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The first posted infant formula advisory for parents of infants - Austin Texas

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  • Doug
    This is what I consider a historic first. The city of Austin decided to post an advisory in their WIC clinics about the fluorosis risk when infant formula is
    Message 1 of 5 , Mar 8, 2012
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      This is what I consider a historic first. The city of Austin decided to post an advisory in their WIC clinics about the fluorosis risk when infant formula is prepared with fluoridated tap water. WIC advisors in these clinics hand out free powdered or concentrated infant formula to low income parents. Yes, the advisory is perhaps not worded the best way, but it's a great start.

      There is even more good news. Today I spoke to the Texas state WIC expert on infant formula. After I spoke to her in 2009 she created new training modules for the WIC advisors. The WIC advisors are now being taught to find out the fluoride level in the local tap water. If the fluoride level is at what is considered the optimal level or higher then the WIC advisors are being trained to tell the parents about the fluorosis risk from infant formula. In Texas there are areas with very high natural levels of fluoride in the ground water. She agreed with me that in those areas it's even more important that parents be informed. The term "Texas teeth" was an early way of describing dental fluorosis. Of course, whether the WIC advisors are actually following their training would require a lot more research.

      There are several weak point in the posted Austin advisory.
      1) Enamel fluorosis can be much more severe than "faint white markings or streaks." One of the top pro-fluoridationists, Howard Pollick wrote in 2003: "Likely total exposure values for children older than six months living in communities with water fluoridated
      at up to 1.2 mg/L (ppm) do not exceed the upper limit set to be protective of moderate dental fluorosis by the Institute of Medicine. Total dietary exposures of fluoride can exceed this threshold
      amount (0.7mg/day) in infants fed formula reconstituted
      with optimally fluoridated water." In other words, young infants can swallow so much fluoride that they are at an increased risk if moderate fluorosis. Most pictures you see of moderate flurosis show brown stains on a lot of teeth. That is not easy to fix, and no government program or dental insurance will pay for it. Even mild fluorosis can mean visible brown stains.

      2) "you can minimize exposure to fluoride by using ready-to-feed formula" WIC does not provide ready-to-feed formula, it costs too much. So the low income parents who use WIC are unlikely to spend extra money on formula when WIC provides them free powdered or concentrated formula.

      3) "You can also alternate using tap water and non-fluoridated water for formula preparation." If a parent wants to avoid fluorosis risk it's best to always use non-fluoridated water for formula. The only reason not to would be to save money. Nobody has directly said that these infants get any benefit from this big fluoride exposure. This statement encourages parents to use tap water when they don't need to for any reason - other than cost or convenience. Infants on breast milk or who live in non-fluoridated areas never get a big fluoride exposure, and yet nobody is saying these infants have more tooth decay or need to swallow additional fluoride.

      4) "However, if you use only non-fluoridated water...to prepare you baby's formula, your baby's doctor may recommend fluoride supplements beginning at age six months." This is technically a violation of the fluoride supplement schedule, since in fluoridated areas supplements are never supposed to be proscribed. This creates a weird situation where the infant is given fluoride supplements for only a few months until they start drinking tap water and eating solid foods. Once they start on drinking tap water fluoride supplements are definitely not recommended and no doctor should proscribe them. The other problem with this is that it could be interpreted by parents to say that if they don't use fluoridated water for the first six months then the doctor will proscribe fluoride supplements at the age of 6 month because they didn't use fluoridated water before that. This idea comes from an expert at the Mayo clinic who apparently didn't realize that his recommendation was a violation of the fluoride supplement schedule and that parents could interpret it the wrong way.
    • MRN Olenick
      Doug,   Your accomplishment in getting WIC instructors on board is the real historic achievement.  Congratulations on helping them to see the light.  That s
      Message 2 of 5 , Mar 8, 2012
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        Doug,
         
        Your accomplishment in getting WIC instructors on board is the real historic achievement.  Congratulations on helping them to see the light.  That's big. 
        As to the city of Austin's so-called advisory:  a warning that has more weaknesses than strengths isn't much of a warning, is it? The language was carefully and deliberately crafted by health bureaucrats to be deceptive. It's not a mistake, it's not a misunderstanding, it's an agenda.  
         
