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Subject:
From:
Harvey Karp and Nina Montee <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 15 Dec 2002 10:35:18 -0800
Content-Type:
text/plain
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Sorry for resending this ...the first was sent with the wrong subject
heading


Dear Gina,

< Do you have any statistics or research to prove that reflux leading to
dental caries is rare?  >

< But what about a fat and happy
baby who urps all the time?  Is that severe?  >


< In my experience, babies who spit up a lot continue to do so until
they have started solids.  >

< Many
breastfed babies (particularly if they are prone to allergies) thrive on
human milk alone for much of the first year, if not more.  This is ample
time for the reflux to affect the teeth--including the first molars.>


<What I am saying is that if some of these early infancy maladies that
are
considered *normal* are, in fact, manifestations of food sensitivites,
we
would be remiss not to address that b/c there might be long-lasting
implications.>

Dear Gina,

The reason I said caries from GERD must be a rare occurrence is because:

1) During my 25 years as a pediatrician I have seen so few babies with
caries during the 18 months (the period of maximal reflux) other than
babies assumed to have bottle carries or carries from CONTINUOUS night
nursing.

2) GERD (frequent large spit ups associated with poor weight gain,
pneumonias, persistent crying) only occurs in about 0.3- 0.4% of babies
(~2% of the 15-20 % of all babies said to have colic in our culture).
And, in children, it tends to disappear by the end of the first year.
Since the entity is so uncommon, the tiny number who might get dental
caries as a complication from it must be exceedingly uncommon.

It is quite unusual for the first molars (so-called 15 month molars) to
erupt during the first year of life.  So, any risk for caries in those
teeth (even in a child with GERD) is miniscule...and certainly not worth
giving every mom whose baby is a "happy spitter" another thing to worry
about.

I encourage you to try the 5 S's when you run into a mom who is having a
tough time soothing her baby.  If the baby calms easily with this simple
approach, they chance of overlooking a medical problem (and even of
overlooking a hungry baby) is nil.  Babies with GERD, food allergy, ear
infection, urinary tract infections...and hunger may be calmed for a few
minutes with these techniques, but they will soon break out of the
calming reflex because of their level of discomfort.

Best wishes,

Harvey

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End of LACTNET Digest - 13 Dec 2002 - Special issue (#2002-1637)
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