The Lead Concentration of Reconstituted Infant Formula

Abstract

Objective: To characterize practices of infant formula reconstitution and to measure the lead concentration of the home-prepared reconstituted infant formula. Methods: Convenience sample of metropolitan Boston infants less than 9 months of age who were being evaluated in an urban pediatric emergency department and had home-prepared reconstituted infant formula available. A questionnaire was administered to gather demographic information and details of formula preparation. A 30-90 mL sample of home-prepared reconstituted infant formula was collected in an acid-washed, distilled water-rinsed glass tube, then analyzed for lead by atomic absorption spectrophotometry (precision ± 2 μ/L or 2 ppb). Results: Forty infants were evaluated. Mean (SD) chronological age was 112 ± 78 d. Reported daily reconstituted infant formula daily volume was 870 ± 300 mL. Two of the 40 samples (5% [95% CI: 2.0, 18.2%]) had lead concentrations above 15 μ/L, the current action level for safe water according to the Environmental Protection Agency. The two samples with lead concentrations of 17 and 70 μ/L were prepared using cold tap water (water run for 5 and 30 sec, respectively) drawn from the plumbing of houses greater than 20 years old. Conclusion: These data suggest that the use of infant formulas which require reconstitution may present inadvertent lead hazards to young infants. Pediatricians should provide education about these potentially hazardous practices to parents who use these formulas