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Bad news (post #42) WAS: Seriously considering nightweaning due to ECC

post #1 of 58
Thread Starter 
My 22 mo dd has what's considered severe early childhood caries. After nursing children for 4.5 years solid, and after tandem nursing for almost 2 years, I am seriously considering nightweaning dd.

Apparently infants and toddlers at risk for ECC:
Quote:
• Have mothers with untreated dental disease or
mothers who have previous experience with dental
caries.
• Have older siblings with high rates of dental disease.
• Have weak or pitted teeth due to premature birth or
to their mothers’ poor diets during pregnancy.
• Have poor or nonexistent oral hygiene (which may
result from limited access to dental services, financial
challenges, or resistance by family members due to
negative dental experiences in the past).
• Have a diet high in sugar (refined, added, and natural).
• Are given bottles at bedtime or naptime, or to modify
behavior (e.g., crying).
• Are breast-fed on demand throughout the night.
• Are given pacifiers dipped in sugary substances, such
as honey.
• Frequently take sugar-laden medications or oral
antibiotic formulations.
"On demand" breastfeeding at night is the major risk factor that applies to dd. Yes, I have had minor caries in the past, but very little. I guess my diet wasn't great while PG, due to PG nausea, but it's not like I was chowing down on junk food either. Dd's dental hygiene wasn't great, but we did have some brushing happening (with stages of resistance where she mostly played with the toothbrush herself).

I did find a study where on demand nightnursing in toddlers (>12 mo) was linked to ECC, especially if nursing sessions were longer than 15 minutes. Other studies have demonstrated the same thing. Although breastmilk alone doesn't cause cavities, it seems to be problematic when carbohydrates are present in the diet, especially at night when saliva flow is low. Because extended breastfeeding is not the norm in North America, I don't think it's been studied much here.

At first I felt that I would not consider nightweaning. Now I am seriously considering it. I feel somewhat nauseous thinking about it. One, I'm worried about dd's nutrition - I am not sure that I would be able to provide her with the equivalent amount of breastmilk during the day due to all the distractions. Two, the actual process would be really hard. I don't think that dh would have the stomach for helping me with it, so he'd have to sleep with ds and I'd have to cope with dd's screaming by myself.

I'm so confused. But it's horrible to watch the enamel melt off dd's teeth. We are doing all sorts of things to stop the decay and remineralize, but I'm worried that continuing to nightnurse undermines all that.

A dedicated mom on the alternativekidsteeth yahoogroup came up with another solution - she actually brushes her child's teeth after every nightnursing session! She said that it took two months for her child to get used to it. I'm not sure I'd be willing to do that though.

I definitely tend to be overprotective of my children. I think that I tend to underestimate their resilience - partly because they are extremely "expressive". I need to come to a place where I can make a decision, feel solid in it and convey my confidence that we will all be OK with my plan.

Dd is still my "baby"
post #2 of 58
My ds has terrible teeth, and I'm pretty sure that night nursing was a contributing factor -- but now he's no longer doing that, and he's still getting major tooth decay. I am sure there are other things involved.
post #3 of 58
Hey Ksenia. Huge hugs to you!!!!! I have some thoughts and will definitely express them, but it seems Ryland REALLY needs me right now, and in 10 minutes I have a piano lesson - so I'll have to find a calmer moment to collect my thoughts.
post #4 of 58
Ksenia - are all of dd's teeth decaying? ds's front top 4 teeth completely decayed and I continued to nurse him, and so far all of his other teeth have been fine.

I have heard of wiping the teeth after each night nurse and that seems reasonable compared to brushing. What about offering an angel brush with toothpaste on it for dd to chew on throughout the day?

hth
post #5 of 58
Hey Ksenia!

So, a few thoughts about this......first of all, I'm not sure nightweaning will fix Uma's dental problems and since you think it will be so stressful on everyone in your family, and potentially affecting both Uma's overall nutrition and her sense of attachment/trust in her relationship with you, I'm not convinced that the health of her teeth trumps all that, you know?

However, if you do choose to nightwean her, I do not think it will destroy her. I think Kea was around the same age as her when I night weaned her, and it went better than I thought. I warned her that it was going to happen in a week, counted down with her, gave her lots of warning and then stuck by my guns once the date came. I also insisted that it be her and I that worked it out, rather than J coming and taking her away in the middle of the night. I sang, cuddled, got up and walked around with her - for 3 nights we did the night waltz a few times, and then she seemed to realize that I meant it, and nursing only happened during the day from then on.

