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Dental Caries Features
Leigh Anne O’Connor, IBCLC
Photo: Sadie Jimenez by Sydney Richardson

Dental caries and breastfeeding 

When my first child, Phoebe, was about a year and a half old I noticed some discoloration on her front teeth. Our pediatrician referred us to a pediatric dentist. Phoebe had cavities! I was shocked and embarrassed. I had made sure her food was fresh and healthy. The first taste of sugar was a tiny bit of cake on her first birthday. How could this be?

The pediatric dentist was very nice and calming to both Phoebe and me. She told me it was from nursing at night. Hmmm. I asked my La Leche League Leaders about this. They assured me that if breastfeeding at night caused dental caries that would be evolutionary suicide. That made sense to me but I still wanted to know why my daughter had these cavities. Luckily, they were quite superficial and did not require any painkiller, just a sense of humor, and some gentle guidance from Dr. Wild.

Much of the information on night nursing was in connection with “bottle rot,” a condition that does cause cavities in babies who sleep with a bottle. The milk is pooled in the mouth differently from when a baby nurses at the breast. Also, what is in the bottle is important—is it formula, cow’s milk or juice? These liquids, as well as being sweet, do not have the antibacterial properties of human milk.

When I was pregnant with Phoebe, I had  a urinary tract infection for most of my second trimester. This infection was resistant to all of the antibiotics I was taking and I was on antibiotics for about six weeks. I took cranberry tablets and it eventually cleared up. Although there is no scientific research to back me up, I wonder whether there might be  a correlation between prenatal use of antibiotics and dental caries.

The second thing I found was from Brian Palmer DDS, who carried out pioneering dental research demonstrating the importance of breastfeeding for the proper development of the human species  It is evidence-based research on why breastfeeding does not cause dental caries.

What does cause cavities?

  • Diet: a diet high in sugar including dry fruit, sugary treats, especially those that are sticky and do not dissolve, fruit juices, and sodas
  • The bacteria Strep mutans
  • Poor oral hygiene—both in the infant and the family
  • Enamel defects
  • Saliva flow: a dry mouth is more likely to develop caries

Oral hygiene is very important. It can affect your entire health, good or bad. Poor oral hygiene has been linked to diabetes and heart disease.

So what are we to do about the oral health of our nursing preschoolers? 



The first thing to do is find a child friendly dentist and bring your baby for a checkup around his first birthday. Make sure the atmosphere is fun, the experience not too overwhelming, and that they have pintsized sunglasses and silly stickers.

Be prepared for some education. I mean you may need to educate your dentist. You may have a conversation about your nursing history. If you are nursing your baby at night (how many babies actually sleep through the night?!) you might get something like this:

“You should not be breastfeeding at night, it will cause dental caries. And if you do, you must wipe your baby’s teeth with a cotton gauze after each feeding.”

The American Dental Association did a study that found there is no association between breastfeeding and early childhood caries.

What can you do? As with parenting in general, be a good role model. Go to the dentist regularly, and brush your teeth regularly. Eat a healthy diet of whole foods. Avoid sugary foods except in small quantities and for special occasions. And brush your teeth!

If you have poor oral health do not share food with your child directly from your mouth. You could pass the bacteria Strep mutans to him.

There is research that supports pre-mastication for babies and young children as saliva can support the immune system; however, if your mouth is full of cavities you can pass those on as well. If you have a healthy mouth bite off that piece of Granny Smith apple and feed it to your baby, if not, cut the apple.

Let your baby see you brush your teeth. Let your baby brush your teeth! Make it fun. Brush each other’s teeth.

Let your baby help you in the kitchen, in the garden, in the grocery store. These are all teaching moments. You can build upon the strong foundation you began with breastfeeding.

Babies get cavities in spite of breastfeeding not because of it.

Oral hygiene is very important. It can affect your entire health, good or bad.

Leigh Anne O’Connor, IBCLC is a La Leche League Leader in New York City and maintains a private practice as a Lactation Consultant. She especially loves leading the LLL Toddler Meeting. She lives in Manhattan with her husband, Rob and their three children.


Breastfeeding and Dental Health

Breastfeeding and Oral Development

Dental Caries

Is Breast Milk Nature’s Toothpaste?

Tooth Decay in Toddlers

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