's milk and live in communities with fluoridated water.

Observational StudyHighly Cited

1979·

87citations

·L. Singer et al.

Prenatal fluoride exposure, offspring visual acuity and autonomic nervous system function in 6-month-old infants

Prenatal fluoride exposure is associated with reduced visual acuity and altered cardiac autonomic function in 6-month-old infants, adding to the growing body of evidence suggesting fluoride's developmental neurotoxicity.

Observational Study

2023·

3citations

·John E. Krzeczkowski et al.

Feeding patterns, water sources and fluoride exposures of infants and 1-year-olds.

Infants and 1-year-olds have higher fluoride exposures than adults due to their feeding habits, water sources, and toothpaste use.

Observational Study

1993·

35citations

·Steven M. Levy et al.

In utero exposure to fluoride and cognitive development delay in infants

In utero exposure to fluoride is associated with cognitive development delays in infants, potentially starting in early prenatal stages.

Observational Study

2017·

64citations

·L. Jiménez et al.

A Quantitative Look at Fluorosis, Fluoride Exposure, and Intake in Children Using a Health Risk Assessment Approach

Some children may be at risk for fluorosis due to higher daily fluoride intake than the upper tolerable intake limit, even in fluoridated communities.

Observational StudyRigorous JournalHighly Cited

2004·

154citations

·S. Erdal et al.

Fluoride retention in infants living in fluoridated and non-fluoridated areas: effects of weaning

A large proportion of fluoride intake is retained in the body in weaned infants, highlighting the need for fluoride-based prevention programs to maximize caries prevention while minimizing dental fluorosis risk.

Observational StudyVery Rigorous Journal

2018·

22citations

·F. Zohoori et al.

Fluoride exposure from infant formula and child IQ in a Canadian birth cohort.

Exposure to increasing levels of fluoride in tap water is associated with diminished non-verbal intellectual abilities, particularly in formula-fed children.

Observational StudyRigorous JournalHighly Cited

2019·

76citations

·Till C et al.

Fluoride intake and prevalence of dental fluorosis: trends in fluoride intake with special attention to infants.

Fluoride intake in infants and children has steadily increased since 1930, potentially increasing the prevalence of dental fluorosis unless intervention measures are implemented.

Literature ReviewHighly Cited

2000·

164citations

·S. Fomon et al.

Health Risks and Benefits of Fluoride Exposure During Pregnancy and Infancy.

Fluoride ingestion during pregnancy and infancy is not essential for dental caries prevention, offers little benefit to the fetus and young infant, and may pose an unfavorable risk-benefit ratio for pregnant women and young children.

Literature Review

2025·

0citations

·Christine Till et al.

Domain-specific effects of prenatal fluoride exposure on child IQ at 4, 5, and 6-12 years in the ELEMENT cohort.

Prenatal fluoride exposure negatively impacts children's IQ, particularly in non-verbal intelligence, suggesting visual-spatial and perceptual reasoning abilities may be more affected than verbal abilities.

Observational Study

2022·

19citations

·Carly V. Goodman et al.

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