For Tiegan, her personality was such that it wasn't worth the fight for me - an all or nothing approach would only really work, and I didn't mind night nursing enough to fight the battle. HOWEVER, when I was pregnant with Ryland, I knew that I didn't have the patience to tandem nurse, so I weaned her early in the pregnancy. At that point, she was almost 3 and still nursing lots. I was shocked by how much she needed to eat after we weaned, and often woke up in the middle of the night starving. So we created new habits of protein filled night snacks and big breakfasts - but once the milk was no longer there, she did shift to eating more.

With Uma, I agree that kids are more resilient than many of us give credit to them, AND they follow our lead. If we *know* that we are doing what is best, we'll all be okay and we CAN get through this, I think they pick up on this. However, if you're not sure about it, decide to do it but feel wracked with guilt, she'll pick up on this and I doubt it'll go well. I also have this theory that if the mother is desperate enough to follow through (ie not getting enough sleep, sick of contorting their body and beginning to resent nursing) than they can wean quickly. But, if they feel they should or are being pressured to do it, but don't really mind nursing and aren't totally convinced about the reasons to do it, it usually does not go well. So I personally would do some soul-searching and decide what is the true path for you - and then don't worry about it anymore, don't second guess or torture yourself with more research, just trust that your choice is the right choice for you and your family.

Good luck to you, and lots of hugs. xoxo
post #6 of 58
Just hugs and commiserations for you, mama.

Just today the dentist laid it out for us - my buddy has ecc, severe enough that the pulp of one of his teeth is exposed and that tooth may not be able to be saved.

When his first tooth erupted, I did tons of research and decided that night nursing would not cause carries, and conscioously ignored his pedi (and everyone else) 's advice.

I can only say I don't doubt anymore that night nursing is the main, if not only cause of his carries. I will night wean, immediately. In my mind it is all I can do to try and reverse the damage I have caused my poor little guy.

Good luck and hugs. What is your plan for reversal/reminirealization? Are you choosing any medical/dental treatment?
post #7 of 58
At this point I am confident that night feedings did not cause DS ECC. Three of the four upper teeth that he has are affected. My nipple is not anywhere near those teeth at night. No milk pools in his mouth after he eats. If anything, I feel that the night feeding is beneficial due to the increased saliva that he has after his nursing session. I read an article about the benefits of breastfeeding (including night feeding) on the WAP site, but I can't find it right now- I will post it once I find it.

Good luck!

(what dietary changes are you making?)
post #8 of 58
Thread Starter 
Quote:
Originally Posted by Pookietooth View Post
My ds has terrible teeth, and I'm pretty sure that night nursing was a contributing factor -- but now he's no longer doing that, and he's still getting major tooth decay. I am sure there are other things involved.
I'm sorry that things are getting worse
Quote:
Originally Posted by anna_2 View Post
Ksenia - are all of dd's teeth decaying?
Dd has decay on 6 of her 8 upper teeth - as far as I know! There may be more decay that I haven't seen.
Quote:
Originally Posted by anna_2 View Post
ds's front top 4 teeth completely decayed and I continued to nurse him, and so far all of his other teeth have been fine.
I hope it stays that way. Unfortunately, it is quite typical that the decay spreads to the other baby teeth . I assume we will be dealing with this for years to come.
Quote:
Originally Posted by anna_2 View Post
I have heard of wiping the teeth after each night nurse and that seems reasonable compared to brushing.
Either wiping or brushing would definitely wake dd up. Even putting a qtip under her lip wakes her up if I don't time it very carefully.
Quote:
Originally Posted by anna_2 View Post
What about offering an angel brush with toothpaste on it for dd to chew on throughout the day?
We've been doing that for about a year.
Quote:
Originally Posted by beaner&tiegs View Post
first of all, I'm not sure nightweaning will fix Uma's dental problems and since you think it will be so stressful on everyone in your family, and potentially affecting both Uma's overall nutrition and her sense of attachment/trust in her relationship with you, I'm not convinced that the health of her teeth trumps all that, you know?
Good points.
Quote:
Originally Posted by beaner&tiegs View Post
I also insisted that it be her and I that worked it out, rather than J coming and taking her away in the middle of the night.
Interesting. I had thought that it would be easier for dd if dh was with her instead of me because he wouldn't be withholding breastfeeding. But I guess that she might feel abandoned by me in that scenario.
Quote:
Originally Posted by beaner&tiegs View Post
I also have this theory that if the mother is desperate enough to follow through (ie not getting enough sleep, sick of contorting their body and beginning to resent nursing) than they can wean quickly. But, if they feel they should or are being pressured to do it, but don't really mind nursing and aren't totally convinced about the reasons to do it, it usually does not go well.
for your wisdom. You do give me pause for thought.

