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does breastfeeding cause cavities?

Getting to the root of this common misunderstanding

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The benefits of breastfeeding are well-known and well-documented. The World Health Organization (WHO) recommends exclusive breastfeeding for babies up to six months of age and continued breastfeeding with appropriate complementary foods up to two years of age or older.

Even with recent studies into prolonged breastfeeding and cavities, the research still weighs in favor of the adage that “the breast is best.”

A meta-analysis of research studies published by the NIH in 2015 concluded that breastfeeding is more effective at preventing dental caries in early childhood than bottle-feeding with formula.
 

The perfect food for your baby


Not only is breastfeeding NOT a leading cause of cavities in infants, it has multiple, stacking benefits for your baby’s oral health.

Breast milk has been shown to:
  • Boost the immune system with antibodies, which protect from infection
  • Promote healthier, straighter teeth
  • Establish a balanced oral and gut microbiome
  • Strengthen oro-facial muscles for healthy jaw and skull development
  • Deliver vital nutrients and minerals for healthy bones and teeth
  • Contain Lactoferrin, a protein that kills S. mutans., which is one of the main bacterias that causes tooth decay

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The only food that adapts to your baby’s needs

As mammals, humans have evolved to provide our young with ideal nutrients (high in protein, low in sugar), as well as healthy fats and antibodies. Perhaps one of the most astounding properties of breast milk is that it not only adapts to the infant’s developmental stage, but it actually adjusts to a baby’s individual needs in the moment.

During breastfeeding, the mother’s body “reads” small amounts of the baby’s saliva that enter through the nipple during feeding. Her body then produces breast milk that is fine-tuned to fit the baby’s needs, in real time! For example, if the baby is sick, the milk will be loaded with the antibodies it needs to fight off infection.

Science is just beginning to scratch the surface of the incredibly complex and astounding physiological dynamic between a breastfeeding mother and her child. The more we learn, the more we see how breast milk is much more than an excellent source of nutrition — it also protects and strengthens your child’s health!

 

Setting your baby up for a healthy life

In addition to the short-term benefits of colostrum for newborns, breastfeeding can also help children's health as they grow up.

Breastfeeding has been shown to reduce the risk of:
  • Bowel diseases such as Crohn’s disease
  • Type 1 and Type 2 Diabetes 
  • Allergies
  • Childhood leukemia
  • Middle ear infection
  • Colds and respiratory tract infections
  • Gut infections and gastrointestinal illnesses
  • Throat, and sinus infections
  • Sudden infant death syndrome (SIDS)
  • Asthma, atopic dermatitis, and eczema

Beyond the health benefits for the breastfed baby, breastfeeding also has benefits for the mother, and emotional and bonding benefits too.

 

Where did the breastfeeding-cavity misunderstanding come from?


Some very limited but highly publicized research has led to the unfortunate assumption that breastfeeding causes cavities. While there is some evidence to suggest that specific breastfeeding behaviors at a certain age can be linked to cavities, much more research is needed to find out what is actually happening.

Just like any other food, particles of breast milk that remain on the tooth surface can lead to decay. But the reality is more complex than saying “breastfeeding causes cavities.”

 

The difference between the bottle and the breast

The first area of confusion is related to nighttime bottle feeding with formula. Although medical professionals agree that breastfeeding is the ideal food for infants, there are medical and personal reasons why a parent may choose not to breastfeed their baby. In these cases, a baby will usually take formula instead of a bottle.

Babies feed very differently from a bottle than from the human nipple. When breastfeeding, the nipple is pulled back quite far into the baby’s mouth, which generally prevents pooling near their teeth. With bottle-feeding, the artificial nipple is usually closer to the middle of the mouth, which can allow formula to pool around teeth and cause cavities. This is why medical professionals generally advise against putting your baby or toddler to bed with a bottle.

 

Breastfeeding beyond 24 months

The second area of confusion is related to several limited research studies about “prolonged” breastfeeding. These were conducted in only a few countries and with specific populations that do not necessarily apply to all babies everywhere. Some of these studies appear to indicate that breastfeeding could be linked to cavities in breastfed babies (with teeth) over 24 months old. An important correlation to note is that many babies who continue to breastfeed past 24 months are also babies who breastfeed “on-demand” throughout the night. Babies at this age not only have more teeth, but the teeth they have are farther back in the mouth.

 

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The thinking here is that when babies fall asleep on the breast, or “sleep-feed”, left-over milk can pool around the teeth (especially the back molars) and cause tooth decay. Because babies who breastfeed multiple times throughout the night usually do not have their teeth brushed or cleaned after each feeding, the sugars from the milk could stick around for hours. This can lead to bacterial imbalance, the production of acid on the surface of the teeth, and the formation of cavities.

