I am a huge advocate of breastfeeding, and I’m dismayed by well-meaning dentists who are misinformed about the effects of breastfeeding on cavities. It breaks my heart when I hear someone is told to stop breastfeeding partially or completely for these reasons. The ones who end up on the losing end are the babies.
Does breastfeeding cause cavities?
People are reasonably concerned with the causes of early childhood caries or “baby bottle decay”. This disease can cause severe and rapid decay of the baby teeth, with that causing a myriad of problems for the child. This disease has been linked particularly with putting a baby down at night with a bottle full of milk or juice, but practitioners and researchers alike have implicated breastfeeding as well.
The thoughts about the link between breastfeeding and cavities have been changing as more studies have been done. There is now growing consensus that breastfeeding until age 12 months is not associated with a higher risk of cavities. In fact, breastmilk may offer higher protection from getting cavities over the use of formula. (One reason is that breastmilk contains antibacterial properties as laid out in this great kellymom article)
The evidence about cavity risk and breastfeeding toddlers (over age 12 months) isn’t great quality. It certainly isn’t enough to tell mothers to stop breastfeeding! Breastfeeding has so many benefits that outweigh any potential risks in causing cavities, regardless.
What about breastfeeding at night, on demand?
First off, as a breastfeeding mom who nurses on demand all night, I scoff at the suggestion of brushing or wiping my baby’s teeth after each nighttime feeding. That would wake her and me up! It’s just ridiculous and not a good solution.
My suggestion is to clean the teeth well with a toothbrush twice a day, especially before bed. (Food particles mixing with milk have been implicated in causing decay as opposed to milk alone) See a breastfeeding friendly dentist twice a year to monitor for cavities. If you aren’t opposed to fluoride, fluoride varnish that is applied at the dentist is much lower dose than gel and highly effective at strengthening the teeth. (Some who already have decay starting may also be encouraged to do a small amount of fluoride toothpaste at home as well) Monitor baby’s teeth at home for any changes in color (bright white, brown, yellow, or black spots). Notify the dentist of any changes. And nurse away!
What about lip ties?
A “lip tie” is the term used to describe a low lip frenum, or muscle attachment. Everyone has a frenum and you can see where yours or child’s is by flipping up the upper lip. It attaches somewhere on the gums right in the middle of the lip (right to left). The closer it is to the teeth, the more it is “tied”. The thought goes is that it could form a pocket where milk can sit and decay the teeth. This hasn’t been studied well. It really is just anecdotal that it causes a problem at all. But if you follow the above suggestions for monitoring and cleaning, you should be covered. You can also choose to have the lip tie fixed.
The benefits of breastfeeding are numerous and outweigh the possible risk of cavities. It is my personal belief that breastfeeding does not cause cavities, but this has yet to be proven beyond all doubt. Take a reasonably cautious preventive approach and keep on nursing, mamas!