Guideline / position statementindependent cross-checkabstract only checked I-VEG-08 standard review
Nitrate and infant blood disorder
Infant methemoglobinemia: the role of dietary nitrate in food and water.
Overview
Greer FR, Shannon M. Pediatrics 2005 · PMID 16140723 · DOI 10.1542/peds.2005-1497
Babies can be poisoned by nitrate mainly from well water or home-made vegetable foods; breastfed babies are not at risk.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Advise on infant nitrate
- How was the study done?
Clinical report
- How many people, animals or samples were studied?
Not applicable
- What was actually found?
Infant risk specific
- How large was the observed effect?
Not applicable
- What do the results mean in everyday life?
Avoid home-made high-nitrate broths for infants.
- What are the study's limitations?
Not systematic
- What does it say about Elawady's specific claim?
Infant-specific
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Cannot show adult harm.
Scientific in-depth review
1. Full reference
- Authors
- Greer FR, Shannon M
- Journal
- Pediatrics
- Year
- 2005
- Identifier
- PMID 16140723 DOI 10.1542/peds.2005-1497
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Infant nitrate risk from food and water.
3. Study design and population
- Study design
- Guideline / position statement – AAP clinical report
- Population
Infants
- Country
USA
- Period
Not applicable
- Sample size
Not applicable
- Inclusion and exclusion criteria
Not applicable
4. Methods and endpoints
- Exposure / intervention
Nitrate in well water and home-prepared vegetable foods
- Comparator
Not applicable
- Endpoints
Methaemoglobinaemia
- Statistical methods
Not applicable
5. Actual results
- Results
Well-water formula is the main risk; little or no risk from commercial infant foods; reports from home-prepared vegetable foods continue; breastfed infants not at risk even with high maternal nitrate intake.
- Absolute risks
not reported
- Authors' conclusion
Test well water; caution with home-prepared vegetable foods.
6. Strengths
- Authoritative guidance
7. Weaknesses
- Not systematic
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Guidance.
9. Assessment of the statistical interpretation
Not applicable.
10. Relevance to the specific claim
Supports infant-specific risk (C-VEG-07).
11. Independent contrary findings
None.
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Key guidance.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
None.
15. Linked fact checks
- Nitrate-rich vegetables (e.g. courgette soup) given to young infants can cause severe methaemoglobinaemia. – Studies supporting the claim