pregnancy should be increased above the level recommended for women during the nonpregnant state.

AI for Pregnancy

14 through 18 years

3 mg/day

AI for Pregnancy

19 through 50 years

3 mg/day

Lactation

No data from human studies document the metabolism of fluoride during lactation. Because fluoride concentrations in human milk are very low and relatively insensitive to differences in the fluoride concentrations of the mother's drinking water, fluoride supplementation during lactation would not be expected to significantly affect fluoride intake by the nursing infant or the fluoride requirements of the mother. The AI for women during lactation is therefore not increased above that for women in the nonpregnant state.

AI for Lactation

14 through 18 years

3 mg/day

AI for Lactation

19 through 50 years

3 mg/day

Special Considerations

Fluoride Supplements in Areas without Water Fluoridation. Infants and children living in nonfluoridated water areas will not easily achieve the AI for fluoride. Thus, fluoride supplements have been recommended based on life stage and level of water fluoridation. Table 8-3 shows the recently revised dietary fluoride supplement dosage schedule that was approved for United States children by the American Dental Association and American Academy of Pediatrics (ADA, 1994) and for Canadian children by the Canadian Paediatric Society (1996). The daily fluoride dose is based on the age of the child and the fluoride concentration of the child's main drinking water source. Compared with the previous dosage schedule that was adopted in 1979, the current schedule represents a reduction of approximately 50 percent in the amount of fluoride to be prescribed for children up to the age of 6 years. Other changes from the previous schedule include starting supplementation at 6 months instead of at birth and reducing the water fluoride concentration to a level above which supplements should not be prescribed from 0.7 mg/liter to 0.6 mg/liter. The main reasons for these changes were the increased prevalence of enamel fluorosis in the United States and Canada and the identification of dietary supplements as one of



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