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Comtessa 10-25-2012 11:06 AM

Dear Dr. Sears,


I am hoping you can help arbitrate a dispute I am having with my husband regarding extended breastfeeding and dental caries.


I am tandem nursing both of our children, aged 3 years and 18 months. (The 3 year old is nearly, though not entirely, weaned.) My husband has not been supportive of my choice to breastfeed beyond infancy. It has become the scapegoat of a number of parenting disputes in our household.


The problem of the moment is our 18-month-old’s mouth. He has developed a fairly serious problem with early childhood caries, a problem for which he is seeing a pediatric dentist.


While we do not entirely avoid sugar, we keep it to a minimum, and he generally drinks only water as a beverage, with occasional highly-diluted juice as a treat. He does not drink anything out of a bottle. We brush his teeth 2-3 times a day. There is, in other words, no obvious cause of his dental problems in his lifestyle or diet. I have also become much more vigilant about cariogenic foods & beverages since his tooth decay was discovered.


Despite the fact that our daughter, who is still nursing, has no trouble with her teeth, my husband is convinced that the singular cause of our toddler’s dental problems is his extended nursing. He has insisted that I wean both children immediately, something I am reluctant to do, especially with the toddler. It is causing great conflict in our home.


Our pediatric dentist has encouraged us to night-wean in order to help prevent any further damage to our son’s weakened teeth. I agree that this is wise. I no longer nurse him to sleep, or nurse him at night. However, I still nurse him in the early morning when he wakes, which will occasionally make him fall back to sleep for a short time (30-45 minutes). My husband is outraged over this, declaring that I am causing more problems for his teeth by nursing him to sleep for even that brief amount of time in the morning. I am reluctant to stop, both because I treasure the extra half-hour of sleep and the sweetness of that early-morning nursing session, and because I honestly do not believe it is a risk, especially if I brush his teeth soon after he wakes.


So, my questions are these – I hope you can help us answer them!


1) Does breastfeeding beyond infancy cause dental caries, in your opinion?

2) Does continuing to breastfeed our toddler put his teeth at greater risk than if I wean him?

3) Is nursing him back to sleep in the morning putting his teeth at risk? Does the risk outweigh the benefits, in your opinion?


Our family thanks you greatly for sharing your opinion and advice!

DrBobSears 01-16-2013 10:21 PM

1. no - nursing doesn't CAUSE this.

2. Possibly - once there is significant decay, i do believe that prolonged exposure to milk at night can speed up further decay.

3. Not sure - this exposure, only once a night, might not be that significant. There's already damage, and it will likely slowly progress. The benefits of this nursing time might outweight the slight decay effect. But I'm not sure.  That has to be your call. You could discuss ozone treatments with a dentist that offers that - this can slow down or halt the decay.

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