         
        Just last night several of us sat in on a bizarre board meeting of a small nearby community water district where they were considering doing away with fluoridation.  A team of county and state level "experts" arrived, told many lies, and persuaded them to change their minds.  And the dentist-bureaucrat-in-chief was more than pleased to have the "advisory" to wave around in front of the clueless board members (See, we've done our job -we've told you about fluorosis in case you should be silly enough to care.)  The board all but swooned at this demonstration of good faith.  I knew the advisory could and would be misused in this way - and very effectively so.
         
        Incidentally, the same dentist, earlier in the evening, described mild fluorosis as "a teenager's heaven" because the rest of the teeth could then be bleached to match the snowy white fluorosis stains; he also maintained, while holding up a supposed study, that the body has a nutritional requirement for F and can suffer from F deficiency.
         
        These are the kind of people we're up against, and we are not amused to have given them some more ammo.  Just a little, perhaps, but every little bit hurts.  Therefore, I wouldn't describe as a great start a "victory" that can so easily be turned against us.  Far from winning any real concessions (much as I wish I could say we did), we at most played to a draw.
         
        Rae
         
         

        --- On Thu, 3/8/12, Doug <cragoe@...> wrote:

        From: Doug <cragoe@...>
        Subject: [FluoridePoisoning] The first posted infant formula advisory for parents of infants - Austin Texas
        To: FluoridePoisoning@yahoogroups.com
        Date: Thursday, March 8, 2012, 1:54 PM

         
        This is what I consider a historic first. The city of Austin decided to post an advisory in their WIC clinics about the fluorosis risk when infant formula is prepared with fluoridated tap water. WIC advisors in these clinics hand out free powdered or concentrated infant formula to low income parents. Yes, the advisory is perhaps not worded the best way, but it's a great start.

        There is even more good news. Today I spoke to the Texas state WIC expert on infant formula. After I spoke to her in 2009 she created new training modules for the WIC advisors. The WIC advisors are now being taught to find out the fluoride level in the local tap water. If the fluoride level is at what is considered the optimal level or higher then the WIC advisors are being trained to tell the parents about the fluorosis risk from infant formula. In Texas there are areas with very high natural levels of fluoride in the ground water. She agreed with me that in those areas it's even more important that parents be informed. The term "Texas teeth" was an early way of describing dental fluorosis. Of course, whether the WIC advisors are actually following their training would require a lot more research.

        There are several weak point in the posted Austin advisory.
        1) Enamel fluorosis can be much more severe than "faint white markings or streaks." One of the top pro-fluoridationists, Howard Pollick wrote in 2003: "Likely total exposure values for children older than six months living in communities with water fluoridated
        at up to 1.2 mg/L (ppm) do not exceed the upper limit set to be protective of moderate dental fluorosis by the Institute of Medicine. Total dietary exposures of fluoride can exceed this threshold
        amount (0.7mg/day) in infants fed formula reconstituted
        with optimally fluoridated water." In other words, young infants can swallow so much fluoride that they are at an increased risk if moderate fluorosis. Most pictures you see of moderate flurosis show brown stains on a lot of teeth. That is not easy to fix, and no government program or dental insurance will pay for it. Even mild fluorosis can mean visible brown stains.

        2) "you can minimize exposure to fluoride by using ready-to-feed formula" WIC does not provide ready-to-feed formula, it costs too much. So the low income parents who use WIC are unlikely to spend extra money on formula when WIC provides them free powdered or concentrated formula.

        3) "You can also alternate using tap water and non-fluoridated water for formula preparation." If a parent wants to avoid fluorosis risk it's best to always use non-fluoridated water for formula. The only reason not to would be to save money. Nobody has directly said that these infants get any benefit from this big fluoride exposure. This statement encourages parents to use tap water when they don't need to for any reason - other than cost or convenience. Infants on breast milk or who live in non-fluoridated areas never get a big fluoride exposure, and yet nobody is saying these infants have more tooth decay or need to swallow additional fluoride.

