To be shocked that on demand breastfeeding caused tooth decay

[Ditheringdooley]

My 2 year old needs two teeth extracted and further fillings.

She was bf on demand and fed until 2 and in the night until at least 18m. I did attempt to brush her teeth when first teeth came in at 6m but not religiously and only did so after 12m but it was a horrific battle and she was still having feeds in the night afterwards.

Dentists say that this caused her teeth to rot and she needs extensive work- they suggest under general but I’m pushing for local as could not live with myself if she died under general because I had allowed her teeth to be effed up.

We did seek a referral to NHS over a year ago but never heard anything so will probably have to do this privately. Can’t wait for another potential delayed referral esp with current covid delays.

Any experience to share? I can’t believe this has happened to us. I thought ‘bottle rot’ didn’t happen to BF babies and with my second I will not allow bf at night past 6m.

@Ditheringdooley
The last time I posted on this subject, some of the replies were so vile I left Mumsnet for a year.
I can remember reading a newspaper interview a paediatric dental consultant gave ? about 5 years ago, within this she discussed extended night breast feeding on demand and the number of these children having to undergo GA dentals at her hospital ( I think it was in the Daily Mail -sorry). Anyway, the online newspaper comments were awful, far worse than on this thread.

Her interview definitely mirrored our departmental experiences. Controversial but I very much doubt many UK general practice dentists have seen or experienced anything like the scale of gross caries that most Hospital/ Specialist / Community Paediatric dentists deal with daily in UK children. It's really easy for those within the specialism to become immune, so I think it's important to post ( when I'm feeling brave) on this type of thread from a different viewpoint.

I note you mention that your daughter's Upper lateral incisors are affected most severely, the central incisors less so; bottle caries manifests this way but I have seen the exact same pattern in children who've been nightly on demand breast-fed, within our GA service.

As soon as your daughter becomes cooperative enough, fissure sealing deciduous teeth may be possible. Most 6 year olds can cooperate enough for their newly erupted 1st permanent molars to be fissure-sealed. In my experience, not many general practice dentists do this routinely, so remember to nag yours or ask for a dental therapist/ hygienist referral instead. 3 monthly duraphat applications are a must going forward, not usually used in the under 3s but a case can be made for this in individual high-risk toddlers. There are prescription only fluoride toothpastes and rinses, but your daughter is too young yet and also, the local levels of fluoride in your water supply need to be taken into account.

Safe snacks- carrot sticks, cucumber sticks , cheese, toast & butter, crackers & cheese, plain ready salted crisps ( most crisps contain sugar) and tap-water to drink.
All sugar containing food & drink should be consumed strictly at breakfast, lunch ,dinner. Teeth have enough time then to remineralise between the 3 meals, Stephan's curve shows how the oral pH changes after meals.

Please let her have the GA. I've had 12 adult teeth out and the first ones the dentist pulled so hard my head was lifted off the head rest if the chair. Under GA you feel groggy afterwards but it much better.I have a very small mouth btw and that's why they were removed.

@Angrymum22 Thanks for your informative post. What do you recommend for sweet-toothed 10-year-olds? Apart from trying to reduce their access to sugary things as much as possible, and as pointed out above not snacking through the day on sugary things. Does the chewing gum after meals help?

@SnackSizeRaisin my daughter was losing weight and had no appetite because of iron deficiency anemia. So there was a significant period where getting any food into her was a success. With grandparents that may have included sweet things.

@Angrymum22 absolutely agree with your comments re sugar. I avoid things marketed for children and pre prepped food as it’s full of sugar. I grew up with no taste for sweet drinks and she doesn’t have them, ditto smoothies etc.

Weaning was baby led weaning so more cooked veg and fresh fruit, omelettes, plain yoghurt, bready things rather than fruit based purées. She will not eat cheese, fish only occasionally and we don’t eat meat. But she didn’t really eat anything before 1 and had mostly breastmilk - the issue started well before any other form of sugar was introduced.

I think constant snacking is an issue. Now that she is eating a bit better we will try to be more rigorous around 3 sq meals and fewer snacks - but it’s hard to let go of the fear of her not getting enough nutrients.

@2024R thanks for your helpful post.

Mumsnet is brilliant but Lord it can get heated and massive pile ons. I suppose the thing with parenting is that it’s really easy to criticise others as a way to reinforce choices that you have made for yourself. And a person on the internet is pretty one dimensional and can be made into a monster quite easily. Same goes for the below the line comments you mention.

Many thanks for suggestions for future management and treatment. We will be on this and manage it proactively in the future.

Op I really don’t think people were being mean.

You did post on AIBU on quite a controversial topic - that ebf causes tooth decay. Which you can see from this thread dentists don’t even agree on themselves.

Many people like me are keen people aren’t necessarily put off ebf, while being very sympathetic to what you’ve been through.

@Onceuponatimethen I don’t think I said people were being mean? Unless I’ve missed it... I have certainly seen meaner on Mumsnet and I can certainly handle it - and as you say posted in Aibu for traffic. But appreciate your comment and sympathy :)

I don’t begrudge any comments made (only a couple which just don’t read the OP but even then, this became a long thread and not many are likely to RTFT). I understand most saying ‘it’s brushing not bf’.

I am a huge bf and ebf supporter. But brushing teeth only to feed again half an hour later still exposes the teeth to milk.

I fed my daughter to sleep a lot of the time, whether by choice or that’s just what would happen - do people wake up a baby that’s finally asleep to brush teeth? And bf a baby to sleep is such a lovely way for them to fall asleep and very very hard to end. I only managed it by having partner take over bedtime.

@Ditheringdooley

Hi. Ive got the web address for you. It's a Scottish website but it has some good information for parents and carers.

www.child-smile.org.uk/

Tooth decay can be genetic or due to diet ( a lot of sugar or even lack of nutrients). Don't stress to much. Sometimes it's out of our hands. My daughter has decay even though we brush regularly. But other things have contributed to it.

It’s because milk has a high sugar content, no blame at all but really at 2 he should be having his teeth cleaned last thing before bed.

@Torvean32 thank you for the link.

@faithfulbird thanks. Yes, my mum has a number of siblings- all raised and fed in the same way. All have great teeth except one who just always got cavities eating exactly the same stuff (a no snacking, v little sugar family).

@HOkieCOkie thank you- her teeth are brushed morning and night. And have been since 6m, but brushing 6-12m wasn’t great/ consistent- and undermined by on demand feeding overnight.

Saw a further specialist - v experienced consultant who said that the brushing wasn’t the issue, it was the on demand bf overnight. Presented as classic early childhood tooth decay. Hopefully adult teeth will not be too impacted and will look to a number of things including fissure sealants as part of ongoing treatment.

www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/When-Your-Baby-Gets-Teeth.aspx