Below is a news release on a clinical report appearing in the September issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

For Release:
September 6, 2005, 12:01 am (ET)

CHICAGO - As formula and food prepared with well water may cause nitrate poisoning in infants, a revised AAP clinical report continues to recommend regular water testing and breastfeeding of infants in areas where only well water is available.

"Infant Methemoglobinemia: The Role of Dietary Nitrate in Food and Water," outlines the dangers of nitrate-containing well water in food and formula preparation, especially for infants age 3 months and younger.

Nitrates are a natural component of plants and nitrate-containing fertilizers that often seep into well water. They are potentially hazardous when converted to methemoglobin-producing nitrites before or during ingestion. While adults naturally pass nitrites through urine, in infants they cause methemoglobinemia, a dangerous blood condition that limits oxygen in the circulation. Symptoms may include bluish skin and irritability.

Health care professionals who suspect methemoglobinemia should call their local poison control center or a toxicologist for assistance. If the methemoglobin concentration is less than 20 percent, no treatment is required; however, the source of nitrates must be eliminated.

An estimated 15 million families drink water from private, unregulated wells, and 2 million families from wells that fail to meet the federal drinking-water standards for nitrate.

The report recommends that pediatricians and health care professionals ask parents about well water use during prenatal and well-child visits. If the family drinks well water, the well should be tested for nitrates.

Nitrate-containing well water should not be used for infant formula or food preparation. Pediatricians should recommend breastfeeding, as high levels of nitrate are not passed through breast milk, and commercially prepared infant foods. Food or formula may be prepared with purchased water, public water supplies or water from deeper wells with minimal nitrate levels.

Because vegetables, including green beans, carrots, squash, spinach and beets, can have nitrate levels as high or higher than that of well water, infants should not eat these foods until after age 3 months.

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.