Fluoride content of powdered infant formula meets Australian Food Safety Standards.
ABSTRACT To identify the fluoride content of powdered formula for infants 0-12 months in products available from Brisbane stores in 2006/07 and compare this with the fluoride content of infant formula products available in Australia 10 years earlier.
A range of available infant formula powders were collected from major supermarkets and chemists in Brisbane, Queensland. The fluoride levels in infant formula powder samples were determined using a modification of the micro-diffusion method of Silva and Reynolds(1) utilising perchloric acid and silver sulphate and measured with an ion selective (fluoride) electrode/meter. Fluoride content both prior to and after reconstitution, as well as estimated daily intake according to age was calculated.
Formula samples contained an average of 0.49 microg F/g of powder (range 0.24-0.92 microg F/g). After reconstitution with water containing 0 mg/L fluoride, the fluoride content averaged 7.09 microg F/100mL (range 3.367-22.72 microg F/100mL). Estimated infant fluoride intakes ranged from 0.0039 mg/kg/day for a 6-12 month old infant when reconstituting milk-based formula with non-fluoridated water (0 mg/L), to 0.1735 mg/kg/day for a 0-3 month old infant when reconstituting soy-based formula with fluoridated water (1.0 mg/L).
Infant formula powders contain lower levels of fluoride than previously found in Australia in 1996.
This confirms that infants consume only a small amount of fluoride from milk-based powdered infant formula. Although soy-based infant formulas contain more fluoride than milk-based products, the levels still comply with national food standards.
- Food and Chemical Toxicology - FOOD CHEM TOXICOL. 01/2007; 6(11):23-23.
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ABSTRACT: This study aimed to measure the fluoride (F) content of all infant milk formulas (IMF) available for purchase in Japan and estimate the F exposure of infants whose primary source of nutrition is IMF when reconstituted with different F concentrations of water. Twenty-two commercially available IMFs were purchased from 6 manufacturers in Japan. These IMFs included 21 milk-based products and 1 soy-based product. Each IMF was reconstituted using distilled water and 0.13 μg F/ml fluoridated water according to the manufacturers' instructions. The F concentrations in each sample were measured using the hexamethyldisiloxane diffusion technique and an F ion-selective electrode. The mean F concentration of all products was 0.41 (range 0.15-1.24) μg/g. There were no statistically significant differences among mean F concentrations of newborn milks, follow-on milks and other milks or among manufacturers. The mean F concentration of all products, when reconstituted with distilled water and 0.13 μg F/ml water, was 0.09 and 0.18 μg/ml, respectively. The mean F intake from IMF ranged from 0.039 to 0.134 mg/day with distilled water and from 0.078 to 0.258 mg/day with 0.13 μg/ml fluoridated water, respectively. These results suggested that F intake of infants from IMFs depended on the F concentration of added water, and therefore the risk of dental fluorosis for most Japanese infants would be small since most Japanese municipal water supplies are low in F. However, there was a possibility to exceed the tolerable upper intake level, even under the limit of the law, especially for infants within the first 5 months of life.Caries Research 09/2011; 45(5):486-93. · 2.51 Impact Factor
Fluoride content of powdered infant formula meets Australian Food Safety Standards
Helen Clifford (author for correspondence: Queensland Health, PO Box 267, Southport, QLD
4215. Fax: (07) 5528 1681; e-mail: email@example.com),
Megan K Young,
Objectives: To identify the fluoride content of powdered formula for infants 0-12 months in
products available from Brisbane stores in 2006/2007 and compare this with the fluoride
content of infant formula products available in Australia 10 years earlier. To present results
in a format to allow easy calculation of individual infants’ estimated daily intakes.
Methods: A range of available infant formula powders were collected from major
supermarkets and chemists in Brisbane, Queensland. The fluoride levels in infant formula
powder samples were determined using a modification of the micro-diffusion method of Silva
and Reynolds1 utilising perchloric acid and silver sulphate and measured with an ion selective
(fluoride) electrode/meter. Fluoride content both prior to and after reconstitution, as well as
estimated daily intake according to age was calculated.
Results: Formula samples contained an average of 0.49 µg F/g of powder (range 0.24 – 0.92
µg F/g). After reconstitution with water containing 0mg/L fluoride, the fluoride content
averaged 7.09µg F/100mL (range 3.367 - 22.72 µg F/100mL). Estimated infant fluoride
intakes ranged from 0.0039 mg/kg/day for a 6-12 month old infant when reconstituting milk-
based formula with non-fluoridated water (0 mg/L), to 0.1735 mg/kg/day for a 0-3 month old
infant when reconstituting soy-based formula with fluoridated water (1.0 mg/L).
Clifford, Olszowy, Young et al 2008
Conclusions: Infant formula powders contain lower levels of fluoride than previously found
in Australia in 1996.
Implications: This confirms that infants consume only a small amount of fluoride from milk-
based powdered infant formula. Although soy-based infant formulas contain more fluoride
than milk-based products, the levels still comply with national food standards.
Keywords: Fluoride, infant formula, oral health, water fluoridation, fluorosis, dental, micro-
diffusion, ion selective electrode.
