Forced to nightwean due to dd tooth decay

[kdescalzi]

Oh mamas,

please help me feel ok about this! I feel so sad and scared to nightwean my 2yrd dd. She has just been diagonosed with severe early childhood caries and I need to nightwean her. I know the night nursing is not the sole reason for her tooth decay but is definately a large contributor. Especially because for 2 straight years she has basically slept with my nipple in her mouth all night long! I know it needs to be done to protect her other teeth but I feel so bad. Please send any words of encouragement or advice my way!! I need someone to tell me she will be ok, that I will be ok, and that our relationship will not suffer. I am already in tears for the lost moments of snuggling her at my breast during the night. My friends and family think she is too old to nurse anyway so I don"t get the sympathy I need.

[tibeca]

Nightweaning is a personal choice that only you can make. It is a hard road to go.

When my daughter was but a year old, she began the slippery slope of dental caries. It was awful. I refused to night wean. We kept nursing, she underwent surgery to repair the cavities. We kept night nursing. She was cavity free for 8 months, we kept night nursing. Cavities began to build up again. We kept night nursing (get the picture yet?). I finally night weaned at 2 years, 3 months (I was pregnant and couldn't stand the night nursing anymore). Guess what? She still has cavities! We find a new cavity about every other month, much more quickly than when she was nursing at night. She has been night weaned for over a year and the cavities keep coming.

We did however change many things surrounding other foods and dental care. We have been flossing and brushing DD's teeth twice a day (we do the actual work so her teeth should be impeccably clean). She drinks water after every meal and uses water to rinse her mouth out in between brushings. No sticky candies, foods or high sugar stuffs. On special occasions, she has her "sweet" treat and then we brush.

Breastmilk is not dangerous to teeth (even cavity filled teeth). Breastmilk rebuilds enamel and is an excellent treatment for cavities. However, breastmilk when in contact with other food, does create an excessively good breeding ground for bacteria, so spotless teeth are key.

Having read all that, you may still want to night wean, and that is okay! Before beginning any of this, we talked over each step with our dd. We talked over the whole process and then a few times a day, we talked about how bedtime was going to be that night. Here's how we did it:

First we moved the bedtime nursing to before teeth brushing. This helped us to parent our baby to sleep when we were "fresh" and most

awake to help her. Once we knew she could sleep without nursing the second part was much easier!

Once that was the new routine, we began the night weaning process. When she awoke asking for milk, I would say only for 1 minute. I would allow her to nurse for an arbitrary 1 minute (either what I counted in my head or noticed on the clock, depending on how awake I was). I would then let her know the minute was up and unlatch her. She would usually cry. I would then say, "You can have the other side for 1 minute if you will feel better, then time to sleep." I would do that every time she awoke. Sometimes she'd cry and be hysterical. I would let her nurse again, for just 1 minute. It is frustrating, exhausting and sometimes horrible. I never let her scream or yell, but we only nursed for 1 minute then stopped, then switched sides, etc. That 1 minute means she's not likely to fall asleep and also isn't going to be getting much milk (as let downs usually take a little longer). ALWAYS make sure that she is unlatched, either by you or of her own free will, before sleeping.

Little by little she should just stop waking asking for milk. Of course make sure that there is some point in the morning when she knows that nursing is allowed again.

That's how we did it. Whether it will work for you, I don't know. Good luck on making the right decision for your babe and your family. Know that you won't "ruin" your child if you handle this with love.

[kdescalzi]

Thank you for your great reply. I do wonder if her teeth will remain bad after nightweaning. I don't know if I could ever forgive myself for doing that to her, only to find it was in vain! But, I do need to realize that she will end up sleeping longer stretches and that is also very healthy for her. She wakes sometimes every hour to re-latch and that disrupted sleep has got to be hard on her little body....i know it has been hard on me! This is just the hardest decision I have had to make so far in parenting....I am so scared to make the wrong decision.

[tibeca]

We actually use a paci at night because DD has always insisted to suck the whole time she is sleeping (even still at 3!). Pacis are bad for cavities too though.

Good luck finding the right decision for your family.

[transylvania_mom]

You don't need to nightwean because tooth decay. As you said, breastmilk can contribute to that, but only if your dd sleeps latched onto your breast. If you nurse her, unlatch, then she falls asleep, it won't cause problems. Also, don't share utensils, water bottle, food from your plate with her. Don't kiss her on her mouth.

