Nutrient minerals in drinking-water: Implications for the nutrition of infants and young children
Introduction
The WHO Global Strategy on Infant and Young Child Feeding emphasizes the importance of infant feeding and promotes exclusive breastfeeding in the first six months of life. In infants who cannot be breast-fed or should not receive breast milk, substitutes are required. These should be a formula that complies with the appropriate Codex Alimentarius Standards or, alternatively, a homeprepared formula with micronutrient supplements (WHO 2003). Drinking water is indispensable for the reconstitution of powdered infant formulae and needed for the preparation of other breast-milk substitutes. As a result of the long-term intake of a considerable volume in relation to body weight, the concentrations of nutrient minerals in drinking water may contribute significantly to the total trace element and mineral intake of infants and young children. This is especially applicable to formula-fed infants during the first months of life, who may be the most vulnerable group affected by excessive concentrations of nutrients or contaminants in drinking water.
Defining essential requirements of the composition of infant formulae, the importance of the quality of the water used for their reconstitution has been acknowledged by the Scientific Committee on Food of the European Commission (SCF 2003a). Although it was noted that the mineral content of water may vary widely depending upon its source, the optimal composition remained undefined. Recommendations for the composition of infant formulae refer to total nutrient content as prepared ready for consumption according to manufacturer’s instructions. However, these usually inform the consumer about the quantity of powder and drinking water required as well as other technical advice for the reconstitution of the formula, but do not refer to the mineral concentration in drinking water itself.
The use of desalination to provide drinking water may continue to increase all over the world. Remineralization of mineral content in waters that have been treated by demineralization may provide an opportunity to improve compositional choices. Specific aspects of vulnerable groups have to be considered, but the needs of infants and young children, especially if nourished with infant formula instead of human milk, may be of special concern. The question arises whether special nutrient mineral properties of these waters should be considered for use for infants and young children.