 

Diet and other factors

What this research fails to adequately account for (and something that is harder to assess) is everything else that a toddler is eating at two years old that could cause cavities. Multiple factors beyond just breastfeeding, like other foods a baby eats, also contribute to early childhood caries.

Because the modern diet is rife with harmful processed foods, including sugars (like fruit juice) and carbohydrates from refined grains (such as white flour), diet should be taken into consideration in these types of studies.

 

Processed Food and Early Childhood Cavities

Around the beginning of the 19th century, the US and other nations saw a significant uptick in tooth decay. It is no coincidence that this came with the Industrial Revolution, when cheap, processed carbohydrates and refined sugar replaced traditional diets of whole fruits and vegetables, grains and meats.

In his book The Dental Diet, the Australian dentist Dr. Steven Lin highlights the importance of a healthy diet for healthy teeth. He advocates for a return to more whole, unprocessed foods that are rich in minerals, vitamins and fats for both oral health and overall health. This is true for people of all ages, and especially for babies who are learning how to eat and what to eat.

 

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From spoon-fed to self-fed

When it comes to babies' first foods, many of us think of mushy cereals or pureed fruits and vegetables that adults spoon-feed into their (sometimes reluctant) mouths. A growing number of dental professionals and parents are challenging this largely un-questioned norm in industrialized cultures. Perhaps babies are not meant to live exclusively on mush and liquids, and instead need to exercise their growing oro-facial muscles by chewing and biting foods with their tiny teeth.

In their book Baby-Led Weaning, authors Gill Rapley and Tracey Murkett propose allowing your baby to lead their own transition from breast milk/formula to solid food. When they are ready, usually after 6 months and when certain developmental milestones have been met, babies can explore different textures and flavors from an array of healthy foods. In this approach, babies self-feed from a variety of healthy “finger foods” such as fresh fruits, soft cooked vegetables, healthy carbohydrates and fats.

Parents certainly play a huge role in helping their kids avoid unhealthy processed foods, choking-risk foods, added salts and sugars, and stimulants like chocolate or sugar. More importantly, parents can prepare and offer a variety of healthy choices and give their children autonomy as they grow. In this way, babies will naturally learn how to listen to their own bodies for cues about what and how much they need to eat to be healthy.

It is very important for pregnant and breastfeeding mothers to pay special attention to their nutrition, especially minerals and nutrients that they need for their own health and for their growing baby. By avoiding processed foods and sticking to whole, nutritious foods, you protect your own dental health as well as your child’s. You can essentially “feed your teeth” by providing the body with the building blocks for strong, healthy enamel which is more resistant to cavities.

 

Takeaways

Although breastfeeding and cavity studies are easily misrepresented and misunderstood in the media, learning more about possible risks of specific breastfeeding behaviors and cavity prevention can be useful. However, these studies should not steer you away from breastfeeding, or cause you to preemptively wean your baby.

Parents can take extra precautions to prevent tooth decay if they continue breastfeeding a toddler past 2 years old, especially if they nurse on-demand throughout the night.

If you are concerned about breastfeeding leading to cavities in your baby or child, you can take solid steps to become proactive about prevention. Be extra vigilant about preventing tooth decay with good oral hygiene, dental check-ups and nutrition.

 

Good habits start early

Even before your baby begins teething, you can gently wipe down your baby’s gums with a soft clean cloth or gauze.

Once your baby has teeth, gently brush their pearly whites with a small soft-bristled infant toothbrush at least twice a day — especially before bed.

Take your baby to their first dental visit before they turn one year old and bring them for check-ups every 6 months.

If your baby or toddler has cavities, be sure to find a trusted healthcare professional who can not only treat the cavities, but also help you with prevention and screening for less-obvious issues such as an oral restriction.

 

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Lead by example

Parents who take care of their own oral health are more likely to have children with healthy mouths and teeth. Babies and children learn by watching you in your daily life. Modeling a healthy diet, nasal breathing, brushing and flossing is the best way to teach your children healthy habits that will serve them for the rest of their lives.

 

The bottom line

Early childhood cavities (ECC) is an important issue that deserves our attention; however, breastfeeding is not the leading cause. We should instead focus our attentions on preventing cavities through improvements in nutrition, oral hygiene, oral restrictions and making dental care more accessible to families so that all babies and children can have healthy mouths and bodies.



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The circle makes it easy for you to surround yourself with caring and knowledgeable healthcare professionals across many healthcare fields and healing modalities who can guide and advise you through the ups and downs of diagnosing, treating, and recovering from the long-term effects of an oral restriction.

The health:latch circle is a radically kind, community-based online platform that allows interested parents and professionals to ask questions, learn together and connect to trusted professionals who are committed to helping families thrive.

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