        4) "However, if you use only non-fluoridated water...to prepare you baby's formula, your baby's doctor may recommend fluoride supplements beginning at age six months." This is technically a violation of the fluoride supplement schedule, since in fluoridated areas supplements are never supposed to be proscribed. This creates a weird situation where the infant is given fluoride supplements for only a few months until they start drinking tap water and eating solid foods. Once they start on drinking tap water fluoride supplements are definitely not recommended and no doctor should proscribe them. The other problem with this is that it could be interpreted by parents to say that if they don't use fluoridated water for the first six months then the doctor will proscribe fluoride supplements at the age of 6 month because they didn't use fluoridated water before that. This idea comes from an expert at the Mayo clinic who apparently didn't realize that his recommendation was a violation of the fluoride supplement schedule and that parents could interpret it the wrong way.

      • David M Augenstein
        A year ago I explained to my bosses boss, the Health Commissioner, that about the warning for infants be given out in the WIC program. He never responded or
        Message 3 of 5 , Mar 8, 2012
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          A year ago I explained to my bosses boss, the Health Commissioner, that about the warning for infants be given out in the WIC program. He never responded or apparently looked into it. I had given him the CDC, ADA statements. Last week, I obtained the flyer they give the mothers. It says city water is the safest water because it contains F and is protected by federal law. I emailed him last week expressing my concern he ignored my gently phrased request. My email this time was less than professional - it had a tone-- but all this got me in big trouble. He then stated the top achievement in the 20th century wherbey I told him you are just repeating what you have heard and waht you are told to say without any background in FI had an Investigative Hearing and they got me on using work time to prepare a memo and printing out 2 pages of documentation; he was upset I used a condescending tone--which I apologized for-- and that I cc'd my boss rather than send it only to her. The certified mail I opened today at home said I have a choice of counseling or 3-days suspension without pay (the teacher accused of sexual contacts with children gets indefinite suspension with pay). Further, they evaluated my performance and marked me lower than my annual review even though I improved in my work before each of these evaluations. They accused me of researching F during work time which is not true as I do that at home and produced the best flyer around as a result. I will now write WIC at Columbus on my own time and will get in more trouble if they find out. The concern I had made in the hearing (I had two witnesses and it was recorded) is the Duty to Warn and the lack of response by the Health Commissioner (and he saw Professional Prospectives and got hard copys of all this)
           


          Mr. Augie
          DAVID MICHAEL AUGENSTEIN, MS, P.Eng.

          livingfood.us
          Vaccines, Milk, Fluoride & More









          From: MRN Olenick <mrn_olenic@...>
          To: FluoridePoisoning@yahoogroups.com
          Sent: Thu, March 8, 2012 6:58:36 PM
          Subject: Re: [FluoridePoisoning] The first posted infant formula advisory for parents of infants - Austin Texas

           

          Doug,
           
          Your accomplishment in getting WIC instructors on board is the real historic achievement.  Congratulations on helping them to see the light.  That's big. 
          As to the city of Austin's so-called advisory:  a warning that has more weaknesses than strengths isn't much of a warning, is it? The language was carefully and deliberately crafted by health bureaucrats to be deceptive. It's not a mistake, it's not a misunderstanding, it's an agenda.  
           
           
          Just last night several of us sat in on a bizarre board meeting of a small nearby community water district where they were considering doing away with fluoridation.  A team of county and state level "experts" arrived, told many lies, and persuaded them to change their minds.  And the dentist-bureaucrat-in-chief was more than pleased to have the "advisory" to wave around in front of the clueless board members (See, we've done our job -we've told you about fluorosis in case you should be silly enough to care.)  The board all but swooned at this demonstration of good faith.  I knew the advisory could and would be misused in this way - and very effectively so.
           
          Incidentally, the same dentist, earlier in the evening, described mild fluorosis as "a teenager's heaven" because the rest of the teeth could then be bleached to match the snowy white fluorosis stains; he also maintained, while holding up a supposed study, that the body has a nutritional requirement for F and can suffer from F deficiency.
           
          These are the kind of people we're up against, and we are not amused to have given them some more ammo.  Just a little, perhaps, but every little bit hurts.  Therefore, I wouldn't describe as a great start a "victory" that can so easily be turned against us.  Far from winning any real concessions (much as I wish I could say we did), we at most played to a draw.
           
