Tooth decay: Can it be caused by nursing?

My baby often falls asleep at the breast -- and I usually just let her crash that way. My mother told me that nursing has the same effect as a bottle on a baby's teeth. Can nursing really cause tooth decay?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Some breastfeed babies will develope tooth decay -- but there seems to be no evidence that tots who nurse at night are as susceptible as those who sleep with a bottle in their mouths.

Tooth decay in infants, sometimes referred to as "nursing bottle mouth" is thought to be infectious. The strep mutans bacteria is responsible for dental caries. The transfer occurs through saliva to saliva contact, from mother or caregiver to baby, once the baby teeth have erupted. It is thought that only around 20 percent of the population has increased levels of high acid producing bacteria, putting them at risk for developing dental decay.

There are several other factors associated with dental caries: defective tooth enamel; maternal stress during the pregnancy, limited intake of dairy products during pregnancy; and an illness in the mother during pregnancy.

Some dentists recommend altering a baby's pattern of breastfeeding, reducing total number of feeds, and avoiding nighttime feeds, but this can be hard to accomplish.

To help cut down the chance of early tooth decay:

  • Regular dental care is very important for the pregnant mother. When dental decay is repaired, it is theorized that the amount of strep mutans bacteria present in the mouth is reduced, so there is less likelihood of exposing her child to this bacteria that can cause decay. This is especially important if she has a history of dental decay.
  • Brush your baby's teeth as soon as they erupt with a small, soft bristle brush, or wipe with a damp washcloth (at the minimum) following daytime feeds.
  • Avoid saliva-to-saliva contact with your baby. (Basically this means that you should avoid sharing spoons, chewing food for your baby, or putting your baby's pacifier in your mouth.)

Good dental habits will prevent dental decay: help your tot brush his teeth (hold the brush with him), use floride toothpaste, limit nighttime eating and serve healthy snacks. 

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