Blue baby syndrome

Nitrate (measured as Nitrogen) 10 10 "Blue baby syndrome" in infants under six months -life threatening without immediate medical attention. Symptoms Infant looks blue and has shortness of breath. Runoff from fertilizer use leaching from septic tanks, sewage erosion of natural deposits... 

Although NOT is not usually thought of as a "toxic" chemical, it does cause several health problems including methemoglobinemia in infants (blue-baby syndrome) and may also be linked to stomach cancer. Agricultural runoff can lead to significant, potentially harmful, concentrations of NOT in ground or surface water. 

There are cases of bottle-fed infants in the catchment suffering from "blue baby" syndrome. 

High nitrate concentrations can cause methaemoglobinaemia (blue-baby syndrome) in bottle-fed infants. This condition is also associated with the simultaneous presence of bacterial contamination. The primary approach to managing nitrate contamination is prevention, particularly for rural wells, which are the major problem with regard to methaemoglobinaemia. In particular, protection of wells from runoff from fields and siting of manure stores, pit latrines and septic tanks will help to prevent contamination with nitrate and microbial pathogens. 

There has long been concern expressed over the presence of nitrate in drinking water at concentrations exceeding the EC guideline of 50 mg L because of the risk of methaemoglobinaemia (blue baby syndrome). Here,... 

Excess nitrate in drinking water can lead to methemoglobinemia ( blue-baby syndrome). It also may be linked to stomach cancer, although this link has not been proven. The EU has set a maximum limit of 50 ppm in drinking water. 

Some of the more important applications in food analysis include nitrates and nitrites in baby food products, excess of which can lead to induce methemoglobinemia (blue baby syndrome), and the monitoring of sulfite, which is added to many foodstuffs as a preservative and to bleach food starches, and is only recently being linked to serious health effects. Also, residual bromate can be monitored in bakery products from the continuing use of bromate salts as dough conditioners. 

Nitrates in drinking water can create problems for infants. On reduction of nitrate to organic compounds, toxic nitrite is formed as an intermediate ion. This can react with iron in hemoglobin and make it incapable of transporting oxygen in the blood. This is the so-called blue baby syndrome , and is a strong reason to restrict the nitrate content in drinking water. 

In many countries there are strict limits on the permissible concentration of nitrate in drinking water and in many surface waters. The limit is 50 mg/1 of nitrate in the EU and 44 mg/1 in the United States (equivalent to 11.3 and 10 mg of nitrate nitrogen in 11, respectively). These limits are in accord with WHO recommendations established in 1970 and reviewed and reconfirmed in 2004 and ensure that drinking water will not cause methaemoglobinaemia, also known as blue-baby syndrome (see Section 6.6.1.2). For example, the permissible concentration of nitrate in bottled water for infants in the Czech Republic is only 15 mg/1. 

This isn t the only problem with fertilisers being leached from the soil. Nitrates have also been detected in our drinking water, especially in agricultural areas. People are worried that nitrates in drinking water cause blue baby syndrome (when a newborn baby s blood is starved of oxygen), as well as stomach cancer. But others argue that links between nitrates and diseases have not been proven and that recommended nitrate levels are set unrealistically low. 

Nitrites Maximum Contaminant Level (MCL) and Maximum Contaminant Level Goal (MCLG) limits have been determined as 1 mg/L each by the Environmental Protection Agency (EPA). Infants below the age of six who drink water containing nitrite in excess of the MCL could become seriously ill and, if untreated, may die. Symptoms include shortness of breath and blue baby syndrome. 

Effects progress from cyanosis (blue baby syndrome) to shortness of breath and eventual asphyxiation (chemical suffocation) as the blood turns chocolate brown. Fortunately, an infant treated in a timely manner with ascorbic acid or methylene blue will experience a complete recovery, and adequate intake of vitamin C provides... 

Pretty, J. N., and G. R. Conway. 1990. The Blue-Baby Syndrome and Nitrogen Fertilisers A High Risk in the Tropics. London IIED, pp. 4-5. 

---