https://www.tandfonline.com/doi/10.1080 ... 26.2616406
Abstract
Fluoride is recognized for its dental health benefits; however, excessive intake during infancy may pose risks such as dental fluorosis. This review evaluated fluoride levels in breast milk (BrM), influencing factors, and potential health effects in infants. The methodology involved searching PubMed, Scopus, Web of Science, IranDoc, Science Direct, and Google Scholar for studies published from 1974 to 2025. The search strategy included Medical Subject Headings (MeSH) terms and free-text keywords - such as "fluoride," "breast milk," "breastfeeding," 'human,"and "level," along with other relevant terms - combined with Boolean operators (AND/OR) for a comprehensive literature search. Inclusion criteria: peer-reviewed studies with original data on fluoride in BrM. Exclusion criteria: informal reports, reviews, and studies without primary data. Of the 204 records, 9 studies were included in the final analysis. Lacking raw data, values were re-simulated in Excel (2016) using mean, standard deviation, and sample size. Results showed that the mean fluoride in BrM met the European Food Safety Authority (EFSA) guideline (100 µg/L) in 12 of 19 cases (63.2%), with 36.8% outside this range. The health risk assessment showed that, for one-month-old infants, the hazard quotient (HQ) exceeded the permissible limit (HQ = 1) in 7 of 19 cases (36.8%).
Keywords: Fluoride; breast milk; breastfeeding mothers; dental fluorosis; health risk assessment.
Plain language summary
Of 1394 breast milk samples evaluated for fluoride levels, 36.8% exceeded the EFSA guideline (100 µg/L). HQ value surpassed the exposure limit for one-month-old infants in 7 out of 19 cases (36.8%). The overall mean fluoride level in 1394 breast milk samples worldwide was 256.7 ± 256.9 µg/L, much higher than the EFSA guideline. The 95th percentile for the HQ factor was 1.05, higher than the acceptable level.