Bundoo® • January 2, 2019 • 5 min read
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
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.
Nitrates
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.
Sources:
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Is Performing a C-Section Better Than Inducing Labour, when it comes to giving birth, usually the preferred option is to let labour proceed naturally. However, there are times when it is not in the mother or baby’s interest for this to happen. When the health of either is at risk, or if gestation has exceeded [41 weeks duration,](https://nabtahealth.com/articles/doctor-tips-weeks-27-40/) then it is highly probable that an alternative strategy will need to be implemented. There are two options available, [inducing labour](../) or performing a [C-section](../). With an induction, the [uterus](https://nabtahealth.com/glossary/uterus/) is artificially stimulated to contract, and it is then hoped that labour will proceed as per a natural delivery. In contrast, a C-section is a surgical procedure, whereby a cut is made in the abdomen and the baby is removed that way, rather than via the [vagina](https://nabtahealth.com/glossary/vagina/). Sometimes the only safe option is to perform a C-section, for example if the baby is breach, or when an emergency situation arises. However, there are other times when you may be presented with a choice and if this happens, what is the correct answer? Unfortunately there is no definitive right answer. An induction can be at least as safe as spontaneous labour and, if performed in the week prior to the [due date](https://nabtahealth.com/glossary/due-date/), it is thought to reduce [the risk of](https://nabtahealth.com/articles/what-is-preeclampsia/) [preeclampsia](https://nabtahealth.com/glossary/preeclampsia/) in the mother and respiratory distress in the child, possibly as a result of the [placenta](https://nabtahealth.com/glossary/placenta/) remaining fully functional. Unlike C-sections, inductions are not surgical procedures and thus, if all goes to plan, the recovery period is shorter. It is however, a big ‘IF’. [Induced labours](https://nabtahealth.com/articles/induction-of-labour/) are typically more painful, meaning more women will request stronger pain relief including epidurals, and there is a greater likelihood of assisted delivery, such as the use of forceps or ventouse. There is also an increased [risk of hyperstimulation](https://nabtahealth.com/articles/what-is-ovarian-drilling/) of the [uterus](https://nabtahealth.com/glossary/uterus/)., Uterine hyperstimulation causes more frequent, longer [contractions](https://nabtahealth.com/glossary/contraction/), which can [lead](https://nabtahealth.com/glossary/lead/) to complications such as foetal heart rate abnormalities and, in rare cases, uterine rupture. In a significant number of women, induction does not work and a C-section becomes necessary. The advent of the C-section was undoubtedly a medical revolution, instantly saving the lives of millions of women and children. However, C-sections bring with them all the risks of regular surgery, including blood clots, wound infection and bleeding. The recovery period is typically longer after a C-section than after a natural birth, driving restrictions are enforced and a scar remains, although this will fade over time. Whilst current guidelines stipulate that an induction should only be performed when [the risks of continuing the pregnancy](https://nabtahealth.com/articles/complications-during-pregnancy-polyhydramnios/) outweighs the benefits, with more women than ever requesting elective C-sections, the World Health Organisation has highlighted an urgent need for medical assessment efforts to address the risks of induced labour compared to elective C-section. Until such work is undertaken, it becomes a matter of individual circumstance, personal choice and ultimately weighing up what is best for you and your baby. **Sources:** * Grobman, W A, et al. “Labor Induction versus Expectant Management in Low-Risk Nulliparous Women.” _The New England Journal of Medicine_, vol. 379, no. 6, 9 Aug. 2018, pp. 513–523., doi:10.1056/NEJMoa1800566. * WHO Recommendations for Induction of Labour. World Health Organisation, [http://apps.who.int/iris/bitstream/handle/10665/44531/9789241501156\_eng.pdf?sequence=1](http://apps.who.int/iris/bitstream/handle/10665/44531/9789241501156_eng.pdf?sequence=1). Accessed on 23/01/2019. * _Inducing Labour. Clinical Guideline \[CG70\]_. NICE (National Institute for Care and Health Excellence), July 2008, www.nice.org.uk/guidance/cg70/chapter/Introduction. Accessed on 23/01/2019

Sushi is considered a healthy eating option and its popularity is growing in the US. Many parents wonder if it is safe for their young child to eat sushi and when they can safely introduce it in the diet. According to the American Academy of Pediatrics (AAP), there is no need to delay the introduction of fish or shellfish beyond [4-6 months](https://nabtahealth.com/articles/when-can-your-child-eat-sushi-and-raw-fish/) of age in healthy, low food allergy risk children. Specifics about whether the fish is cooked or raw are not made, and the assumption is that this stance reflects cooked fish and shellfish. The Food and Drug Administration ([FDA](https://nabtahealth.com/glossary/fda-2/)) specifies that no raw fish or shellfish should be given to high-risk groups, highlighting very young children as one such group. At what age is a child no longer considered at high-risk? --------------------------------------------------------- A [child’s immune system](https://nabtahealth.com/articles/when-can-your-child-eat-sushi-and-raw-fish/) development is slow and