Infant Formula

Because most infant formulas contain low levels of fluoride, regularly mixing powdered or liquid infant formula concentrate with fluoridated water may increase the chance of a child developing the faint white markings of mild fluorosis.

Three types of infant formula are available in the United States: powdered formula, which comes in bulk or single-serve packets, concentrated liquid, and ready-to-feed formula. Ready-to-feed formula contains little fluoride and does not cause dental fluorosis. The kinds of formula that must be mixed with water—powdered or liquid concentrates—may increase the chance of dental fluorosis if they are the child’s main source food and if the water is fluoridated.

Yes, you can use fluoridated water for preparing infant formula. However, if your child is only consuming infant formula mixed with fluoridated water, there may be an increased chance for mild dental fluorosis. To lessen this chance, parents can use low-fluoride bottled water some of the time to mix infant formula; these bottled waters are labeled as de-ionized, purified, demineralized, or distilled, and without any fluoride added after purification treatment. The U.S. Food and Drug Administration (FDA) requires the label to indicate when fluoride is added.

Yes, you can use bottled water to reconstitute (mix) powdered or liquid concentrate infant formulas, but be aware that the fluoride content in bottled water varies. If your child is exclusively consuming infant formula reconstituted with water that contains fluoride, there may be an increased chance for mild dental fluorosis (a change in the appearance of tooth enamel creating barely visible lacy white markings). To lessen this chance, parents may choose to use low-fluoride bottled water some of the time to mix infant formula. These bottled waters are labeled as de-ionized, purified, demineralized, or distilled and are without any fluoride added after purification treatment (FDA requires the label to indicate when fluoride is added). Some water companies make available bottled waters marketed for infants and for the purpose of mixing with formula. When water is labeled as intended for infants, the water must meet tap water standards established by the EPA and indicate that the water is not sterile. For more information, see the FDA’s general Q&A about bottled water and infant formulaexternal icon.