I've listed below what we are doing about dd's caries. If we figure out that she's in pain, however, we will get the cavities treated conventionally under GA.

Stopping decay:
  • we have an appointment for HealOzone
  • we will be using very small amounts of fluoride topically after the HealOzone treatment
  • once I receive it, other members of the family will be doing regular 3% food grade hydrogen peroxide mouthwashing to knock back our mouth bacteria levels to reduce transmission to dd
  • 5x per day Spry xylitol candies
Remineralizing:
  • frequent cheese
  • applying a small amount of MI paste with a qtip after dd falls asleep at night
  • 5x per day Spry xylitol candies
Diet:
  • stopped all dried fruit (dh was feeding it to her regularly before)
  • cut back sugar treats (they were occasional before)
  • reduced refined carbs (haven't stopped completely because sometimes we just need her to eat)
  • increased meat and cheese (we had reduced our intake because of a serious health condition that dh has)
  • increasing frequency of bone stock
  • dd almost never had juice and still doesn't
Supplements:
  • high vitamin cod liver oil (400 IU of Vitamin D)
  • high vitamin butter oil supplements (I am taking them and hoping she is getting it via my breastmilk - still working on how to get her to take it directly)
Hygiene
  • brushing 2x per day with Spry Infant Tooth gel using a Sonicare electric toothbrush with an ultracompact head
post #9 of 58
I'm a bit confused... Obviously night nursing is not the CAUSE of ECC since many children night nurse without any dental issues (my kids, for example). Does it exacerbate the condition in a child with ECC? I'm guessing the answer is yes. But note that, if this is true, then nightweaning will only REDUCE the severity of ECC. The $10,000 question then, is how much of an improvement will you see should you nightwean?

I think the suggestion to just wipe her teeth with a damp cloth is a good one. I realize this means more interruptions to your night. But it may be less traumatic for you than trying to nightwean.

OTOH, if you do decide you need to go ahead and nightwean there are many ways you can try it, depending on your DD's temperament. Honestly, though, you need to be prepared for the fact that it may not make much difference to her dental health.
post #10 of 58
Quote:
Originally Posted by beaner&tiegs View Post
Hey Ksenia!
However, if you're not sure about it, decide to do it but feel wracked with guilt, she'll pick up on this and I doubt it'll go well. I also have this theory that if the mother is desperate enough to follow through (ie not getting enough sleep, sick of contorting their body and beginning to resent nursing) than they can wean quickly. But, if they feel they should or are being pressured to do it, but don't really mind nursing and aren't totally convinced about the reasons to do it, it usually does not go well. So I personally would do some soul-searching and decide what is the true path for you - and then don't worry about it anymore, don't second guess or torture yourself with more research, just trust that your choice is the right choice for you and your family.

Good luck to you, and lots of hugs. xoxo
I'm so right here, right now.
post #11 of 58
Thread Starter 
Quote:
Originally Posted by Piglet68 View Post
I'm a bit confused... Obviously night nursing is not the CAUSE of ECC since many children night nurse without any dental issues (my kids, for example).
Although night nursing does not cause ECC in 100% of cases, it definitely is a risk factor for ECC in children 12+ mo - in combination with other factors, some of which may be very important. I posted about some of the research here.
Quote:
Originally Posted by Piglet68 View Post
Does it exacerbate the condition in a child with ECC?
I'm assuming that it does, since it is one of the risk factors for getting it in the first place.
Quote:
Originally Posted by Piglet68 View Post
But note that, if this is true, then nightweaning will only REDUCE the severity of ECC. The $10,000 question then, is how much of an improvement will you see should you nightwean?
: It's hard to know. I guess the important thing here is that the decay can get much worse than it is now. Spreading to the molars, to all the other teeth, the teeth dying, getting absesses, pain, etc. - these are all common in the progression of ECC. So reducing the progression of ECC would be a good outcome, even if it doesn't completely eliminate the need for conventional treatment. Of course, the inverventional studies have not been done on this so we just have to make educated guesses.
post #12 of 58
Can you pause for a bit and take the wait and see approach?
You are doing a lot right now, and its a lot on your plate.
Nightweaning would add to your stress right now.
I know what you mean about dd being your baby. I too am
not ready to night wean, so I know how you feel. Perhaps
place faith in what you are doing is helping and she won't
worsen (until if and when you do see evidence of this).