Clifford, Olszowy, Young et al 2008
There are numerous guideline values for the level of exposure to fluoride that maximises
health benefits (tooth decay prevention) and minimises adverse effects (dental fluorosis).2,3,4
In Australia, 64% of children experience tooth decay (dental caries) which causes concerns
from mild discomfort through to debilitating pain as well as reduced capacity to chew, talk
and smile. In comparison, approximately 22% of children experience some form of dental
fluorosis.9,17 Dental fluorosis is mottling of teeth which may result from excessive fluoride
being ingested while teeth are developing and may be of aesthetic concern. The NHMRC
dietary guidelines for Australia and New Zealand, recommend fluoride adequate intake (AI)
for infants which ranges from 0.01mg/day (birth to 6 months) to 0.5 mg/day (7 to 12 months).
The upper limit (UL) is 0.7mg/day and 0.9mg/day, respectively.3 Other authors have also
reported guidance values 0.05 - 0.07 mg F/kg body weight/day and UL’s of up 0.10 mg F/kg
In recent years it has become widely accepted that little pre eruptive benefit to tooth enamel is
achieved through the ingestion of fluoride, as the majority of benefit occurs from frequent
exposure of the tooth enamel to fluorides post eruption.6 Therefore, benefit from fluoride will
not begin until the first teeth erupt, at about 6 months of age at which time fluoride intake
may come from an increasing variety of sources with the introduction of solid foods. Risk from
excess fluoride ingestion in the first twelve months has been shown to have an association with
deciduous teeth but not with permanent teeth as the critical period in which permanent teeth
are most vulnerable does not begin until 15-21 months of age.7,8 This is supported by recent
studies which show that reconstitution of infant formula with fluoridated water at 1mg/L has
little impact on fluorosis levels of permanent teeth, compared to other sources of fluoride
ingestion, such as toothpaste ingestion and fluoride supplement use.9,10 Despite lack of
Clifford, Olszowy, Young et al 2008
agreement on guideline values and varying units of measurement, fluoride intake from infant
formula has been frequently identified as a potential source of excess fluoride for infants
depending on production processes and fluoride concentration of water used for
In 1996, Silva and Reynolds investigated fluoride concentrations in infant formula in
Australia and found that, when water fluoridated at 1mg/L was used to reconstitute their
formula samples, all exceeded their suggested UL of fluoride intake. In 1999, the NHMRC
made a recommendation to develop a strategy to reduce excessive intake of fluoride from
infant formula in Australia.6 The Australia New Zealand Food Standards Code was amended
to include mandatory dental fluorosis risk labelling of powdered or concentrated infant
formula if it contains more than 17μg F/100 kilojoules (kJ) prior to reconstitution.12 Since that
time there has been no reported investigation of the levels of fluoride in powdered or
concentrated infant formula products commercially available in Australia. This study sought
to redress this deficit.
One tin of every infant formula that was present on the shelves of two different major
supermarkets in Brisbane was purchased in March 2006. Where possible a different batch
number was obtained in another two stores of the same supermarket chain to achieve a sample
of 33 different infant formula products. Two Chemist chain stores were also accessed to
identify other common brands and different batches of products (June 2007). This produced a
total sample of 53 tins of infant formula powder (15 products were double sampled, 1 triple
sampled and 1 had four samples). Product labels identified country of manufacture as New
Zealand, Ireland/Singapore, France/Germany/Netherlands and Australia.
Clifford, Olszowy, Young et al 2008
Fluoride in the infant formula powders was determined using a modification of the micro-
diffusion method of Silva and Reynolds utilising perchloric acid and silver sulphate. Square
polystyrene Petri dishes with unvented lids to prevent loss of liberated hydrofluoric acid
(100mm x 100mm x 18mm) were used throughout this work and were pre-cleaned by soaking
in 5% perchloric acid overnight, rinsed with deionised water and oven dried prior to use.
Analytical Reagent (AR) grade perchloric acid and silver sulphate may contain low levels of
fluoride as an impurity and must be processed to reduce the fluoride contamination to
acceptable levels. This was achieved by 0.3g finely ground silver sulphate and 14mL of 48%
perchloric acid (prepared by diluting concentrated 70% perchloric acid) was placed in a Petri
dish and mixed with a stirring rod. The lid was placed slightly ajar on top of the Petri dish (to
allow contaminant HF vapours to escape) and placed in an air oven at 50 C overnight. After the
heating process in the air oven overnight, the perchloric acid and silver sulphate was ready to
At least 12 x 12 drops of 0.5M sodium hydroxide solution were pipetted to the inside of the
Petri dish lids using an 8 channel Finn-pipette, ensuring that the 144 drops were evenly spaced.
The Finn-pipette was set so the volume of each drop was approximately 3.5 L resulting in a
final volume of 0.5M sodium hydroxide spotted onto the lid of approximately 0.5mL. The lids
were placed, with drops facing upwards, into a clean air oven for at least 2 hours to allow the
moisture in the sodium hydroxide solution to evaporate.
A weight of 0.35g of infant formula powder was transferred to the prepared (decontaminated)
perchloric acid/silver sulphate mixture and covered with the spotted lid as quickly as possible.
The mixture was evenly dispersed by swirling and then placed in a clean air oven at 50 C for