Estimated reading time: 4 minutes
Updated December 2015
Mandy Handke, Berlin, Germany (translated by Cathy Pilgram, Munich, Germany)
Breastfeeding a baby born with teeth
Johanna was born in 2010 with two bottom central incisors.
This early appearance of teeth is very rare—about one in two thousand babies is born with one or two teeth. Most babies are born without teeth, although the central incisors are almost completely formed in the baby’s jaws at birth. Usually the first milk teeth do not appear until at least the age of four months.
Usually a baby with natal teeth cannot bite his mother while nursing, as the teeth are covered by his tongue and the baby does not yet have teeth in the top of his mouth.
Johanna’s teeth slanted toward the back of her mouth. The sharp edges cut into her tongue while she was nursing and the tongue covered the lower dental ridge. To protect her tongue Johanna developed a method of nursing whereby she retracted her tongue, but this meant that she was nursing less effectively and had problems triggering the initial milk ejection reflex. Another effect of this was that her teeth dug into my nipple and areola. For the first seven weeks, latching her on was extremely painful. And my poor little girl cried frantically. During feeds she would cry loudly, arch, stiffen and refuse to carry on drinking.
In retrospect, I am grateful that we were able to use nipple shields. They made it possible for us to start breastfeeding successfully.
Johanna was not able to latch onto my flat nipple; she was too weak. She kept giving up and needed lots of breaks to gather energy for suckling. Johanna needed two and a half hours for a feed. After that she would pause for about half an hour. She kept falling asleep from exhaustion and I could only motivate her to continue drinking by massaging her feet. I kept trying to latch her on all day long. When Johanna managed it, I made sure that she did not lose the sensation of having my nipple in her mouth. This often meant that I stayed in the same position for hours.
My nipples were sore. At the checkups after birth and at discharge from the hospital no one treated Johanna’s tongue. She did not receive any local anti-inflammatory medication and our request for light pain relief was declined.
The pediatrician advised us to wait and see how things developed. There was some hope that the teeth would fall out as a result of the pressure exerted during suckling, as natal teeth do not “normally” have roots. Full of anxiety I observed her tongue was getting worse. Even the parts that had been intact began to bleed; the swelling and scabs spread further and into adjacent areas. Her teeth cut into her tongue every time she suckled and it became sore and swollen. After two-and-a-half weeks I noticed that her sleeves were often blood stained. She would suck on her sleeves. Later she would spit blood. After four weeks we consulted the pediatrician, who tried to calm us down and asked us to visit him a month later.
I was not prepared to put up with our misfortune any longer. Something had to be done. I searched the Internet and consulted another pediatrician. She referred us to a pediatric dentist, who referred us to a specialist clinic. Two specialists examined my child and quickly came to the conclusion that both teeth should be extracted immediately.
According to specialist literature, natal teeth do not have roots and fall out quickly as a result of suckling. This does not correspond with our experience: Johanna’s teeth were stuck so fast that the dentist only managed to get them out on the second attempt. The roots were deep. You could see holes in her lower jaw where they had been. After the operation Johanna was in a state of shock and did not drink much. She fell asleep almost immediately in my arms and slept for the whole of the journey home.
I was worried about her and whether I had made the right decision. I had swabs to soak in cold water and apply to the wound. When we got home she was hungry and wanted to nurse. I latched her on. She did not cry! I could hardly believe it and still had doubts. But she drank, calmly and eagerly. Maybe this was because she was still affected by the pain medication she had received? I would see how the next feeds went. But even then she was calm and attentive and fed with enjoyment.
We had made it! It took me a long time for me to believe my luck. That night was the first night since her birth in which she nursed calmly and easily. I was very happy. The holes in her mouth and her tongue healed up quickly. She still has a scar.
We had hoped that her natal teeth would be so-called “third teeth” and that Johanna would get “proper” milk teeth. I rang the clinic again and they assured me that the lower incisors would come and that they might be lower in the jaw than usual. However, my gut feeling was confirmed: her natal teeth were her milk teeth and Johanna will have a gap until she gets her permanent teeth. By now (age four) nearly all of Johanna’s milk teeth have come through and our dentist is satisfied with the development of Johanna’s teeth.
Will my baby bite?
When your baby is latched on correctly and nursing actively, getting milk from your breast and swallowing, it’s physically impossible for him to bite you. Your nipple is far back in your baby’s mouth and your baby’s tongue extends over his gums, between his lower teeth and the breast. He can’t clamp down on the breast tissue.
Be extra careful about positioning and give your baby lots of positive reinforcement for latching-on well and releasing your breast gently. Saying “thank you” or “well done,” and smiling, hugging, and kissing can really help even if your child is preverbal.
Pulling him in as close as possible to the breast will cause him to release your nipple because he will feel he cannot get air if his nose is against you. Gently pinching your baby’s nose may also get him to open his mouth and release the nipple.