          Rae
           
           

          --- On Thu, 3/8/12, Doug <cragoe@...> wrote:

          From: Doug <cragoe@...>
          Subject: [FluoridePoisoning] The first posted infant formula advisory for parents of infants - Austin Texas
          To: FluoridePoisoning@yahoogroups.com
          Date: Thursday, March 8, 2012, 1:54 PM

           
          This is what I consider a historic first. The city of Austin decided to post an advisory in their WIC clinics about the fluorosis risk when infant formula is prepared with fluoridated tap water. WIC advisors in these clinics hand out free powdered or concentrated infant formula to low income parents. Yes, the advisory is perhaps not worded the best way, but it's a great start.

          There is even more good news. Today I spoke to the Texas state WIC expert on infant formula. After I spoke to her in 2009 she created new training modules for the WIC advisors. The WIC advisors are now being taught to find out the fluoride level in the local tap water. If the fluoride level is at what is considered the optimal level or higher then the WIC advisors are being trained to tell the parents about the fluorosis risk from infant formula. In Texas there are areas with very high natural levels of fluoride in the ground water. She agreed with me that in those areas it's even more important that parents be informed. The term "Texas teeth" was an early way of describing dental fluorosis. Of course, whether the WIC advisors are actually following their training would require a lot more research.

          There are several weak point in the posted Austin advisory.
          1) Enamel fluorosis can be much more severe than "faint white markings or streaks." One of the top pro-fluoridationists, Howard Pollick wrote in 2003: "Likely total exposure values for children older than six months living in communities with water fluoridated
          at up to 1.2 mg/L (ppm) do not exceed the upper limit set to be protective of moderate dental fluorosis by the Institute of Medicine. Total dietary exposures of fluoride can exceed this threshold
          amount (0.7mg/day) in infants fed formula reconstituted
          with optimally fluoridated water." In other words, young infants can swallow so much fluoride that they are at an increased risk if moderate fluorosis. Most pictures you see of moderate flurosis show brown stains on a lot of teeth. That is not easy to fix, and no government program or dental insurance will pay for it. Even mild fluorosis can mean visible brown stains.

          2) "you can minimize exposure to fluoride by using ready-to-feed formula" WIC does not provide ready-to-feed formula, it costs too much. So the low income parents who use WIC are unlikely to spend extra money on formula when WIC provides them free powdered or concentrated formula.

          3) "You can also alternate using tap water and non-fluoridated water for formula preparation." If a parent wants to avoid fluorosis risk it's best to always use non-fluoridated water for formula. The only reason not to would be to save money. Nobody has directly said that these infants get any benefit from this big fluoride exposure. This statement encourages parents to use tap water when they don't need to for any reason - other than cost or convenience. Infants on breast milk or who live in non-fluoridated areas never get a big fluoride exposure, and yet nobody is saying these infants have more tooth decay or need to swallow additional fluoride.

          4) "However, if you use only non-fluoridated water...to prepare you baby's formula, your baby's doctor may recommend fluoride supplements beginning at age six months." This is technically a violation of the fluoride supplement schedule, since in fluoridated areas supplements are never supposed to be proscribed. This creates a weird situation where the infant is given fluoride supplements for only a few months until they start drinking tap water and eating solid foods. Once they start on drinking tap water fluoride supplements are definitely not recommended and no doctor should proscribe them. The other problem with this is that it could be interpreted by parents to say that if they don't use fluoridated water for the first six months then the doctor will proscribe fluoride supplements at the age of 6 month because they didn't use fluoridated water before that. This idea comes from an expert at the Mayo clinic who apparently didn't realize that his recommendation was a violation of the fluoride supplement schedule and that parents could interpret it the wrong way.

        • Doug
          ...   Just last night several of us sat in on a bizarre board meeting of a small nearby community water district where they were considering doing away with
          Message 4 of 5 , Mar 8, 2012
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            --- In FluoridePoisoning@yahoogroups.com, MRN Olenick <mrn_olenic@...> wrote:
              "Just last night several of us sat in on a bizarre board meeting of a small nearby community water district where they were considering doing away with fluoridation.  A team of county and state level "experts" arrived, told many lies, and persuaded them to change their minds.  And the dentist-bureaucrat-in-chief was more than pleased to have the "advisory" to wave around in front of the clueless board members"

            This brings up a bunch of questions. Is this the same advisory that's put in the Austin WIC clinics? If so, is this water district within the Austin city limits but not under the control of the central Austin water system? I'd like a bit more explanation if possible. I don't understand how an Austin city warning would go to a place that doesn't get Austin city water.

