Cavities, Breastfeeding and Dentists


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Dentists will often say that nursing in general is not good for our toddler’s teeth because the milk in breastfeeding causes cavities. 

In fact many mothers have been scolded by their kid’s dentists for night nursing beyond infancy with the implication that nursing is affecting their dental hygiene thus increasing their risk of tooth decay and cavities.

As informed mothers we know breastfeeding past infancy is biologically NORMAL. How can something so natural be detrimental at the same time? It can be difficult to find reputable information about breastfeeding and cavities to back up what we already know. 

Look no further! 

I’ve got your back. 

Interview with Gill Kelly

Lets demystify the topic of breastfeeding and cavities and what better way than speaking to a dentist with experience in breastfeeding. Following is my interview with Gill Kelly, a dentist AND natural term breastfeeding mama. She is currently pregnant with number 2 and planning to tandem feed (mama power!)

Dr. Gillian Kelly

Why do you want to address the topic of breastfeeding and cavities for nursing mothers?

I’ve been seeing quite a lot of posts on FB recently about dental problems in nurslings, and a fair bit of concern/ misinformation/ dentist bashing. I’m a dentist, and a fellow natural term breast feeder. I am hoping to shed some light on dental health for all the boobie monsters out there. 

What causes dental decay/ cavities/ caries?

In order for decay to happen you need three things. 

  1. Sugar
  2. Plaque Bacteria
  3. Time

Remove any of these factors, and you cannot get decay. 

The bugs in plaque are not selective about where the sugar comes from, they just love the stuff. Over time they convert it into acid which then demineralizes tooth enamel. This is what causes a cavity and hole then provides a lovely home for more bacteria to colonize and wreak havoc!

Is breast milk high in sugar?

Unfortunately, breast milk is high in sugar too. (we’ve all had a cheeky swig at some point right?), and as above plaque bacteria doesn’t differentiate:

Sugar = Fuel. 

This is why a lot of dentists will warn you about the dangers of fruit sugars, hidden sugars in table sauces, breakfast cereal, white bread etc etc etc. These can cause cavities.

If you are looking for a toothbrush to help clean those little teeth easier I highly recommend these finger brushes. They are advertised for babies but I still use them on my toddler and it makes it so much easier to “really get in there”

I’ve heard breast milk has enzymes that protect toddler’s teeth against cavities, is this true?

There are protective elements and enzymes in breastmilk, which slow down the sugar converting process, but not completely. If the balance between sugar, plaque and time is tipped in favour of sugar (and again it doesn’t really matter where it comes from), cavities can occur. 

This is why dentists will warn you about sugar in milk (and again any milk). If you can imagine your child’s normal daily diet; and how many episodes of sugar intake they have in mealtimes or snacks a day.  Multiply those meals and add several episodes of breastfeeding or milk intake in the same 24hr period. The balance can quite quickly tip into plaque bacteria having an open buffet. 

Can you explain a bit further why nursing at night can lead to cavities?

The reason that prolonged night nursing is seen as particularly risky is that saliva flow is naturally reduced overnight, and therefore the protective elements that are present in the mouth are reduced.

Also be aware a lazy latch or sleepy nursling may not be as well attached to the breast as they would during normal alert feeding, and the nipple can slip from its usual position at the back of the mouth towards the soft palate, to the middle of the mouth, allowing breastmilk to pool. 

The lack of saliva, and increased exposure to lovely sweet milk overnight is why dentists get so anxious about advising you to try as best you can to reduce night feeds. It really can make all the difference when it comes to the risk of your child developing decay. 

As a Breastfeeding Mama, what can we do to protect our toddler’s teeth while still nursing?

I understand that the above message can quite often be conveyed in an inflammatory manner. Hearing it can seem like an attack on breastfeeding. As I’m sure you’re all well aware not all health professionals are coming from a place of extensive training in breastfeeding support. 

Make sure to brush your kid’s teeth at least twice a day

The overall take home should be:

1. Reduce Sugar

Reduce overall sugar intake as far as you can. That means fruit, processed foods, table sauces, juice drinks, sweets, all count towards the sugar load the teeth are under. 

2. Brush at least twice a day

Use a fluoride containing toothpaste. The fluoride will disrupt the plaque bacteria and help tip the balance back in favour of remineralising the enamel.

3. Continue breastfeeding

It’s amazing and the benefits go on forever. Do be aware that it’s not risk free when it comes to dental health, and there is a benefit to avoiding a constant milk intake overnight. 

Do you have any last words?

No dentist wants to see a toddler with decay, it’s a professionally heart sinking moment, and I’m sorry that so many moms feel they haven’t been supported through their dental issues. I’m hoping the above sheds a bit of light on the advice and why it’s given the way it is. 

As I said, I’m a dentist, a passionate breastfeeding advocate, trained peer supporter, and a mother, and I want to see many more children fed past infancy. 

Looking for a KID’S STEPPING STOOL to encourage more independence at the sink? “Little Partners The Growing Step Stool Adjustable Height Nursery, Kitchen or Bathroom Footstool”.

This is the one we use and Luca LOVES it.

A Few Words from the Author:

There is a lot of research published on the internet stating that breastmilk does not cause cavities. A lot studies quote:

“If breastmilk caused decay – evolution would have selected against it.
It would be evolutionary suicide for breastmilk to cause decay.”

quoted by the late Dr. Brian Palmer

In response to those who quote Dr. Brian Palmer, we have to remember that our diets are much heavier in sugars now than they were in prehistoric times.

Dentists know this, but there needs to be a stronger initiative by part of dentists for alternative strategies to decreasing a child’s sugar intake. Banishing breastfeeding as a first resource is not the solution.

As an informed night nursing mama, I think it is important to think about everything we do in life as being a balance between risk and reward.

For example, going out of the house has its risks, driving has its risks, eating grapes has its risks (you could mistakenly choke). Therefore everyone decides on the level of risk they are comfortable taking and assess if the reward is worth it.

Breastfeeding has an innumerable list of benefits for both mama and child, therefore supporting those families in their breastfeeding journey is so important. There are many other forms of sugar in our children’s diet that can be reduced in order to continue and breastfeed our gorgeous little humans for as long as they need.

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