Can you also try adding Concentrace minerals to her water?
If the water is filtered it is devoid of minerals and the
bad stuff.

Oh yeah, are you giving her calcium? Would that help?
or the homeopathic (I know calc phos in a low potency,
like 6c? That would deliver calcium, as would a general
tissue salt formula, to give a few minerals all together.

post #13 of 58
Ksenia, once again, I'm impressed by the thoughtfulness and thoroughness of your posts and research. I'm sorry this is such a difficult decision.

If it's any help, I'll share my experience:

My 13 mo dd is almost nightweaned (goes to bed at 7-730, nurses at 4 or 5 am and then back to sleep until 6ish. This is absolutely heavenly compared to how it used to be), and currently an acceptable comromise to the balance of sleep, ECC and not all out night-weaning. She still gets at least 50-75% of her calories from breastmilk. It started at 9 months or so...when, thoroughly exhausted from being woken up for nursing every hour or two for the past 5 months (and then battling insomia on top of that) I decided that things needed to change. This also happened to be around the time that her upper central incisors were erupting...with chunks missing out of the ends (presumably due to food, milk that had pooled in a hidden crevice in gums).

I just picked a time I thought was a reasonable amount of time to go without nursing, and gradually increased that length of time (about by 30 min. each night...but there were times when I did give in earlier - so it took at least a couple months to get where we are now). She wasn't happy about it at night, but I did sing and cuddle (and my dh helped on the nights I didn't think I could do it, or let me sleep in when I'd been up lots). She seemed to forget all about it by morning - didn't seem to affect her. I did, however, notice that the amount of nursing did increase in the daytime. And maybe, coincidentally, she increased her solid food intake.

I'm happy to report that since adopting better dental hygeine and almost nightweaning the two cavities do not appear to have progressed. It's impossible to say why, but I suspect that nightweaning has helped. Since nightweaning (or almost) she has, however, develped one whitish area on side of lateral incisor near gumline...but I hadn't been as picky as I should have been with getting into that spot well with the toothbrush. We don't have molars to deal with though yet....so I know we're not out of the woods.

My dd is happy and nursing every 1-2 hours in the daytime when I'm with her. We brush thoroughly a couple times a day, and always finish snacks with water out of a cup (she likes to blow bubbles...and it's amazing to see how much food particles wash off into the water). When she's hungry she lets me know in many ways (e.g. asking to nurse, fussiness, walking over to her high chair, etc.). Growing well and seemingly very healthy (nothing worse than a mild cold and a bout of roseola to date).

If you choose to nightwean, perhaps your dd will be more resilient than you think? I'm no parenting expert but my experience taught me that my dd can adapt to new routines, when done with love.

Whatever you choose will be the right for you. Best wishes.
post #14 of 58
Thread Starter 
Quote:
Originally Posted by mimi! View Post
Can you pause for a bit and take the wait and see approach?
I don't know. I feel like it's a race against time. I found out that dd has decay on all of her 8 upper teeth . It might have been like that before but I hadn't had a good enough look.
Quote:
Originally Posted by mimi! View Post
Nightweaning would add to your stress right now.
, but OTOH, dd's ECC is my #1 stressor right now. I want to take action if it means protecting her from dental pain and unnecessary procedures.
Quote:
Originally Posted by mimi! View Post
Can you also try adding Concentrace minerals to her water?
If the water is filtered it is devoid of minerals and the
bad stuff.

Oh yeah, are you giving her calcium? Would that help?
or the homeopathic (I know calc phos in a low potency,
like 6c? That would deliver calcium, as would a general
tissue salt formula, to give a few minerals all together.
I'm assuming that she's getting enough minerals from eating cheese every day, and from my breastmilk (I'm taking cal/mag supplements and eating dairy). But I'll look into concentrace, not familiar with that.

dot1, thanks for sharing your experience. I wish you the best of luck with stopping your dd's ECC.
post #15 of 58
Just popping in to add my two cents.

My boy's teeth were perfect up until around the time he fully weaned (2 1/2). It was *after* that that the staining of the molars and the other decay began to creep up.
post #16 of 58
Thread Starter 
Since I have posted about this, I have been trying to shift things a bit with dd. For example, I got her used to falling asleep at bedtime without the nipple in the mouth - this was easier than I expected. Contrary to the the No-Cry-Sleep-Solution theory, however, it doesn't seem to affect the frequency of her nightwaking. The second night she actually slept from 8:30 PM to 3:30 AM. But since then there have been many nights that she has nursed almost all night (seriously). Sometimes when ill, sometimes because she just didn't eat much dinner (when I was alone with the kids and had trouble getting them to focus on eating long enough), sometimes for some random unknown reason. Basically, I don't think it has made any difference. I also tried to get her to drink some water after nightnursings, but that didn't really work.

