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Infants have relatively low acidity in their stom- achs compared to adults. This allows for the / growth of certain bacteria that readily convert ni- trate to nitrite, which in turn causes methemo- globinemia. In infants, this is commonly called Blue Baby Syndrome, because the lack of oxygen J ' causes the baby's skin to turn a bluish color, par- ticularly around the eyes and mouth.If untreated, infants can die from this condition. Pregnant Women and Methemoglobinemia During pregnancy, it is common for methemoglo- bin levels of the pregnant woman to increase from normal (where 0.5 to 2.5% of the total hemoglo- bin is in the form of methemoglobin) to a maxi- mum of 10% in the 30th week of pregnancy. The level of methemoglobin declines to a normal level after delivery.Therefore,pregnant women are par- ticularly susceptible to methemoglobinemia and should be sure that the nitrate and nitrite in their well water is at safe levels. (These levels will be discussed later in the fact sheet.) Effect of Nitrate/Nitrite on Development of the Fetus and the Birth Process There is no clear evidence that appreciable amounts of nitrate can be transferred to the fetus from the pregnant woman. Although the mother may be experiencing methemo- globinemia, the fetus may not be directly affected. There have not been many studies which look at the effect of nitrate and nitrite on pregnancy or on the normal develop- ment of a fetus. Some studies of laboratory animals, where nitrate/nitrite levels are very high, have found a potential negative impact on reproductive and developmental sys- tems. There is also little indication that breastfed infants would develop methemoglo- binemia from exposure to nitrate and nitrite through breastmilk. Does Exposure to Nitrate Cause Cancer? There is no evidence that nitrate or nitrite causes cancer in laboratory animals or hu- mans. Studies have shown that diets lacking dietary fiber and including foods with high levels of nitrate and nitrite such as smoked meats, may promote stomach cancers. How- ever, studies have not indicated that drinking water high in nitrate is associated with stomach cancer.