Fluoride Supplements in Childhood
From: NEW BEGINNINGS, Vol. 13 No. 4, July-August 1996, p.107
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time.
Fluoride helps teeth resist decay. Fluoride is ingested from a variety of sources--it may be added to your municipal water supply, or your water may contain naturally occurring fluoride. In addition, you may eat or drink things that have been made using fluoridated water. Toothpastes and mouthwashes may have added fluoride. The amount of fluoride ingested from all these varying sources is impossible to estimate.
However, increasing numbers of children living in the United States have developed dental fluorosis, a condition that appears during tooth formation and is caused by an excess of fluoride intake. Affected teeth may show a range of changes, from white specks or striations that can barely be seen, to areas of pitting or brownish-gray staining. The condition is believed to have only cosmetic effects on teeth.
Given the rise in dental fluorosis, health care practitioners have changed their recommendations for fluoride supplementation in babies and young children, since many infants apparently ingest enough fluoride from other sources. The Committee on Nutrition of the American Academy of Pediatrics (AAP) is in the process of revising its 1986 policy statement on "Fluoride Supplementation" to reflect current information. Recommendations for fluoride supplementation now include the following:
Babies should not receive fluoride supplements in the first six months of life. This includes exclusively breastfed babies. If the baby is receiving artificial baby milk, this may be mixed with fluoridated water.
After six months, the AAP recommends supplementation for children who live in low-fluoride areas whether or not they are breastfed. For children six months to three years old, a low-fluoride area is defined as an area that has a water fluoride content of less than 0.3 parts per million (ppm). For children over three years, a water fluoride content of 0.3-0.6 ppm is also considered low-fluoride, but requires lower levels of supplementation. When water fluoride levels are above 0.6 ppm (previously 0.7 ppm), supplements are not needed.
THE WOMANLY ART OF BREASTFEEDING states, "Mother's milk contains some fluoride, and while the amount is small, it seems to be perfectly suited to the baby's need. As long as your baby is thriving on human milk alone, he has no need for additional vitamins, iron, fluoride, or other supplements in the early months."
American Academy of Pediatrics, Committee on Nutrition. Fluoride supplementation: revised dosage schedule. Pediatrics 1979; 63(1):150-52.
American Academy of Pediatrics, Committee on Nutrition. Fluoride supplementation for children: interim policy recommendations. Pediatrics 1995; 95(5):777.
Finberg, L. et al. American Academy of Pediatrics, Committee on Nutrition. Fluoride supplementation. Pediatrics 1986; 77(5):758 61.