            "(See, we've done our job -we've told you about fluorosis in case you should be silly enough to care.)  The board all but swooned at this demonstration of good faith.  I knew the advisory could and would be misused in this way - and very effectively so."

            The advisory is only in the Austin city WIC clinics, so all parents who do not use WIC are still unaware of the risk, as are almost all dentists, pediatricians, and doctors. The American Academy of Peidatrics had a web page that said no additional fluoride for infants 0 to 6 months of age. But there was nothing on that page about infant formula. So I asked them about it, and their expert replied back that their statement meant that infant formula should be prepared with non-fluoridated or low fluoride water. My next question to them was had they ever notified their members about this? The answer, in a round about way, was no. They said they had no policy on infant formula. But they then said that they were going to do something this year about informing their members. So it's a matter of keeping after the authorities in a nice civil manner. That's what works, and many of them eventually see the need to inform parents about this risk.

            But there are many in public health who do not want parents informed because it draws negative attention to fluoridation. That is the primary reason why last year a proposed law in the New Hampshire legislature that would have required an advisory about infant formula on water bills was shot down. Now this year it's been re-introduced. And it will be very interesting to see the testimony on this bill - I hope it is made available to us.

            "Incidentally, the same dentist, earlier in the evening, described mild fluorosis as "a teenager's heaven" because the rest of the teeth could then be bleached to match the snowy white fluorosis stains"

            I would like to ask that dentist is there something about mild fluorosis that makes the teeth able to be bleached? Is that enamel more porous? Can teeth without fluorosis be bleached? I thought they could. If that's true then some kids have ugly spots and can have their teeth bleached just like kids without ugly spots. Seems like no advantage to me to have spots. But maybe there is something about tooth bleaching I don't know. I just checked the internet, and it seems there are problems with bleaching teeth that have fluorosis.

            "he also maintained, while holding up a supposed study, that the body has a nutritional requirement for F and can suffer from F deficiency."

            I bet he didn't give you a copy of that study. Did he give it to the board? Did you ask for it? I'd love to see it.

            "These are the kind of people we're up against, and we are not amused to have given them some more ammo.  Just a little, perhaps, but every little bit hurts.  Therefore, I wouldn't describe as a great start a "victory" that can so easily be turned against us.  Far from winning any real concessions (much as I wish I could say we did), we at most played to a draw."

            I would have told them you had to work hard to get the city to even put out this warning on infant formula, and if it were not for you no parents would have been informed, and more kids would have grown up with spots on their teeth. Did you take credit for the advisory? Sounds like the other side did when you were the ones that made it happen.

            Perhaps the next historic first would be to have warnings about fluoridated water posted in hospitals and clinics that treat severe kidney patients.
          • Doug
            David- You ve got to remember that everything that is written in this Yahoo group is carefully monitored by people with big salaries who are paid to promote
            Message 5 of 5 , Mar 8, 2012
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              David-
              You've got to remember that everything that is written in this Yahoo group is carefully monitored by people with big salaries who are paid to promote fluoridation. I found out the hard way when I posted sarcastic comments about the California WIC program which were then spread across the country to the public health community. I had obtained California WIC documents that showed what the WIC advisors were being taught about infant formula and fluorosis. In California the WIC advisors were told to not to tell the parents anything unless the parents had asked specifically about the risk of fluorosis. And since very few parents know about this very few were being told.
              One of the stages many of go through is getting over our anger at those who lie or don't care about the risks to infants and children. After talking to many public health officials in 2009 I found that by being polite and listening to their concerns I was then able to get my points across. I still get upset once in a while, but it's usually a mistake and counter-productive. Some public health officials do understand the issue, and they do do believe parents need to be informed about the fluorosis risk.

