Question: I’m concerned about my nine month old baby nursing to sleep and during the night because I’m afraid that the milk will pool in her mouth and cause cavities and gum disease. It seems like such a natural thing to me to nurse to her sleep. Does breastfeeding cause cavities?
Answer: There is no evidence that breastfeeding during the night or during the day will cause cavities.
Dental decay in baby teeth was rarely seen until the use of baby bottles. Researchers examined human skulls from 500-1000 years ago to study tooth decay in babies and children. These babies were breastfed for extended periods of time (years, not months) and of course they co-slept. Based on this research, the conclusion was that breastfeeding does not cause cavities.
When babies are given bottles during the night, liquid pools in their mouth, so the teeth are exposed to the sugar in the milk or juice for extended periods of time. That’s why decay in baby’s mouths is often called ‘bottle mouth’.
A bottle held upside down will drip milk, but breast milk doesn’t flow unless the baby is actively sucking. If he is actively sucking and swallowing, the milk won’t collect in his mouth and expose his teeth to milk or juice for extended periods of time.
Tooth decay is caused by a type of strep bacteria, which feeds on sugar to produce acid. The acid is what causes the cavities. When nursing babies develop cavities, it’s largely due to genetics , or the frequent ingestion of sugary food or drinks (including 100% juices) in their diet.
Breast milk has high levels of lactoferrin, an immune factor that kills the strep bacteria. Unlike formula or other sugar containing food or drinks, breast milk produces very little acid in the mouth. Because of this, breastfed babies actually have an advantage when it comes to having healthy teeth.
Breastfeeding not only decreases the incidence of cavities, but it also reduces the need for orthodontics (braces) when your child is older. Breastfed babies have different sucking patterns than bottle fed babies, so their jaw development encourages proper placement of the teeth.
Once your baby gets teeth, it’s a good idea to brush them daily. You can also squirt a bit or water into his mouth and after he nurses or eats, and that extra swallowing will help clear the milk out of his mouth.
From first hand experience, I know that only one of my six kids has ever had a cavity, and that was pure genetics (I blame it totally on her dad, who had terrible teeth). All my kids co-slept, but she was the one who co-slept the least – she wanted to sleep in her ‘big girl’ bed really early on.
I almost felt sorry for the perky young dental hygienist who tried to hand me a brochure about the dangers of night nursing. I was more than ready to ‘educate’ her as well as the pediatric dentist about the benefits of breastfeeding versus the risks of bottle feeding.
Anne Smith, IBCLC