My ds had many of his upper teeth affected by cavities by 15 mo, and went through dental surgery under general anesthesia at 18 mo. Luckily they were able to save all his teeth. Since then, I made sure his teeth were brushed well before bedtime and he had no more problems. He continued to nurse at night until 3ish and CLW at 4 y/o.

I learned my lesson and made sure dd doesn't fall asleep at the breast. She has no dental issues (she's almost 2 and we already went to a couple of check-ups, I'm paranoid about it now).

If you decide to nightwean, don't feel bad about it. It doesn't mean she needs to give up nursing for good.

[kdescalzi]

pp, so you think if I can get her to un-latch every time I won't need to fully night wean her? I am having such a rough time with this and I am getting no symapthy or understanding from dh or my family. I would love to continue night nursing and just work on her not staying latched on all night. So you continued night nursing even after your lo had dental surgery? no more problems? thank you so much for your reply and any other help you can offer....so alone and confused right now.

[EviesMom]

Oh I have done this. Tried xylitol everything, fish oil, etc. We night weaned. We did jay gordons cosleeping night weaning method, which worked for us. Her teeth got better. Now DD has many grown up teeth, all w no cavities! A couple things that helped us:

Brush well 2-3 times a day, like crazy. Carry a brush and paste in your bag if you think she might fall asleep while you're out.

Try to have a stretch of time during the day of at least five hours with no breast milk or food on her teeth. Our dentist feels this is more important than nightweaning per se for remineralizing teeth. They need a stretch of time without nursing/snacking.

Get a really good, thorough dentist. We had one who filled baby front teeth repeatedly, and the fillings ALWAYS came out in a month or less. Her molar fillings were also not secure. She kept putting in loose fillings which fell out or trapped bacteria, and DD ended up with a baby root canal because of the poor job that dentist did on that filling repeatedly.

We finally found our awesome dentist who says filling front baby teeth is usually useless because they don't hold fillings well. He will watch and see, do caps if needed, but not fillings on those teeth. He did a great job on fillings and caps, with special tools to keep the childs mouth open and to keep the filling area dry/clean so it seals and bonds better. It's a bit harder for the child at the time, but one filling that lasts til the tooth falls out is way better than repeated falling out fillings!

[transylvania_mom]

Originally Posted by kdescalzi 

pp, so you think if I can get her to un-latch every time I won't need to fully night wean her? I am having such a rough time with this and I am getting no symapthy or understanding from dh or my family. I would love to continue night nursing and just work on her not staying latched on all night. So you continued night nursing even after your lo had dental surgery? no more problems? thank you so much for your reply and any other help you can offer....so alone and confused right now.

This was our experience. I also agree with PP, no constant snacking and no sippy cups between meals (only water or breastmilk from the breast). Ds had this habit, where he would keep his last bite of food (for example meat) for about 30 minutes in his mouth, after finishing his meal. I had to make sure there was no food in his mouth after meals, constant exposure to food is not good for teeth. There is a website where I found this story about twins and cavities, and it helped me understand that the length of the exposure is what causes problems:

A pair of identical twins was brought into Tufts dental clinic while I was there. One twin had perfect teeth without a single cavity. The other had rampant decay all over his mouth. Being from the same family, they both ate the same things at each meal (mom was adamant that she gave them almost no sweets) and being identical twins, they were genetically identical, so neither one should have been any more susceptible to cavities than the other. No one could pry out of the twins any differences in their eating habits. Finally, one of my older professors cornered the two of them and after much prodding finally discovered that the cavity prone one liked to suck on bread balls. "Bread balls?? What are bread balls?" "Well you take the soft middle out of a slice of bread, ball it up real tight and suck on it!" Bread is not sweet. How could that cause cavities? Actually, bread is made of starch which normally does not cause decay, but when kept in the mouth for a long time, an enzyme in the saliva called amylase begins to break down the starches into their constituent parts, and those parts are simply sugar.

I talked with numerous dentists, some suggested night weaning, some said nursing through the night was no problem, BUT I had to make sure ds's teeth were not in constant contact with my milk. Some people say nursing is different from bottle feeding because milk doesn't pool in the baby's mouth, but I have several pictures of ds sleeping with milk dribbling out of his mouth. I have many friends who nursed through the night until their dk were older, I asked some of them and they told me their kids didn't stay latched on.

Ds's surgery was at 18 mo. We have had dental appointments every 6 mo and he has had no problems since then. He's 6.5 y/o now.

Also, I have dental problems and I shared food and utensils with ds. I made sure not to do the same mistake with dd.