              --- In FluoridePoisoning@yahoogroups.com, David M Augenstein <daugenstein@...> wrote:
              >
              > A year ago I explained to my bosses boss, the Health Commissioner, that about
              > the warning for infants be given out in the WIC program. He never responded or
              > apparently looked into it. I had given him the CDC, ADA statements. Last week, I
              > obtained the flyer they give the mothers. It says city water is the safest water
              > because it contains F and is protected by federal law. I emailed him last week
              > expressing my concern he ignored my gently phrased request. My email this time
              > was less than professional - it had a tone-- but all this got me in big trouble.
              > He then stated the top achievement in the 20th century wherbey I told him you
              > are just repeating what you have heard and waht you are told to say without any
              > background in FI had an Investigative Hearing and they got me on using work time
              > to prepare a memo and printing out 2 pages of documentation; he was upset I used
              > a condescending tone--which I apologized for-- and that I cc'd my boss rather
              > than send it only to her. The certified mail I opened today at home said I have
              > a choice of counseling or 3-days suspension without pay (the teacher accused of
              > sexual contacts with children gets indefinite suspension with pay). Further,
              > they evaluated my performance and marked me lower than my annual review even
              > though I improved in my work before each of these evaluations. They accused me
              > of researching F during work time which is not true as I do that at home and
              > produced the best flyer around as a result. I will now write WIC at Columbus on
              > my own time and will get in more trouble if they find out. The concern I had
              > made in the hearing (I had two witnesses and it was recorded) is the Duty to
              > Warn and the lack of response by the Health Commissioner (and he saw
              > Professional Prospectives and got hard copys of all this)
              >
              >
              >
              >
              > Mr. Augie
              > DAVID MICHAEL AUGENSTEIN, MS, P.Eng.
              > livingfood.us
              > Vaccines, Milk, Fluoride & More
              >
              >
              >
              >
              >
              >
              >
              >
              >
              >
              >
              > ________________________________
              > From: MRN Olenick <mrn_olenic@...>
              > To: FluoridePoisoning@yahoogroups.com
              > Sent: Thu, March 8, 2012 6:58:36 PM
              > Subject: Re: [FluoridePoisoning] The first posted infant formula advisory for
              > parents of infants - Austin Texas
              >
              >
              > Doug,
              >
              > Your accomplishment in getting WIC instructors on board is the real historic
              > achievement. Congratulations on helping them to see the light. That's big.
              >
              >
              > As to the city of Austin's so-called advisory: a warning that has more
              > weaknesses than strengths isn't much of a warning, is it? The language was
              > carefully and deliberately crafted by health bureaucrats to be deceptive. It's
              > not a mistake, it's not a misunderstanding, it's an agenda.
              >
              >
              > (The flyers can be downloaded from
              > http://blog.fluoridefreeaustin.com/2012/02/03/fluoride-date-lecture-49---wic-bilingual-deception.aspx).
              >
              >
              > Just last night several of us sat in on a bizarre board meeting of a small
              > nearby community water district where they were considering doing away with
              > fluoridation. A team of county and state level "experts" arrived, told many
              > lies, and persuaded them to change their minds. And the
              > dentist-bureaucrat-in-chief was more than pleased to have the "advisory" to wave
              > around in front of the clueless board members (See, we've done our job -we've
              > told you about fluorosis in case you should be silly enough to care.) The board
              > all but swooned at this demonstration of good faith. I knew the advisory could
              > and would be misused in this way - and very effectively so.
              >
              >
              > Incidentally, the same dentist, earlier in the evening, described mild fluorosis
              > as "a teenager's heaven" because the rest of the teeth could then be bleached to
              > match the snowy white fluorosis stains; he also maintained, while holding up a
              > supposed study, that the body has a nutritional requirement for F and can suffer
              > from F deficiency.
              >
              > These are the kind of people we're up against, and we are not amused to have
              > given them some more ammo. Just a little, perhaps, but every little bit hurts.
              > Therefore, I wouldn't describe as a great start a "victory" that can so easily
              > be turned against us. Far from winning any real concessions (much as I wish I
              > could say we did), we at most played to a draw.
              >
              >
              > Rae
              >
              >
              >
              > --- On Thu, 3/8/12, Doug <cragoe@...> wrote:
