Fluoride Action Network

Potential for infant over-exposure to fluoride by diluting formula with too much water

Source: TBO (Tampa Bay Online) | Diluted Formula Nearly Kills Baby | December 2nd, 2008 | By SHERRI ACKERMAN and MARY SHEDDEN

NOTE FROM FAN: While this important article does not mention fluoride, we include it because of the real potential for over-exposing an infant to fluoride. The amount of fluoride an infant receives who is fed formula made with fluoridated water, when the tap water contains 1 ppm, is estimated to be up to 250 times more than an infant who is breast fed. However, as this article poignantly reveals, parents who do not have enough money to buy the necessary amount of formula are adding more water in an attempt to save money. The calculations for this over-exposure scenario for infants has not been calculated, and tragically, it is the poorest who are the most vulnerable to fluoride’s toxic effects

TAMPA – No one ever told 23-year-old Jeri Moss that putting too much water in her baby’s formula could kill him.

She had used the money-saving trick with her 18-month-old daughter with no problems.

On Nov. 25, her 5-month-old son, La’Damian Barton, started screaming and curled into a ball inside his stroller. When a frantic Moss reached for her son, he had stopped breathing.

Moss performed CPR, but the infant still wasn’t breathing when he arrived at University Community Hospital. Doctors diagnosed La’Damian with water intoxication and malnourishment. He weighs 8 pounds 6 ounces but should be about 12 pounds.

After two days on a ventilator, the baby has improved and is expected to be released today, Moss said. She agreed to share her story Monday afternoon to warn other parents that too much water can kill.

“I really, honestly didn’t know,” said Moss, who had just learned infant CPR the day before her son’s seizure.

It’s a message the hospital also wants to share.

“This is a very serious situation, especially in thin economic times,” said James Orlowski, the hospital’s chief of pediatrics, who fears more parents strapped for cash may be doing just what Moss did.

Infants on formula should receive no additional water until they are about 10 months old, he said.

Health experts have been documenting cases of infant water intoxication for decades, with the earliest such cases happening in the late 1960s. By the 1990s, several medical journals pointed to the possibility that poverty could be a factor in caregivers providing watered-down formula or bottles of water as a source of nutrition.

Researchers at Baltimore’s Johns Hopkins Children’s Hospital reported three or four such cases this past summer.

Moss said she couldn’t breast-feed and was just trying to stretch the eight to 10 cans of Good Start formula she receives each month through the federal Women, Infants and Children program. The program, known as WIC, provides low-cost or free formula and food for at-risk children.

She really needed about 15 cans, she said, but couldn’t afford $16 to $18 for each.

“I’m really, really tight, and this is all I had,” said Moss, who qualified for food stamps this month. The Department of Children & Families is investigating the incident.

In 2004, parents of a 3-month-old infant spent between $78 and $92 a month – about $1,100 a year – on infant formula, according to the U.S. Department of Agriculture, which oversees the WIC program.

Moss’ boyfriend and La’Damian’s father, Antonia Barton, has a job with a company that sets up tents for special events, but work is sporadic, Moss said. She is studying at Everest University, a private technical school, to be a medical assistant.

Moss figured she could save money by using four scoops of Good Start soy formula per 8-ounce bottle instead of the six scoops called for by the directions, she said. Although La’Damian was feeling full, he wasn’t receiving the proper calories, Orlowski said.

Worse, the baby developed water intoxication syndrome and his sodium levels were so diluted he experienced a serious imbalance that affected his muscles and nerves. “Another hour, he would’ve been dead,” the doctor said.

“It definitely reflects these economic times,” Orlowski said. No parent should have to water down their infant’s formula to make ends meet, the doctor said. “That’s what WIC is supposed to be there for.”

Cindy Morris, environmental administrator for the Hillsborough County Health Department, said Moss has been receiving WIC benefits since June 23. Each time, she received the allotted amount of assistance: vouchers for nine cans of formula a month. The allotment includes both powder and premixed formula.

Morris said federal law prohibits WIC from giving more. “It’s never meant to cover 100 percent of the nutrition,” she said.

The health department encourages families to participate, but if a person is not eligible for the specific program, counselors will look at other available assistance such as food stamps, Morris said.

“We want to help sustain a child,” she said.

An estimated 2 million children each month receive infant formula through WIC. More than half of all formula sold in the United States stems from WIC. Through the program, parents receive vouchers to purchase formula and other food for children up to age 5.

An estimated 34,000 Hillsborough County families a month receive WIC assistance, almost 10 percent more than just a year ago, Morris said.

“The need has increased enormously,” said Jane Murphy, executive director of Healthy Start Coalition of Hillsborough County. “They might not get food stamps, but they will go to WIC for formula.”

WIC used to come to hospitals to educate new moms, Murphy said, but some health advocates felt the program discouraged women from breast-feeding, considered the best choice for infants.

Orlowski said his hospital supports breast-feeding as an infant’s best option, but staff will start explaining to new mothers how to properly mix formulas.


•Breast-feeding is the preferred source of liquid nutrition for children in their first year. However, millions of babies use powdered or premixed formulas. Cow’s milk is not recommended until age 1, as infant kidneys are unable to process it.

•Adding too much water to powdered formula can cause abdominal pain, insufficient calories and an altered salt balance. Results can include excessive sleep, seizures, brain damage or death.

•Doctors also warn parents not to give infants water by itself. Dr. James Orlowski, chief of pediatrics at University Community Hospital, recommends not giving babies water until they are about 10 months old.