Breastfeeding and Tooth Decay

Updated on December 22, 2007
M.B. asks from Huntington Beach, CA
15 answers

Hello,
I have a 9 month old boy who still uses breastfeeding to go to sleep. He has 2 teeth now and is getting more in. I have been seeing a lot of requests on tooth decay and hear it is bad to let my son breastfeed and then fall asleep. I do brush his teeth but don't know exactly how to ween him from eating and then falling asleep. Any suggestions??

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J.R.

answers from Los Angeles on

My daughter did the same thing and I also brushed her teeth every night and they are just fine. I did however stop at nine months due to lack of milk flow. Throw her in bed after she eats and brushes her teeth. She'll fall asleep eventually. The first night is usually the longest, but the 2nd and 3rd get shorter I promise. I am 29 and have 2 now (18 mo. apart) and am 1 of 13 kids. My mom swears by it and she is usually right.

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J.Z.

answers from Los Angeles on

Don't worry about tooth decay. The milk from the nipple is deposited way back in the mouth and since the nipple only releases milk when sucked, the milk doesn't leak out and form pools in the mouth unlike a bottle nipple. Although breastmilk has lots of sugar, it also has antibiotic qualities that will help to prevent decay unlike artificial milk. Dr. Sears also is a big fan of night nursing and feels the benefit of the nursing far outweighs the risk of tooth decay.

My problem with night nursing my 17 month old was that i wasn't getting any sleep, so i put an end to that by moving out of the room for a couple of weeks into my sons room and leaving the baby with daddy. He always slept with us so i thought the trauma of stopping the night nursing would be enough and we would work on getting him into his own room later. Overall the transition has been working well for all of us. Good luck!

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R.C.

answers from Los Angeles on

I have 4 kids all who nursed to sleep until they were 2 or more. None of them have had any dental problems at all. I've heard horror stories too but I thought I'd tell you a positive one. Breastfeed that sweet baby!! :)

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S.W.

answers from San Luis Obispo on

Have you spoken with a lactation consultant? I have not heard that breastmilk could cause tooth decay. I would brush his teeth before you feed him, and then feed to go to bed. Other than that, ween him of that feeding - be prepared for some or a lot of resistance, but eventually you should be able to replace the feeding with reading stories, gentle rocking til he's on the verge of falling asleep and then putting down, or maybe even swaddling again for a couple nights. Just some possible tips for now, Good luck.

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M.E.

answers from Honolulu on

Hi M.,
Many people (doctors included) confuse breastfeeding as being the same as bottle feeding. It isn't good to let babies fall asleep with a bottle of formula or juice because the sugars pool around the teeth, causing tooth decay. Breastmilk is not the same as formula, it doesn't do the same things to a child's body that formula does. And breastmilk actually has stuff in it that protects baby's teeth. How many times have I heard a professional say that you need to wake the baby up after breastfeeding and wipe down his teeth. This is a crazy thought if you think about how many times a baby wakes up during the night to nurse. It's simply not necessary. If it were then humans wouldn't have evolved with teeth. Human milk is made for human children, including human teeth.

Keep in mind also that weaker teeth can be hereditary. Diet is another key. If baby is snacking on sweets (sugared cereals, juice, etc.) all day long then he is more likely to get cavities no matter how he falls asleep.
An excellent link w/medical back-up...
http://www.kellymom.com/bf/older-baby/tooth-decay.html

For what it's worth, my daughter nursed to sleep until the night she weaned (she was 7yrs). I didn't wipe down or brush her teeth afterwards. Her teeth are perfect (beautiful teeth, well-formed jaw, just a few of the many benefits that comes with breastfeeding). At 10 years, she just got her first tiny cavity.

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S.D.

answers from Los Angeles on

Even if it's after he falls asleep, you can wipe his gums and teeth off with a warm, wet washcloth (cold might wake him up). Brush his teeth in the morning and after dinner too. I think it's great you're being proactive about it, because what effects the baby teeth, can damage the permanent ones as well. I use to work for a pediatric dentist for 9 years. Parents don't realize that even though breastmilk is best, it can cause tooth decay just as much as bottles can.

For the moms saying tooth decay from breast feeding is untrue, please do not be naive. Of course, genetics play a role as well, but it IS possible and it's the thinking that it can't hurt the baby's teeth that gets parents crying inconsolably in the dentist office when the baby's are 2 because there are 23 teeth with cavities. Keep an open mind. If it didn't happen to your child, great, but don't make it sound like it couldn't happen to someone else. An ounce of prevention is worth a pound of cure. I've seen hundreds of kids need IV sedation to get their dental work done because they were too little to do it while awake and 50% of those baby's were bottle fed, the other were breast fed. The most common thing the breast fed mother's said was, "I didn't know."