              >
              >
              > >From: Doug <cragoe@...>
              > >Subject: [FluoridePoisoning] The first posted infant formula advisory for
              > >parents of infants - Austin Texas
              > >To: FluoridePoisoning@yahoogroups.com
              > >Date: Thursday, March 8, 2012, 1:54 PM
              > >
              > >
              > >
              > >This is what I consider a historic first. The city of Austin decided to post an
              > >advisory in their WIC clinics about the fluorosis risk when infant formula is
              > >prepared with fluoridated tap water. WIC advisors in these clinics hand out free
              > >powdered or concentrated infant formula to low income parents. Yes, the advisory
              > >is perhaps not worded the best way, but it's a great start.
              > >
              > >
              > >There is even more good news. Today I spoke to the Texas state WIC expert on
              > >infant formula. After I spoke to her in 2009 she created new training modules
              > >for the WIC advisors. The WIC advisors are now being taught to find out the
              > >fluoride level in the local tap water. If the fluoride level is at what is
              > >considered the optimal level or higher then the WIC advisors are being trained
              > >to tell the parents about the fluorosis risk from infant formula. In Texas there
              > >are areas with very high natural levels of fluoride in the ground water. She
              > >agreed with me that in those areas it's even more important that parents be
              > >informed. The term "Texas teeth" was an early way of describing dental
              > >fluorosis. Of course, whether the WIC advisors are actually following their
              > >training would require a lot more research.
              > >
              > >
              > >There are several weak point in the posted Austin advisory.
              > >1) Enamel fluorosis can be much more severe than "faint white markings or
              > >streaks." One of the top pro-fluoridationists, Howard Pollick wrote in 2003:
              > >"Likely total exposure values for children older than six months living in
              > >communities with water fluoridated
              > >at up to 1.2 mg/L (ppm) do not exceed the upper limit set to be protective of
              > >moderate dental fluorosis by the Institute of Medicine. Total dietary exposures
              > >of fluoride can exceed this threshold
              > >amount (0.7mg/day) in infants fed formula reconstituted
              > >with optimally fluoridated water." In other words, young infants can swallow so
              > >much fluoride that they are at an increased risk if moderate fluorosis. Most
              > >pictures you see of moderate flurosis show brown stains on a lot of teeth. That
              > >is not easy to fix, and no government program or dental insurance will pay for
              > >it. Even mild fluorosis can mean visible brown stains.
              > >
              > >2) "you can minimize exposure to fluoride by using ready-to-feed formula" WIC
              > >does not provide ready-to-feed formula, it costs too much. So the low income
              > >parents who use WIC are unlikely to spend extra money on formula when WIC
              > >provides them free powdered or concentrated formula.
              > >
              > >3) "You can also alternate using tap water and non-fluoridated water for formula
              > >preparation." If a parent wants to avoid fluorosis risk it's best to always use
              > >non-fluoridated water for formula. The only reason not to would be to save
              > >money. Nobody has directly said that these infants get any benefit from this big
              > >fluoride exposure. This statement encourages parents to use tap water when they
              > >don't need to for any reason - other than cost or convenience. Infants on
              > >breast milk or who live in non-fluoridated areas never get a big fluoride
              > >exposure, and yet nobody is saying these infants have more tooth decay or need
              > >to swallow additional fluoride.
              > >
              > >4) "However, if you use only non-fluoridated water...to prepare you baby's
              > >formula, your baby's doctor may recommend fluoride supplements beginning at age
              > >six months." This is technically a violation of the fluoride supplement
              > >schedule, since in fluoridated areas supplements are never supposed to be
              > >proscribed. This creates a weird situation where the infant is given fluoride
              > >supplements for only a few months until they start drinking tap water and eating
              > >solid foods. Once they start on drinking tap water fluoride supplements are
              > >definitely not recommended and no doctor should proscribe them. The other
              > >problem with this is that it could be interpreted by parents to say that if they
              > >don't use fluoridated water for the first six months then the doctor will
              > >proscribe fluoride supplements at the age of 6 month because they didn't use
              > >fluoridated water before that. This idea comes from an expert at the Mayo clinic
              > >who apparently didn't realize that his recommendation was a violation of the
              > >fluoride supplement schedule and that parents could interpret it the wrong way.
              > >
              > >
              > >
              >
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