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.

I think there is an understanding about how the mechanics of bf work. When they are latched on, milk goes straight down.

But that isn’t how it works 100% of the time especially when feeding at night and for comfort. As they fall asleep, they lose the latch and the nipple is more forward in the mouth- if you’ve just had a let down there can still be a bit of milk escaping or milk pooling somewhere in the mouth - or it moving around as you swallow etc. The teeth need to be completely clean overnight especially as the reduced saliva reduces protection.

I will certainly try to stop nightfeeds sooner with my next baby as well as being much more rigorous around oral health generally. I am left thinking there has potentially been a combination of my failures and some sensitivity/ weakness in her teeth - or that period where she was reverse cycling causing a lot of sugar exposure overnight. A few medical things to investigate too.

I’m not letting myself off the hook there- but I can’t believe that perfection in diet or oral hygiene is realistically being practiced by so many people out there (but that’s a common bias- to assume that others make the same mistake as you so I may well be wrong).

It’s also not enough to say ‘I bf and my children didn’t have issues therefore it can’t happen’. That also happened to me as a child but that is invalid anecdata on its own. I’m happy that you were lucky - but others are not so.

Thanks to all who have contributed. A shame that an interesting post by a dentist was deleted because they were attacked - I don’t think they were outing any patients. Appreciate all experiences, personal and medical shared.

@Gwynfluff it is amazing. But (I) it should be the default, not formula as the baseline and bf chosen for extras like IQ etc. That encourages people to think well I’m fine with the standard.

I’m not sure I agree that modern formula replaces BF today- even in a rich, industrialised country with access to clean water. I have seen too many people toting around bottles of warm formula where they have fundamentally misunderstood that you can’t keep it warm for long because it contains bacteria.

(2) misinformation helps no one. Bf has some superpowers in terms of immune response etc, satiety, impact on lots of things like future weight control. It’s not a replacement for toothpaste and can impact on oral health. But the impacts and effects do not seem to be fully understood.

It's not the BF itself it's the not brushing the teeth once they came through, which is highly neglectful as we all know that teeth should be brushed daily.

It’s not a replacement for toothpaste and can impact on oral health. But the impacts and effects do not seem to be fully understood.

By whom? Most of us got the memo about brushing teeth

@Ditheringdooley NHS dentists will seal your toddlers teeth for free, and you are advised to start taking them as soon as their first milk teeth appear.

‘Thanks to all who have contributed. A shame that an interesting post by a dentist was deleted because they were attacked - I don’t think they were outing any patients. Appreciate all experiences, personal and medical shared.‘

It wasn’t deleted; the poster withdrew it. I don’t think I attacked the poster. I apologise to her if it came across that way.

My daughter had tooth decay, only in the front top teeth, and I also fed on demand until 2. My son had no decay from a similar feeding pattern. Big difference was the snoring, mouth breathing and drooling, which was caused by v enlarged adenoids. They were removed just after 2 and her snoring largely stopped as did the mouth breathing. However, the damage had been done.. The mouth breathing means the mouth is left partially open through the night, so the protective saliva dries, meaning the sugar is more at liberty to attack the teeth. Her teeth have decayed no further since..

@FourTeaFallOut I don’t think you’re familiar with the concept of reduction ad absurdum in the comparison of breastmilk and toothpaste.

The relationship between dental health and breastfeeding post 12m is not well understand and more research is proposed by researchers in this area. In large part because of confounding factors and because the population of long term bf babies is so small in places like the UK. That is the relationship which is not well understood. Not by me, you, or the preponderance of scientific opinion.

@Stripesgalore withdrawn/ deleted - I wasn’t being precise there. I can’t speak for the other poster but I thought it was a reaction to your comment. Not a big deal, we’re all expressing opinions here and people can withdraw/ delete messages.

I found your messages generally helpful especially links and it’s clear you were well intentioned, thank you for sharing.

@falalalaoops she does sleep with mouth open, always has. So that is quite interesting - and makes sense. Glad you have had no further issues.

@TantricTwist you haven’t read the updates or original post. I brushed, but clearly not well enough and brushed the teeth that were in but not always the gums where no teeth.

I’ll be off to tell the Social services that someone thinks I’m highly neglectful online, thanks.

@Thelnebriati we took her at 12/13m and asked about those services - were told that not available for child of that age and they would refer (which we never saw/ has never come up). It depends who you land upon. I definitely will push more for sealant/ fluoride treatment going forward. And not stop at one dentist.

Of course no dentist can do fillings on a 2 yr old, unless she is unconscious which means a general anaesthetic.

Under no circumstances would I allow a child to have a GA at the dentists surgery or administered  by a dentist.  It must be done by a professional anaesthetist with paediatric experience, in hospital where they have the staff and equipment to deal with any problems, including emergency resuscitation. 

Your daughter must have been eating solid foor for at least 18 months  so that I suggest that's a far likelier  source of  bad teeth , than breastfeeding.

I don't know if this has been mentioned before, but babies are not born with the bacteria in their mouth that causes cavities. They usually get it from their parents, when the parent uses the baby's spoon to taste their food, clean a dirty dummy in their own mouth before giving it to baby etc.. Breastfed milk doesn't pool around the teeth like a drink that's drunk from a bottle or a glass so it's unlikely to cause tooth decay. Also milk teeth should not be flossed. Only advised when permanent teeth have come through. You do use fluoride toothpaste right? Bigger kids should have a piece of fluoride chewing gum after every meal to stop the acid attack in the mouth, a piece of cheese will do the same thing for younger kids.

Sorry, no such thing as fluoride chewing gum. Meant to say xylitol gum..

@Floatyboat

Are you trying to undermine breast feeding. These messages might be harmful to women op.

Yes, the truth is so undermining.