Don't be so harsh on yourself. I remember I was heartbroken and very guilty about ds's dental issues, but one mom on another forum told me: it's just cavities, it's not open heart surgery! It was a little bit blunt, but it helped me put things in perspective. You did the right thing for your dd. Now when I see ds strong, healthy and extremely smart, I am so proud of having nursed him.

[kdescalzi]

pp, thank you so much for your positive reply! You are right, it is just cavites!!! She is not in fatal danger  thank God. My dh believes that it is all my fault her teeth are bad....everyone tells him that the night nursing is what caused her tooth decay and it is my fault for refusing to night wean. I already feel guilty enough but to be honest, I feel worse thinking about night weaning than I do about her cavites. I am just petrified to nw. I seriously get butterflies in my stomach when I think of it. I want  to listen to my gut instincts but then I have everybody telling me I need to do it for her teeth and for her health. I am just sick about it. Thanks again for your reply.

[princesstutu]

It sounds like you've already gotten some wonderful advice.  I just wanted to chime in.

I'm on my 3rd child with really bad caries on the front top teeth.  All were girls.  My boys did not have this issue.  And, I raised them all the same: nurse all night, eat behind me, etc. 

My oldest 2 dds had their front teeth removed at around 3 years old.  I'm trying not to have to deal with that with the 16 month old, so we did night wean like the dentist suggested a month ago.  Earlier this month, she got fillings on her front teeth and they look great so far.  I understand, though, that fillings there are fragile, so I have stopped allowing her to have any bread products.  I have noticed that bread products worsen her teeth (she likes to bite into them with her front teeth). 

Since nightweaning, though, the caries worsened drastically in a month.  I believe that is because breastmilk actually protects against caries (it does) and since she doesn't nurse as much anymore since she doesn't nurse at night, I think her teeth suffered more. 

All that to say: really figure out what feels right to you and do that.  I followed the dentist's advice (even though I didn't think he knew what he was talking about) because I believe in doing different things in order to get different results and I really want a daughter who has front teeth at the age of 5.  With a pretty smile.  So we're trying something new this time.  I won't do caps, though, so if this doesn't work and she needs her teeth pulled, oh, well.  I tried. 

I do brush her teeth more often now, too, so I hope that helps, too. 

Good luck to you!

[rubidoux]

princesstutu, I'm so curious about why you won't do caps.  My older ds got five caps across his top front teeth and 2 crowns on back teeth when he was 3 1/2.  The caps have been so so awesome, imo.  They look beautiful and he had no pain after the surgery.  They also are much better in terms of continuing decay than are fillings.  Fillings tend to weaken the teeth and caps are actually protective to some degree.  I am especially glad we did it now that I know he's such a late tooth-loser.  He's going to be eight in september and still has all those teeth.  He's only lost bottom ones so far, which he never had trouble with.

OP, I'm now going through the same thing with my second little one.  He turned two in february and we discovered the decay before then, at maybe 22 mos or so.  His teeth are visibly obviously decaying, feels like I can see it happening.  And it is so hard to see.  I'm really sad about it.  But we had such a good outcome with his brother (no cavities since his surgery) that we're going to shoot for the same thing.  We probably won't make it to 3 1/2, because they're pretty bad off.  But our plan is to wait as long as possible.  If he starts having any pain or if it seems like he's in danger of losing a tooth, we'll go ahead and do the surgery and completely wean.  (Milo weaned about two weeks before his surgery, which was just a coincidence, but I do feel like it was helpful.)  Our dentist is completely on board with this and we bring Augie in every three months for a checkup so he can see if the situation is looking dangerous.  Is your little one in pain?  Maybe you could consider putting it off a bit, too?  I guess there is a possibility that the teeth will need more work if you wait, but our dentist hasn't acted like that is a worry.  I think if you are at the point that they need a cap, it doesn't matter whether they need a little more of the tooth body drilled out as long as you don't get to the point of needing a pulpectomy.  

As far as feeling guilty for ruining their teeth by nursing (and I know the jury's still out on that one, but assuming, worst case it is the nursing), I think it's well worth it.  If I knew at birth that nursing was definitely going to cause this damage and I had to decide whether to nurse/ruin teeth and not nurse and have healthy baby teeth, I am certain I would still choose to nurse.  And even if the nursing is *causing* the cavities, it is not the real problem.  The real problem is that there's something wrong with these teeth.  Normal healthy strong teeth can survive nursing with flying colors, even if you do it all night (which both of mine do/did).  And we have no idea how much damage bottles of formula would have done.  Ugh.  I'm sure it would have been worse.  And likely would have had other effects.  And certainly wouldn't have fed their souls.  

