Nightweaning 13 month old for dental reasons?

[hazelbranch]

This could really go here, in Breastfeeding, or the Family Bed I suppose...

My 13 month old daughter has developed a cavity on the front/inbetween her bottom front teeth and the pediatric dentist I took her to said it is likely because of her night-nursing and nursing to sleep. She admitted that she usually doesn't see cavities on the front bottom teeth with night-nursing, but she still thinks I should nightwean my LO. I never expected to find myself in this situation, with a potential medical reason to stop night-nursing. We co-sleep and it works so well for us... and she's so young. Has anyone else been in this situation? Did you night-wean? Any suggestions?

[aikigypsy]

In this situation, more or less, except that my daughter is almost a year older and the cavities (on her top teeth) have gotten really bad.

The dentist we saw recommended cleaning her teeth after every time she nurses at night with a damp piece of gauze on your finger, just rubbing them off. He said to do this when she's unlatched and has just fallen asleep... as if that wouldn't wake her up. Ha ha. But I did it a few times and although it made her a bit angry, and woke her up, she wasn't very awake, and settled back to sleep without nursing again without too much trouble.

For us, at 2 years old, I think that night-weaning is the better option, but in your case I would try an in-bed tooth scrub after night-nursing for a few months more.

[Denali]

There are many studies out there that say that cavities, decay, etc. are NOT caused by nursing. Unfortunately, many pediatric dentists either don't know or disregard those studies.

The ped dentist I took my son to wanted me to wean him as well.....at 11 months

I am still nursing, incl. night nursing....DS is 2.5 years now

As you can see, I chose not to follow his "advice". We are using xylitol products, and I have heard from others that they fill a syringe with water and xylitol and squirt a little into their kids' mouths after they finish nursing. I haven't done that, mainly because DS isn't a great sleeper and I didn't want to risk waking him up again. But it might be a good idea.

Instead of using gauze, als the PP recommended, you could also use a spiffies cloth (they are saturated with xylitol).

Our new ped dentist didn't tell me to quit nursing, by the way....maybe you could look for a different dentist, as well?

[baby-makes-3]

I am certain that bf at night contributed to my DD's cavities. Until 2 years of age, there was little else on her teeth except breastmilk.

After her first tooth was cut, I began using spiffies to clean her teeth before bed. At 11 months I began brushing every night before bed with a non-flouride toothpaste. She's only had soda twice in her life, once Ginger Ale and once 7Up. She does not really like juice, but prefers water all day. She also did not show any real interest in solids until 2 years old and has never had a real taste for sweets. She has a dairy intolerance, so has never drank cow's milk and has also been on Calcium + D supplements since about 18 mo. I also was on calcium when pregnant with her and had no other health issues.

She also only fell asleep a few times from birth to 33 months (when we weaned) without the breast. Up to that time, she nursed every single night after having her teeth brushed and woke frequently throughout the night to nurse. Up until about 2 yo, there was little else on her teeth except breastmilk, especially at night.

I did not take her to the dentist until she was 3 years old based on common suggestions I received and had not used flouride on her teeth until then either. When I took her to the dentist, I learned that she had ten cavities, two of which are in her back molars and, upon being x-rayed, were almost to the pulp. I will add that we look in her mouth all the time and neither DH or I noticed this and never suspected a problem.

DD never had a bottle, even of breastmilk, so I thought I was doing the right thing by bf my DD until nearly 3 yo. I still feel that I did, except that I should have made more of an effort to help my daughter learn to fall asleep without the breast. It's not the breastmilk, per se, it's the frequent night nursing and constant bathing of the teeth with bm at night that I am certain basically caused this problem. I feel pretty confident that had I gotten the breastmilk off her teeth at night, I wouldn't have been looking at ten cavities (we've taken care of 8 of them thru laser dentistry and still have the two bad ones that we're just waiting out since any kind of sedation scares me). You can imagine my guilt over this!

Although I realize that some can night nurse for years and never have dental caries, and my dd was probably predisposed to cavities because of my bacteria, the fact is I didn't know that until it was too late. If I had, I would have been more diligent. I think it's better to know that it's a possibility and take preventative measures.

[EviesMom]

I have been down this road, with my DD who is nearly 6 and no longer has frequent cavities. It was a long search to find a pediatric dentist who didn't advocate weaning. The perspective of the dentist we have now, who I trust, and who was absolutely fabulous about DD nursing after procedures, etc.

Some people are very prone to cavities, a combination of genetics regarding enamel, and tending to always have something in their mouths. He doesn't think it's breastmilk per se that is the problem, but rather that frequent night nursers teeth never get a chance to be less wet and to rebuild enamel during the night. He said even a bottle of water that frequently during the night would have the same problem. This wetness also keeps the cavity-causing bacteria active on the teeth throughout the night. He says the breastmilk itself is non-decay causing, so kids who don't have absolutely anything else on their teeth, there's no problem, but that brushing wiggly toddlers teeth usually leaves small bits of food on their teeth.

So, all that in mind, he encouraged us to find a 5 hour stretch per 24 hour period when her teeth could "rest" and remineralize. We ended up nightweaning to get that stretch, but she was 2.5, and I was ready to do it. She got caps on 4 front teeth, 2 fillings, and 1 silver crown. Then nothing for almost 3 years, and she had one very minor filing a few months ago. We use floride toothpaste once a day in a very small amount, but I wouldn't do that with a very young child either.

It's worked very well overall, and I think one proof of the theory for me was the fact that DS is now the age at which DDs cavities were diagnosed. He has no dental problems, and he's never been an all night nurser the way DD was. He nurses at bedtime, at midnight, and then not again until 6am ish without any nightweaning techniques, it's just his personality/style/pattern.

[baby-makes-3]

He doesn't think it's breastmilk per se that is the problem, but rather that frequent night nursers teeth never get a chance to be less wet and to rebuild enamel during the night.

Totally makes sense. I remember researching this topic as DD's teeth were just coming in and finding this article on kellymom.com: http://www.kellymom.com/bf/older-baby/tooth-decay.html. I remember it putting my mind "at ease". Quote:

One of the reasons for nighttime bottles causing tooth decay is the pooling of the liquid in baby's mouth (where the milk/juice bathes baby's teeth for long periods of time). Breastmilk is not thought to pool in the baby's mouth in the same way as bottled milk because the milk doesn't flow unless the baby is actively sucking. Also, milk from the breast enters the baby's mouth behind the teeth. If the baby is actively sucking then he is also swallowing, so pooling breast milk in the baby's mouth appears not to be an issue.

Hindsight, this doesn't make sense. Everyone who has nursed a baby/toddler to sleep knows that the sucking gradually slows down as they fall asleep with the nipple still in their mouth, so that any residual milk not actively swallowed by a half-asleep child would indeed "pool". Also, the nipple can drip right after the sucking stops. It would only take a few drops to "bathe" the teeth.

I am absolutely pro-BF. However, new mothers, especially co-sleeping mothers, need to be aware of this issue. It could prevent them coming to the dental forum 2-3 years later (like me) with their baby full of tooth decay. Of all my friends with similar-aged children, I am the only one who co-slept and nightnursed for over 2 years, and I'm also the only one whose DC ended up with 10 cavities. I just can't believe breastmilk didn't play a part in that tooth decay.