Update: to be absolutely clear, I am talking about children who nurse frequently for two years or more in this post. Not little wee babies.
I wrote the better part of this post at the dentist’s office, waiting for The Princess to wake up after having nine fillings done. We opted to have her put under so that the experience wouldn’t turn her off dentists forever, given her ability to hold a grudge for years. I’d say the whole experience was rather uneventful, especially when you compare it to her first hair cut where she grabbed the stylist’s scissors and tried to stab the poor woman. Being unconscious definiltely helped.
Despite a fabulous toothy grin, I knew that her teeth were bad.
Over the years, I’ve asked various doctors and dentists about having her teeth checked. I worried after I heard horror stories of nursing caries caused by night nursing and I was particularly concerned about a dark spot in her one back tooth. Each time I asked about an appointment, I was told that kids don’t start their check ups until age 3 or 4 and the first visit is just a fun ‘meet the dentist’ type appointment. So I put it off rather than listening to my gut. I’m annoyed because I ignored the bad feeling in the pit of my stomach and listened to “the experts” instead. On the other hand, I’m even more ticked off at the dentists who brushed off my concerns for the past couple years.
When we finally brought The Princess for her first dentist appointment last month, they said that it was bad. They told me to lay off the juice and they asked if she was drinking enough milk. We were told that she would need some fillings and then we were referred to a specialist who would be able to do the work while The Princess’ slept. A few weeks later we went for our initial consultation in the specialist’s office. At that point, I didn’t even know how many cavities she had.
When the dentist came in that day, he looked in her mouth and then he looked at me and he asked “what do you feed her?!” in an incredulous voice. Hmmm… Maybe she had more cavities than I realized.
”Does she eat dried fruit?”
“No.”
“Granola bars?”
“Rarely.”
“Candy?”
“Not too much. Not at home, at least.” Remembering what our dentist said, I added, “She drinks juice, but we’re trying to cut back.”
“Juice didn’t cause this.”
That nagging feeling returned. “She nursed for a long time,” I said. “She nursed to sleep for years.”
“That’s what did it.”
Well, that was the last thing I ever wanted to hear. Particularly in front of my husband.
The dentist paused and looked at me again. He went on to tell me that if I’d asked five years ago if there is a connection between breast milk and cavities, he would have said that he didn’t know. Certainly there is a lot of sugar in a mother’s milk. But in the last five years, he’s had a ton of kids coming with decay that he’s never seen before and the moms tend to be what he called “true nursers”.
Now wait, wait. Stop gathering up your breastfeeding materials and planning your nurse-ins for a moment. I wish that I could convey his tone to you – in no way was he judgmental. He was just sharing his personal experience.
We went on. I told him that I have a one year old and asked if he thought I should I night wean her.
The dentist threw his hands up in the air: “I’m not going to tell a woman what to do.” He went on to say that “they” – and I love that he actually used air quotes when he said “they” – “they” recommend that you wipe the child’s teeth down with a cloth when the child finishes nursing. He quickly then added “but as my wife says, that’s just ridiculous because you’d wake the child up”.
I like this guy’s wife. Apparently we’re on the same wave length. They have five kids – in fact, today while The Princess slept, he came over and talked about baby carriers with me and said he wore his university-aged children back when they were babies. Awesome, right?
In the end, he just recommended that we be extra diligent about The Pixie’s dental hygiene during the day if we choose to keep nursing her at night.
But I still want to know – does breastfeeding at night actually cause cavities?
There is so much research that shows how good breastmilk is for teeth and states that breastfeeding at night does not lead to cavities. I’ve read many excellent articles that encourage women to nurse at night, and in the past week, I’ve reread many of the same articles looking for something that I may have missed. How do I reconcile this information with our experience? I mean, nine cavities at age four! That’s not something I can ignore.
From what I’ve read during this last week, all I can say is this: some kids are more prone to cavities than others, and night nursing could possibly exacerbate their condition. For example, The Princess could have soft or cracked enamel on her teeth, or her grooves could be deeper than normal making it easy for food to get caught, or she could have contracted a bacteria (strep mutans) that encourages decay from adults. I’m sure there are many factors that could have predisposed her to cavities. But I couldn’t really have known. And I don’t expect I’ll wean The Pixie any sooner because of this experience, because I have no idea if The Pixie is predisposed to cavities as well. And I believe that breastmilk is too important to deny my children.
