Extended Breastfeeding Non-Risk #2: Dental Caries
Linda J. Smith, BSE, FACCE, IBCLC
The most important causes of Baby-Bottle Tooth Decay (BBTD) are documented to be: (1) Enamel defects; (2) High carbohydrate intake in the infant's diet; (3) Oral hygiene of the mother and infant, especially strap mutans; (4) Milk pooling in the baby's mouth from a dripping bottle.
As of April 1992, all known references point back to three articles by Kotlow, Brams, and Gardner. The authors present case reports of 9 babies, only 7 of whom received no bottles. Recently, the lactose in milk has been shown to cause decay when teeth are soaked in it.
This evidence does not establish that direct breastfeeding as a risk factor in BBTD because:
FACT: There is no published, valid evidence that establishes long-term, at-will breastfeeding as a risk factor in BBTD. Limitation of the duration of breastfeeding has documented negative consequences to the baby and mother. "Baby Bottle Tooth Decay" is a disease of artificial feeding.
Erickson PR, Mazhari E. Investigation of the role of human breast milk in caries development. Pediatr Dent 1999 ZMar-Apr;21(2):86-90.·
Brams M and Maloney J. "Nursing bottle caries" in breastfed children. J Peds 103(3): 415-416, 1983.
·Gardner DE, Norwood JR, Eisenson JE. At-will breastfeeding and dental caries: four case ports. ASDC J Dent Child May-Jun 1977, 1-6.
·Kotlow LA. Breastfeeding: a cause of dental caries in children. J Dent Child May-June 1977, 192-93.
·Woolridge, M., and Baum, J.D. The regulation of human milk flow. Perinatal Nutrition, Vol 6, ed. BS Lindblad. London: Academic Press, 1988.
·Woolridge, M. Anatomy of infant sucking. Midwifery 2: 164-171, 1986.
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