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T.M.

answers from Los Angeles on

Breast feeding has shown to not cause tooth decay!The benefits are plenty and there are no down sides!

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M.M.

answers from Los Angeles on

Hi M.,

Don't worry about it. I nursed my son until he was 10 months old, and he often fell asleep and his teeth are fine (he's now 2). There's nothing better for your baby than your breastmilk, though I understand your concerns. I think that since you brush your teeth, you shouldn't worry. There's so much to worry about, and this isn't something that you should lose sleep over.

Good luck
M.

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K.R.

answers from San Diego on

I used to nurse with bottle of warm water tucked next to me ot keep it at body temp then i would quickly replace my nipple with the warm bottle. Even if he talkes only a few sips it will wash away some of yur breastmilk making it better for his teeth. Hope this helped. Krissy

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L.N.

answers from Los Angeles on

Never had I heard something so ridiculous. I breastfed one of my children til he was 3 and the other 2 and there were absolutely no residual effects. If you have any concerns, contact a La Leche Legue mom and they will set your worries aside. Enjoy the brestfeeding and creating a healthy, happy, and well adjusted boy.

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I.B.

answers from Los Angeles on

M.,

I just recommmended another Mom to the LaLeche League & it has an amazing amount of information on weaning, as well as support for those Mom's that need help on breastfeeding and they are the professionals in this area. Here is the website link http://www.llli.org/ and then here is the link to their section for resourses & answers, they even have an Mom to Mom section http://www.llli.org/nb.html.

They have A LOT of INFO, I hope this helps you. Blessings to you & your baby this Holiday season

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S.W.

answers from Los Angeles on

My understanding is that is totally untrue. The tooth decay problem happens with bottle fed babies, the formula pools in the mouth and the sugars cause the problem. when one breast feeds, the nipples extends to the back of the throat and shoots the milk right down the throat as the baby sucks and pulls. So, relax, roll over, feed your baby and go back to sleep. Mother Nature made a perfect design. If you've any more questions, Dr. Paul Fleiss in Los Feliz is a big breast feeding advocate/family doctor. All the best, S.

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J.W.

answers from Los Angeles on

here is a great article i found through dr. jay gordon's website (one of the only male lactation consultants out there) and he got it from www.kellymom.com - a wonderful resource for breastfeeding!(www.kellymom.com). i nursed my son to sleep for about 18 months - he is now 3 1/2 years old and has great 'pearly whites'!! :-)
~J.

Is Breastfeeding Linked to Tooth Decay?
By Kelly Bonyata, BS, IBCLC

It's often said that breastfeeding (particularly while lying down at night) will cause tooth decay, just like letting a baby sleep with a bottle of milk can cause "baby bottle mouth." Essentially, a valid link has not been made between nursing (nighttime or otherwise) and cavities.

Before the use of the baby bottle, dental decay in baby teeth was rare. Two dentists, Dr. Brian Palmer and Dr. Harold Torney, have done extensive research on human skulls (from ###-###-#### years ago) in their study of tooth decay in children. Of course these children were breastfed, probably for an extended length of time. Their research has led them to conclude that breastfeeding does not cause tooth decay.

One of the reasons for nighttime bottles causing tooth decay is the pooling of the liquid in baby's mouth (where the milk/juice bathes baby's teeth for long periods of time). Breastmilk is not thought to pool in the baby's mouth in the same way as bottled milk because the milk doesn't flow unless the baby is actively sucking. Also, milk from the breast enters the baby's mouth behind the teeth. If the baby is actively sucking then he is also swallowing, so pooling breast milk in the baby's mouth appears not to be an issue.

A bacteria (present in plaque) called strep mutans is the cause of tooth decay. These bacteria use food sugars to produce acid - this acid directly causes the decay. Strep mutans thrives in a combination of sugars, low amounts of saliva and a low ph-level in the saliva. A portion of the population (around 20%) is thought to have increased levels of this high acid producing bacteria, putting them at higher risk for developing dental decay. After your baby gets teeth, he can get this bacteria through saliva to saliva contact from mother (or other caregiver) to baby. To help prevent transfer of this bacteria to baby, avoid any saliva to saliva contact such as sharing spoons & cups, wet kisses on the mouth, chewing food for baby, or putting baby's pacifier in your mouth. On the other hand, one study indicates that children of moms with high levels of strep mutans may actually have some protection (immunization) from decay through frequent saliva to saliva contact in the months before baby's teeth erupt.

Per Brian Palmer, "Human milk alone does not cause dental caries. Infants exclusively breastfed are not immune to decay due to other factors that impact the infant's risk for tooth decay. Decay causing bacteria (streptococcus mutans) is transmitted to the infant by way of parents, caregivers, and others" (Palmer 2002).