I thought I’d end off with the list the dentist gave me of tooth-happy snacks (mostly because I’m sure I’ll lose the list and this way I’ll have an electronic copy):
DO NOT GIVE
- Fruit roll ups
- Fruit snacks
- Fruit to go
- Granola bars
- Nutrigrain bars
- Oatmeal bars
- Dried Fruits (raisins, trail mix, apricots, etc)
- Sticky candy (toffee, gummy bears, licorice, etc)
- Pop or Gatorade
- Fresh fruits and veggies are the best
- Pretzels
- Peanuts
- Popcorn
- Sunflower seeds
- Pumpkin seeds
- Almonds
- Bits & Bites
- Nachos & dip
- Yogurt, puddings, jello
- Fruit cups, apple sauce
- Plain chocolate bars (Jersey Milk, Aero, etc)
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I hate to say it but there is a strong possibility that therevia a connection between night nursing and cavities. With bottle fed babies there is a phenomenon called “bootle mouth” which is cavities caused by liquid pooling in the mouthbat night when a baby takes a bottle to bed (juice or milk). It is not the nipple that causes the problem but the sugar in the liquid. So it makes complete sense that night nurses would suffer the same fate. Makes sense when I think back to my first born …. I nursed him for a year and then he started taking bottles to bed. At 4 years okd he too met the sleep dentist and ad thirteen teeth repaired, including three extractions and three baby root canals! Ugh! Child number two was only nursed for three months and never took a bottle to bed, and guess what? Her first cavity was not until she was about 8! Coincidence????? Hmmmnnn????? Gotta wonder. I hope your Princess has reivered from her ‘sleep’ and is feeling better;)
Ugh, that sounds awful! Your poor son!
My understanding is that bottles allow milk to pool in the babies mouth while they sleep, while breastfeeding demands that the baby be actively suckling, leaving less chance for the milk to pool. I wonder if it was the bottle in bed that caused the problems and not the breastmilk itself?
I’m glad you’re aware of the fact that most sources do not point to nighttime nursing as causing caries! And you’re not alone – another good friend of mine has a now 5-year old that had many cavities at four as well.
And really, if it was a night nursing = bad tooth decay, I think we’d see a lot more tooth decay … some kids are just predisposed, methinks!
I don’t know – do you think there would be a lot more tooth decay?
You’ve probably met more, but I can’t say that I know very many people at all who nursed their three or four year olds that I can compare my experience to. Most people stop nursing their children well before that.
OK, take a look at this article here on the LLL website:
http://www.lalecheleague.org/nb/nbjanfeb97p11.html
The dentist says that a bacteria transmitted to babies can cause their saliva to become acidic and frequent feedings allows the bacteria to proliferate. In this case, the constant breastfeeding doesn’t cause the cavities but it exacerbates the condition.
I’ve read a few places that 20% of the population carries this bacteria, so its entirely possible that any of our babies will catch it. In this case, I think we need to be making woman aware of this information so that they can work with their dentist to reduce the likelihood of cavities, rather than just arguing that breastfeeding doesn’t cause cavities and leaving it at that.
Holy Cow that’s a tough one!
I’m not sure how I’ll handle it when it is my turn to consider when to wean. I’m glad you shared this, though. Now it’ll be on my mind, and I won’t have to make a “last minute” decision.
Well, I think there’s a good possibility that night nursing CAN contribute to caries, but I don’t think it’s an if/then type of thing. I think minimizing possible damage is the best thing to do – making sure you thoroughly brush teeth before bed (so that there is no extra sugar on the teeth throughout the night), offering sips of water to clean out the mouth, rubbing down the teeth if you’ve got a child showing signs of decay, etc.
But for the general population? I mean, it sucks to have cavities, but they are the baby teeth and as long as it’s taken care of, those adult teeth should grow in just beautiful and fine! I wonder if that’s one evolutionary reason for those baby teeth to fall out? (I mean, other than size …)
We are going through this right now too…. I night nursed my now 4 year old for 2 and a half years and he ended up with a mouthful of cavities (two pulp treatments with crowns and a bunch of other small cavities that needed to be filled. ) We had the work done under sedation. Now, my 12 month old is showing early signs of decay. MY 12 MONTH OLD. WTH. I am devistated!! He goes to the dentist next week… I am hoping we are nipping it in the bud early enough. I have now night weaned him and cut back his day time feedings to a more scheduled pattern instead of letting him just snack when he wants. It sucks. I don’t think that night nursing alone was the culprit, but obviously we have a particularly aggresive form of the bacteria in our household. We are using xylitol and trying to get it under control. Such a bummer :(
Elijah had exactly nine cavities too. We had these filled while he was under as well. Salem has one small spot on one of her teeth that will likely be a cavity. But she’s not nursing anymore. I don’t think it will be as bad as Elijah. It makes perfect sense to me that sugar on the teeth all night can make for a cavity filled mouth. I don’t think it can be an only if/than situation. But a combo of genetics and night nursing frequency. Also- the dentist noted that Elijah had deep “pockets” in his gums, so we have to floss him! It’s one of those things I just decided would have to be, and hope that their adult teeth aren’t too badly affected. Great post!