The difficulty is that there is not much evidence either way, unless I’ve misunderstood.

Extended bf is rare and it’s therefore hard to compare a large population of extended bf children with those who aren’t

Also there are other shared factors between those who extended bf which might be difficult to strip out

Without evidence either way I’m not sure anyone can allege there is a causal connection.

You can’t use any individual child as a control, obviously. Op will never know how her baby’s teeth would have been if she hadn’t bf

More info on what I just said..

www.mychildrensteeth.org/education/parent_fact_sheet_on_caries_bacteria/

The last one I promise 😅 Hope it's helpful ❤️

macgregordental.com.au/transmission-cavity-causing-bacteria-mother-child/

I’m not letting myself off the hook there- but I can’t believe that perfection in diet or oral hygiene is realistically being practiced by so many people out there (but that’s a common bias- to assume that others make the same mistake as you so I may well be wrong). It’s also not enough to say ‘I bf and my children didn’t have issues therefore it can’t happen’. That also happened to me as a child but that is invalid anecdata on its own. I’m happy that you were lucky - but others are not so.

That’s a great mindset to have OP. There are many factors that contribute to tooth decay such that it is all about minimising risks but accepting it can happen even if you do everything right. Breastfeeding minimises the risk for the first year. After that, there are too many other factors in play- tooth brushing, diet, genetically determined enamel strength, availability of dental and hygienist care, etc etc to be able to point the finger and say “it all your fault”.

Anyway, I wish you the best with getting the extraction done.

BF at night until about 2 with both DCs and their teeth at doing great!

How is her diet?

For anyone looking for tricks, with small children is easier if you brush "the other way round". For example you sit in the edge of the bathtub with DC between your legs and you brush from above with their head on your lap. (Does that make sense?!) also get a finger toothbrush.

Dentist here. I bf DS until he was 2. DSis, also a dentist, bf her two dc until they were 18 months. None of them developed dental caries. Contrary to popular belief we don’t deprive them of sugar, but maybe we are more aware of the types of foods that cause the most damage early on. Dried fruit based snacks are probably the worst ie raisins, in fact most ‘healthy’ snacks are incredible unhealthy for teeth.
I am happy to admit that I didn’t do the best job cleaning DSs teeth but relied on positive reaffirmation to control what he ate. From an early age if he was offered any sugar containing foods I just told people he didn’t like them. If I wanted him to eat healthy foods I would always say he loved them ( he still loves broccoli as a result). Children learn what is safe to eat very early on and will refuse most things unless you let them know it is safe, this is a simple survival instinct.

To the OP, it is likely that the dental decay that has developed in your dcs mouth is due to hidden sugars particularly fruit based foods. If you weaned on fruit purées and fruit juice then there lies the problem. I have been in practice for over 30years and have never seen a case of early caries obviously due to bf. I see one family where all three boys were bf until over 5yrs old. All have amazing teeth.

I advise mums to wean on veg purées and raw veg. Fruit smoothies are the devils spawn in dental circles. You can spot a conscientious parent who religiously feeds her DC the healthy 5-7 a day, their children often have awful teeth. Raisin damage can be devastating.
The biggest problem is often the grandparent induced caries. They forget all the rules and will steamroll all of your good work overnight. My Dmil used to reward my nephew ( who she provided full time childcare for) with chocolate buttons after every nappy change from 6mnths old. A dose of sugar at regular intervals is the best way to reduce the ph for long periods of time in anyone’s mouth.

Extended bottle feeding causes tremendous damage particularly bottle propping. Bottle caries is very much ‘a thing’. The decay effects the front teeth mainly and presents very typically. Op, if your Dc has cavities mainly in the back teeth then I would be very surprised it was anything to do with b feeding. Has your dentist considered severe hyperplasia/ hypercalcification. There are many developmental problems in teeth which look like decay and often lead to decay so are not always noticed. Does anyone else in the family have a history of crumbling teeth early in childhood? Also does your child have reflux, it can be symptomless, the only sign is the destruction of the front teeth, it does have a distinct pattern though.
My first step with any child with early caries is to ask the parent to do a food diary then look to see if eating habits and dietary sugars or acids are the cause. You can spend months treating a child with a deteriorating mouth and miss the blindingly obvious if you ignore diet. Once you know what is causing the problem it’s then easier to prevent damage to the permanent teeth further down the line.

Fascinating post @Angrymum22 thank you and very reassuring

Under no circumstances would I allow a child to have a GA at the dentists surgery or administered by a dentist. It must be done by a professional anaesthetist with paediatric experience, in hospital where they have the staff and equipment to deal with any problems, including emergency resuscitation.
^
Dentists haven't administered GA since circa Poswillo report in 1991/1992 and furthermore, dental GA outside of a hospital setting became obsolete in around 2000.
The rest of the statement is factually correct but I take issue with your use "professional anaesthetist" . Hopefully there aren't too many unprofessional anaesthetists around.

Op the breastfeeding is a bit of a red herring here, as is the brushing. Your daughter's teeth were obviously not right when they came through, and anything you did would probably not have prevented the problem.
I doubt many people are managing a perfect tooth brush on their 6 month old every night.
Further research is obviously needed on the breastfeeding issue. I don't think it's rare to bf past 12 months at all. Even if it's only 0.5% of babies, that's still a lot at a national level. Lots of people still give a night feed past one as well. And most bf babies are fed at night up past the age their teeth come through.

On the subject of snacks - just cut them out altogether. 3 meals a day should be sufficient. Plus water to drink. That's probably why so many toddlers have tooth decay nowadays - they eat constantly. This was almost certainly never the case in the past.

Blaming tooth decay on breastmilk when you didn't brush her teeth... is like blaming your dodgy stomach on the pack of ready salted crisps you ate after 10 pints of beer.