What Negative Effect Do Nitrates Have on Infants?

Nitrate occurs naturally in the environment, produced by plants and vegetables and aiding their growth. Nitrate is also commonly used as a preservative and for color enhancement of processed meats. World Health Organization estimates that we ingest 20 to 70mg of nitrate-nitrogen per day. Nitrates themselves are not hazardous to our health. Our bodies metabolize and convert them into nitrites, which are especially dangerous to infants.

Absorption

• In adults, the conversion from nitrates to nitrites takes place in the saliva. In infants, it takes place in the gastrointestinal tract, at a rate double than that in adults, due to a higher intestinal pH or low intestinal acidity. This puts babies at risk of developing methemoglobinemia, also known as "blue baby syndrome."

Acute Effects

• The "blue baby syndrome" is a potentially fatal condition that occurs when the hemoglobin in an infant's red blood cells oxidizes to methemoglobin. The infants have low amounts of methemoglobin reductase, a red blood cell enzyme that converts methemoglobin back to hemoglobin. Also, their higher level of fetal hemoglobin oxidizes faster the nitrite to methemoglobin, which depletes the blood of oxygen.

  Methemoglobin is unable to transport oxygen and determines symptoms of cyanosis and oxygen deficiency. Affected babies have a blue-gray skin color, starting with the fingers, lips and other extremities and can become irritable or lethargic, depending on the severity of their illness. Methemoglobin levels higher than 50 percent can quickly lead to coma and death if the condition is not treated promptly.

Long Term Effects

• According to Southern Nevada Health District, on a long term, nitrates can cause diuresis, increased starchy deposits and hemorrhaging of the spleen if the nitrate exposure levels exceed the allowed 50 parts per million (ppm).

Recommendations

• Many cases of "blue baby syndrome" have appeared over the years especially among the bottle-fed babies, due to the high nitrate levels in the water mixed in with the formula.

  Babies younger than 6 months should eat limited quantities of vegetables like spinach and beets or food containing additives such as cheese and cured meats. They need to drink water from a source previously tested with low nitrate level.

  Do not boil the water before drinking. This will only concentrate the nitrate making levels even higher. You should not give infants water purified with reverse osmosis units, even though these are used to remove nitrates from your water.

  Avoid drinking the contaminated water on a daily basis if pregnant, since it may increase the nitrate level in your breast milk. Immediately contact your physician if you notice your baby's skin color turning blue or gray. If in doubt, test the source of water you normally drink from. Do not drink the water if it contains more than 10 milligrams of nitrate-nitrogen per liter.

History

• Hunter Comly, an Iowa City physician was the first to associate the nitrate-contaminated well water with the "blue baby syndrome." He treated two infants for symptoms of cyanosis in 1945. Comly found that both infants became ill after they drank formulas prepared with water from shallow wells. Today, the infant exposure to nitrate-contaminated water is greatly reduced, but emergency room physicians and pediatricians continue to diagnose and treat infants for this condition.