Up until recently, the only studies that had been done were on the effects of lactose (milk sugar, which breastmilk does contain) on teeth, not the effects of *complete* breastmilk with all its components. Breastmilk also contains lactoferrin, a component in breastmilk that actually kills strep mutans (the bacteria that causes tooth decay). According to a recent article in the March/April 1999 issue of Pediatric Dentistry, "It is concluded that human breast milk is not cariogenic." This study utilized extracted teeth to obtain most of its results and studied children only for determining the pH changes in dental plaque (Erickson 1999). A Finnish study could not find any correlation between caries and breastfeeding among children who were breastfed longer (up to 34 months) (Alaluusua 1990). Valaitis et al concluded, "In a systematic review of the research on early childhood caries, methodology, variables, definitions, and risk factors have not been consistently evaluated. There is not a constant or strong relationship between breastfeeding and the development of dental caries. There is no right time to stop breastfeeding, and mothers should be encouraged to breastfeed as long as they wish." (Valaitis 2000).

In a study done by Dr. Torney, no correlation was found between early onset (< 2 yrs) dental caries and breastfeeding patterns such as frequent night feeds, feeding to sleep, etc. He is convinced that under normal circumstances, the antibodies in breastmilk counteract the bacteria in the mouth that cause decay. However, if there are small defects in the enamel, the teeth become more vulnerable and the protective effect of breastmilk is not enough to counteract the combined effect of the bacteria and the sugars in the milk. Enamel defects occur when the first teeth are forming in utero. His explanation is based on quite a large study of long-term breastfed children with and without caries.

According to this research, a baby who is exclusively breastfed (no supplemental bottles, juice, or solids) will not have decay unless he is genetically predisposed, i.e.. soft or no enamel. In a baby who does have a genetic problem, weaning will not slow down the rate of decay and may speed it up due to lack of lactoferrin.

Much research indicates that it's the other foods in baby's diet (rather than breastmilk) that tend to be the main problem when it comes to tooth decay. The 1999 Erickson study (in which healthy teeth were immersed in different solutions) indicated that breastmilk alone was practically identical to water and did not cause tooth decay - another experiment even indicated that the teeth became stronger when immersed in breastmilk. However, when a small amount of sugar was added to the breastmilk, the mixture was worse than a sugar solution when it came to causing tooth decay. This study emphasizes the importance of tooth brushing and good dental hygiene.

A study by Dr. Norman Tinanoff showed that breastmilk in itself does not give rise to cavities as much as was previously thought. Dr. Tinanoff believes that the milk proteins in breastmilk protect the enamel on the teeth, and that the antibacterial qualities in breastmilk stop the bacteria from using the lactose in breastmilk in the same way as regular sugar. This dentist also showed that 5 minutes of breastfeeding lowered the pH-level only slightly more than rinsing the mouth with a little water.

Once your baby gets teeth, it's a good idea to brush your child's teeth twice daily and perhaps give him a sip of water after meals to wash food particles away. Also, don't allow baby to carry a cup or a bottle around during the day. This results in a constant "bathing" of baby's teeth with whatever he's drinking. Decay is directly related to the amount of contact time of a sugary substance with the teeth. Avoid too many sugary, sticky foods as well, and talk to your dentist about the amount of fluoride in your drinking water. You can read more about fluoride supplements for babies here: Does My Baby Need Vitamins?

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K.R.

answers from San Diego on

Regardless of the tooth decay issues, I would recommend you stop allowing breast feeding to soothe your baby at this point. He is old enough to soothe himself to sleep and it will make your life easier especially if he wakes at night. I did this at about 7-8mo: instead of breast feeding in a dark room before bed, I switched to a well lit room after bath but before stories and bed time song. She still breast fed until just over 12mo, but soothed herself to sleep at naps and bed time and if she woke in the night (after 10mo) instead of needing breast feeding. This allows you to have someone else put her to bed, etc. Much easier now than as a toddler! (Just look at the other question posted today)

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M.W.

answers from Honolulu on

try giving him a warm bottle that is diluted with half pumped breast milk and warmed water. slowly go to just warm water. I would just give my son water to go to sleep. When I went back to work after my son was a year old, he was watched by a family who had six kids that were all home schooled and both parents worked from home.....they were amazed at how whenever my son was tired, he'd grab a blanket, lay down anywhere soft and he'd be out like a light.

just make sure you don't give apple juice or high sugar juices in a bottle, especially to go to sleep. That is the major cause of tooth decay. My son is nine and to this day has never had a cavity or dental issue.

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