We went to a great holistically-oriented dental practice yesterday for dd's HealOzone treatment. The dental assistant who has been doing dentistry for 18 years and who has tons of experience with children was totally pro-BF and didn't make any comments at all (knowing that we are BF night and day). But when I asked her directly about whether she has observed any effect on Early Childhood Caries after toddlers have nightweaned, she said that she has definitely noticed that it has slowed down the progress of ECC. If we continue to nightnurse, Lisa recommended using a Tenders Infant Pre-Toothbrush (she gave me one) rinsed in water after nightnursings, but I've doing doing stuff to dd's mouth at night and very often she is not sleeping soundly enough for that. I know from the appointment that dd's decay is in a very active stage. We are doing the HealOzone and I don't want to undermine that.

At this point I am seriously considering nightweaning dd. I really felt that the dental assistant was well-informed about the benefits of breastfeeding and supportive of it, yet her experience has clearly been that nightweaning is helpful when toddlers have ECC.

edited to add: I had linked to a post about this but it has been removed by the moderators here at MDC.
post #17 of 58
first of all - you are doing such a laudable job of handling this stressful situation, kudos to you, mama. i'm so impressed.
i hate to add another variable but have you considered gluten intolerance?
it, in hindsight, did a number on my dear child's teeth and the decay seems to have halted since we've been gluten free. (maybe this has already been addressed - high vit. butter and all, sounds like you would've thought of it... but i just wish i had realized earlier, so i thought i'd mention it.)
i have two other friends who also suspect gluten intolerance, and subsequent poor mineralization are to blame for tooth troubles.
good luck to you!
post #18 of 58
ugh...just wanted to say that i too am now considering nightweaning my 24 mo ds because of ECC. i am not sure they are considered severe (how would we know?)--he's been to the dentist already for treatment and we're doing tons of stuff to try to stop the progression of decay--but i am just second guessing everything.

i can't wipe his teeth after nursing at night w/out him waking and that's my main concern. i'd feel fine about his night nursing if i could wipe his teeth off, but it just doesn't work. anyone have any suggestions there?

sorry for this weird, disjointed post. i was crying last night as we were brushing his teeth. it's totally traumatic for him (we have to hold him down)--i HATE it.
post #19 of 58
Thread Starter 
Quote:
Originally Posted by aileen View Post
i hate to add another variable but have you considered gluten intolerance?
I haven't addressed the food intolerance issue. When dd was born, I suspected dairy and wheat intolerance and eliminated them for a year (from my diet and hers). The symptoms were pretty subtle. But when I started re-introducing those foods I didn't notice any issues with her and assumed that she had outgrown her intolerances (if in fact she had any in the first place). She doesn't have any issues with her skin, respiration, or digestion so if there is an intolerance, there aren't many symptoms. Anyway, the food stuff takes soooo long to track down - it's on the list but not high on the list given the time urgency we're dealing with.

liam's mom. Brushing has gotten easier for us.

Quote:
Originally Posted by liam's mom View Post
i can't wipe his teeth after nursing at night w/out him waking and that's my main concern. i'd feel fine about his night nursing if i could wipe his teeth off, but it just doesn't work. anyone have any suggestions there?
post #20 of 58
Thread Starter 
So we started nightweaning last night. I decided on cold turkey because we just got the HealOzone and I want to start fresh with her decay presumably in a halted stage. We fed dd ice cream right before bed, which helped, and I explained what was going to happen. Her first waking was at 1 AM. She cried and screamed for an hour . She didn't really let me comfort her in any way, though I tried to verbally empathize with what she was going through. Then she sort of half-slept for about 2 hours, constantly rousing and crying a bit then settling when I patted her back and shushed. Then she finally fell into a deeper sleep at about 4 AM. She next woke at 6 AM, at which time I was thrilled to nurse her (the sun was up - that's when I told her that she could nurse).

The whole thing was emotionally draining and physically exhausting. I feel like crap today. It really sucks that dh is all enthusiastic about the nightweaning, but not terribly empathetic about how painful this is for me and for dd. I think I am doing the right thing for dd's dental health. And I don't think that I'm scarring her for life - I think that it's just such a very strong habit for dd, one that's very very hard to break.
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