Emails seem to come in waves. Last week’s flurry was from mothers concerned about being told by dentists that they had to stop night feedings, in one case completely stop breastfeeding because the toddler had cavities. The dentist blamed the breastfeeding. In one case called the Child Protection Services because the mother did not want to stop breastfeeding. This is another example of how, in general, we take the formula fed/bottle fed baby/toddler as a model for the breastfeeding baby/toddler. There is no doubt that putting a toddler to sleep with a bottle and leaving the bottle in the baby’s mouth causes “bottle mouth” or cavities, often destruction of the teeth, due to bathing of the teeth in formula or other milk. But this is not true for breastfeeding. First of all, unlike bottle feeding where milk pools in the baby’s mouth, breastfeeding is an active process and even when the toddler breastfeeds half asleep, he swallows the milk. In any case, the nipple is far back in the child’s mouth and so the milk doesn’t bathe the teeth. Secondly, telling the parents that the baby must be weaned from the breast or that night feedings must be stopped speaks volumes about how little most health providers know about the breastfeeding toddler. Trying to wean a toddler from the breast, a toddler who “loves breastfeeding” as the mothers often put it in their emails to me, can be terrible psychological trauma for the child. And for the parents too, to be faced with a toddler who will not settle, who will cry for long periods of time until he falls asleep exhausted, only to wake again not too long after to repeat the crying. In fact, there is no evidence that breastfeeding causes cavities. If a child gets cavities while breastfeeding, it is usually because the enamel is weak or under developed (hypoplastic). And enamel can be weak because of hereditary or the mother having an illness during the pregnancy as well as other factors. Several studies do not support breastfeeding causing early childhood cavities. See two of them below: Ribeiro NME, Ribeiro MAS. Breastfeeding and early childhood caries: a critical review. J Pediatr (Rio J) 2004;80(5 Suppl):S199-S210 “This review led us to conclude that there is no scientific evidence that confirms that breastmilk is associated with caries development. This relationship is complex and contains several confounding variables, mainly infection caused by mutans streptococci, enamel hypoplasia, intake of sugars in varied forms and social conditions represented by parental educational and socioeconomic level.” Iida H, Auinger P, Billings RJ, Weitzman M. Association Between Infant Breastfeeding and Early Childhood Caries in the United States. Pediatrics 2007;120;e944-e952 “These data provide no evidence to suggest that breastfeeding or its duration are independent risk factors for early childhood caries, severe early childhood caries, or decayed and filled surfaces on primary teeth. In contrast, they identify poverty, Mexican American ethnic status, and maternal smoking as independent risk factors for early childhood caries, which highlights the need to target poor and Mexican American children and those whose mothers smoke for early preventive dental visits.” Is it worth forcing a child who doesn’t want to stop breastfeeding to stop? No, it’s not. The pain of being forced from the breast is not minimal. The first attached photo shows the teeth of a breastfeeding toddler of about 15 months. But this child’s teeth erupted abnormal; the mother had significant illnesses during the pregnancy. Nobody will convince me that breastfeeding made the teeth abnormal before they even erupted. The second attached photo shows her teeth at age 8. Not too bad at all are they?
Posted on: Sat, 29 Nov 2014 12:56:46 +0000
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