steady during the first 2-3 years of life, and by age 4-6 years old, adult levels of immunity are seen. Your [child’s immune](https://nabtahealth.com/articles/can-daycare-build-your-childs-immune-system/) system continues to develop throughout [puberty](https://nabtahealth.com/glossary/puberty/). Given this information, waiting until 5-6 years of age to introduce raw fish and uncooked sushi is the best way. This will ensure your child is defended against potentially harmful substances. Bacterial contamination is a threat to any temperature sensitive food and cannot be seen, smelled or tasted. [Food poisoning](https://nabtahealth.com/articles/how-to-avoid-food-poisoning-during-pregnancy/) symptoms are similar to the stomach flu, so they may be hard to detect. Asking questions about the quality of food and how it is prepared is good. However, taking care to eat at reputable restaurants that you trust can help prevent adverse reactions to contaminated sushi. US restaurants are required to use sushi that has been properly frozen and/or cooked to eliminate parasitic contamination. ##### Food allergies The [Food Allergy](https://nabtahealth.com/articles/4-ways-to-know-if-your-child-has-a-food-allergy/) and Anaphylaxis Network states that about 7 million people in the US have a reported seafood allergy. In addition to seafood allergy risk, Asian cuisine can often contain other allergens such as peanut, egg, tree nut, and soy ingredients. Raw or cooked sushi is typically assembled into a firm, round food. Sashimi is a raw piece of fish set atop a small amount of rice; it has a slippery texture. Both sushi and sashimi may present a choking hazard, especially for young toddlers. A child to eat sushi may also have a sticky texture that may be foreign to the child. Cutting cooked sushi into small pieces before serving it to your toddler can minimize the risk of choking. When it comes to raw sushi or sashimi, it may be best to leave it out of your child’s diet as they are young and building a strong immune system. However, there is no reason why your toddler can’t safely enjoy cooked or vegetarian Asian cuisine, with special attention paid to its ingredients. If you enjoy sushi and other Asian cuisines and want to pass this along to your child, think about alternatives to raw fish such as: Vegetable rolls ##### **Those containing only cooked fish and/or shellfish** * Rice bowls * Tempura * Soups * Salads * Stir-fry * Teriyaki The truth is that while food safety, allergies, and choking hazards should always be considered. There really is no consensus on an exact age that is appropriate to give a young child raw fish. By 5-6 years old, a healthy [child’s immune system](https://nabtahealth.com/articles/can-daycare-build-your-childs-immune-system/) should be strong enough to graduate to raw sushi with the rest of the family. No magical age, grade level, or number of exposures to sushi will prevent the occurrence of an illness from contaminated food. Good judgment and necessary precautions should always be in place. **Sources:** * U.S * Food & Drug Administration * Fresh and Frozen Seafood: Selecting and Serving it Safely. KidsSafe Seafood. Food Allergy and Anaphylactic Network. Powered by Bundoo®

Food-borne illnesses do not discriminate — anyone can become sick. Raw oysters have earned a reputation as a potentially dangerous food. Also, some groups of people have a [greater risk of serious illness](https://nabtahealth.com/articles/is-fish-oil-safe-for-children/) than others, including children. Eating raw oysters comes with the risk of being exposed to Vibrio vulnificus, a potentially life-threatening bacteria. Young children, those under 5 years of age, are more susceptible to food-borne illness because their immunity isn’t fully developed. Here are some facts you should know before you give your young child raw oysters: ##### What will happen if my child eats a contaminated oyster? In reality, allowing your [child to eat](https://nabtahealth.com/articles/is-it-safe-for-toddlers-and-children-to-eat-raw-oysters/) raw oysters might have zero consequences, no matter how many he or she eats. Unlike other bacteria, V. vulnificus cannot be smelled, seen, or tasted. There is no way to determine if the raw oyster is safe to eat. V. vulnificus cannot be killed by a lot of hot sauce, nor are you guaranteed safety by letting your child just try one or two oysters. If your [child eats a raw oyster](https://nabtahealth.com/articles/is-it-safe-for-toddlers-and-children-to-eat-raw-oysters/) that is contaminated with V. vulnificus, it is important to be familiar with the signs and symptoms of food poisoning. In generally healthy people, V. vulnificus can cause vomiting, diarrhea, and abdominal pain. In some cases, it can become worse and infect the blood (invasive septicemia) resulting in fever, chills, and septic shock. V. vulnificus is a serious cause for concern because about half of people who contract the blood infection die. If you are suspicious of food poisoning and/or your child has symptoms, get in touch with your healthcare provider, or even head to the ER. ##### What should I do? To be safe, you may want to hold off on feeding your child raw oysters for a few years, or at least until he or she is five years of age. If oysters are a staple in your household, or a special treat here and there, make sure to thoroughly cook a few for your little one to try. Cooking (prolonged exposure to high heat) is the only way to kill the bacteria and make sure you and your family will be safe. Get yourself a [coach](https://nabtahealth.com/product/conscious-motherhood-coaching-session/) and learn more. **Sources:** * Food & Drug Administration * Raw Oyster Myths. Powered by Bundoo®