Breastfeeding and Cavities

My husband is a dentist. Up until the time we met, he knew nothing about breastfeeding. Since we’ve been married and had our first child (a little boy, 11-months-old), he has been educated pretty thoroughly by me on breastfeeding and natural parenting philosophies. One of his biggest concerns that stem from breastfeeding is night-nursing and how it might lead to childhood caries (cavities). He’s more concerned about it now that our little boy has some teeth. He’s hinted to me to stop the nighttime feedings altogether. I can’t bear to do that to my child yet. I believe breastfeeding and weaning should be child-led. Right now, I feed my son about three to four times a night. I figure he needs these nighttime feedings for whatever reason—emotional or physical. But this has become quite a stressful issue in our home, since I don’t believe that nighttime feedings will cause cavities. My mother, an International Board Certified Lactation Consultant has researched this issue somewhat and offered some advice to him. But, because he is the dentist, he insists that anything besides water will cause cavities, including breastmilk. Is there any research out there—or accredited dentists, for that matter—that can scientifically explain that breastfeeding at night is a low risk for childhood caries? Or should I be weaning my child from nighttime feedings altogether now that he has teeth? Any evidence-based thoughts or ideas on this issue would be greatly appreciated.

Mothering has an excellent article on this topic here: www.mothering.com/articles/growing_child/child_health/cavities.html

And yes, there is an accredited dentist who has scientifically explained that breastfeeding is a low risk, as you say: Dr. Brian Palmer (no relation to me). He has an online slideshow with references in it here: www.brianpalmerdds.com/pdf/caries.pdf. My own article on this topic has some different references from the two above, babyreference.com/CavitiesBreastfedBottlefed.html, and I provide some ideas about natural foods and herbs that can prevent and fight decay.

I understand your dilemma and your husband’s concerns. I have to say that for me, emotional, nutritional, and developmental health are more important than some temporary teeth, unless there is a major problem developing, but I know your husband won’t see it that way. Yes, any food sitting on the teeth for a long time can feed the bacteria that can lead to decay, though breastmilk has antibacterial factors to reduce this potential and the research bears this out. Saliva, of course, washes the teeth of milk easily. If he has great concern, you can jostle your baby enough after night nursing that he swallows a little or give him a little sip of water after nursing. That’s all it would take, especially if teeth are clean before bedtime, but this really is not necessary. Studies suggest that breastfeeding at night does not increase caries, rather those breastfeeders who develop caries are generally ones who also enjoy sweet snacks.

Below are two references for newer research since the above articles were published. The first is a meta-analysis of several studies since 2000 and the next is a newer study since that analysis was undertaken. They all agree that breastfeeding, even at night, is not a factor in early childhood caries. One more note, candida has been found to also be a factor in caries and this yeast is commonly found growing on pacifiers.

V. White, “Breastfeeding and the risk of early childhood caries,” Evid Based Dent 9, no. 3 (2008): 86-8.

S.Z. Mohebbi et al., “Feeding habits as determinants of early childhood caries in a population where prolonged breastfeeding is the norm,” Community Dent Oral Epidemiol 36, no. 4 (Aug 2008): 363-9.