When you prepare baby formula, you may wonder if using tap water is the safest option. While most tap water is safe, there are three main chemical concerns in using tap water for babies: the presence of fluoride, lead, and/or nitrates.
Fluoride is a naturally occurring mineral that strengthens tooth enamel and prevents dental cavities. Local water utilities often add fluoride to their water to reach an ideal level (usually 0.7mg per liter) as a public health improvement measure. However, when babies consume excess fluoride, they can develop white markings or streaks on their teeth called enamel fluorosis.
While enamel fluorosis does not signal harm your baby, these streaks or discolorations can be permanent.
In order to minimize the risk of enamel fluorosis mix your baby’s formula with tap water one day and low-fluoride water — such as purified, demineralized, deionized, or distilled water — the next day. If you choose to mix your baby’s formula with only low- or no-fluoride water, or your water utility does not add fluoride to your tap water, you may need to give your baby fluoride supplements after about six months. Ready-to-feed formulas, which are pre-mixed, contain very little fluoride but are often more costly than powdered or concentrated formulas
As water travels through your pipes toward your faucet, it may come in contact with lead-containing plumbing fixtures. Even if lead levels are low at a water treatment facility, the water that comes out of your pipes can be different. To minimize your risks for lead exposure for your baby, take the following steps:
- Run your water for 30-60 seconds before mixing it with formula.
- Use only cold water to mix baby formula, as lead is more likely to dissolve in warm water.
- Have your at-home water tested for lead. Your lead levels should not exceed 15 micrograms per liter.
Some water systems have water that contains nitrates. This is a naturally occurring compound that contains nitrogen. Levels greater than 10 mg/liter of nitrate or 45 mg/l of nitrate-nitrogen are associated with an increased risk for a condition called methemoglobinemia. Also known as blue baby syndrome, this dangerous condition can cause brain damage and death in its most severe instances. Symptoms associated with methemoglobinemia include shortness of breath, weakness, and the skin turning blue, especially around the mouth and eyes.
If you are concerned about the levels of nitrates and/or fluoride in your water, contact your water utility or health department. This service should give you information on your water’s quality. If you use a private water source that is not regulated, such as well water, you should have the drinking water tested at least once per year.
- Most tap water formulations in the United States are safe for baby, but testing water is always a good idea.
- Homes with well water can have their water quality evaluated by contacting the Environmental Protection Agency’s Laboratory Certification Program.