[tibeca]

Just wanted to say I agree with pp. Even if I knew that nursing would ruin ALL of my DD's baby teeth, I'd still do it. They are "just teeth" after all.

[l3erly]

Lots of great advice here :)

I'm also night weaning my 16mo DD because of tooth decay. I also make sure not to share utensils, brush with xylitol 2-3 times a day, etc. I absolutely enjoy feeding her. It's our personal bonding moment together, so it saddens me a bit to wean. I EBF her and did so with my DS until around this same age. Although I enjoy our time together, I'm motivated to make sure I do any little thing I can to help her have healthy teeth.

My DS had 4 of his upper front teeth capped by the time he was 2. The dentists then were so rough and always reiterated the whole idea that his bad teeth were from BFing (not entirely true!). The process to get them capped just horrified me and now at 8yo he is still a bit fearful and nervous when it comes to the dentist. All that time he had the caps (they were silver, don't know why they never offered me a more natural color, had I known about it, I would've had those) he was self conscious of his smile and shyed away when kids asked him about his teeth. We always tried to tell him positive things like how his teeth were special because they weren't like others, etc so he wouldn't be so uncomfortable.I t was a bit sad seeing him like that :( Now that he has his permanent teeth in, he is all smiles.

For those reasons I try to stick to our routine of night weaning, although some days are better than others. Even though its a bit sad for her and me, I figure it'll be good for both of us in the long run. I look forward to all the new found bonding moments we'll share :)

Much love and hugs on your journey through night weaning :) It's okay to feel the way you do, while going through a change.  Just remember you'll both come out of this wonderfully :) At least thats what I try to tell  myself when I'm feeling down about al this :)

Blessings.

[princesstutu]

For me, the dental work required for caps is just too much to do and too potentially traumatic for teeth that are just going to fall out in a couple of years, anyway. 

I truly, truly, truly do not think this caries stuff has anything to do with breastfeeding.  Breastmilk is good for teeth and if it was the breastfeeding, shouldn't the bottom teeth and hey...all the teeth be messed up?  Why only certain teeth are affected?  And, in the case of my children, it's only the top, front four teeth.  The other teeth (the bottom teeth would be most susceptible, right?) are perfectly fine.

I appreciate the info in another thread here about the dentist who thinks having a tight connector skin that connects the top lip to the gums is a major player in this teeth drama.  Have any of you read that study?  I can try to find it, again, if anyone's interested.  Another mama posted it in one of these similar threads here on MDC.  I read it last month, so it's fairly recent.  Anyway, that dentist believes the lips stay too close to the teeth, keeping saliva from washing over the teeth appropriately, which keeps bacteria growing and corroding the top teeth.  I know my oldest and youngest daughters both have a tight connector skin.  Well, my oldest dd did until it tore.  It was a bloody mess!  And, it happened when she was around 8 years old.  My youngest dd only had enamel problems (not cavities at first..the cavities come after the enamel has been eroding, I notice) on the top half of her top teeth...the part of the teeth covered by her top lip even when she smiles!  The bottom half are perfectly fine and most people never even noticed she had teeth issues.  She has fallen and bumped those front teeth plenty of times and they never chipped or anything, which is what I would expect with weak enamel there.

I'm not saying this theory is applicable to every child and sitch, but I really think it applies to my youngest dd. 

I've been using an ayervedic toothpaste on dd3 for the past few weeks and I really like it.  I think it's much better for her teeth than any of the more traditional toothpastes or the baking soda we've tried in the past. 

[transylvania_mom]

Originally Posted by princesstutu 

I truly, truly, truly do not think this caries stuff has anything to do with breastfeeding.  Breastmilk is good for teeth and if it was the breastfeeding, shouldn't the bottom teeth and hey...all the teeth be messed up?  Why only certain teeth are affected?  And, in the case of my children, it's only the top, front four teeth.  The other teeth (the bottom teeth would be most susceptible, right?) are perfectly fine.

Actually they say the bottom teeth are covered by the tongue when the child is sucking, so they are protected. I believe (and that's just my personal opinion) that breastmilk and especially being latched on can contribute to caries, because the pattern of caries is the same as in "bottle rot" (the upper teeth are affected, especially the front upper teeth). Milk (and breastmilk) contains lactose, a sugar, which can increase the acidity in baby's mouth if she's continuously at the breast.