Thank you Nancy. Kathleen
At 11:45 AM 7/27/2002 -0400, you wrote:
>Excerpt from my article in Peds Clinics NA, April 2001; 48(2):321-344
>Breastfeeding and Dental Health
> The American Academy of Pediatric Dentistry recognizes the distinct
>nutritional advantages of human milk for infants and endorsed the position of
>the American Academy of Pediatrics on the promotion of breastfeeding. 2,3
>However, they note that the risk of devastating nursing pattern dental decay
>exists for the breastfed child as it does for the bottle-fed child, and
>recommend avoiding at libitum nocturnal breastfeeding after the first primary
>tooth begins to erupt. Many pediatric dentists also recommend complete
>weaning by 1 year of age. The American Academy of Pediatrics recommends
>exclusive breastfeeding for approximately the first six months of the
>infant's life and continued breastfeeding for at least one year with addition
>of appropriate complementary foods and continued breastfeeding for as long as
>mother and infant mutually desire. 4
>Early childhood caries result from a complicated combination of factors.
>(Table 5). Breastfeeding has been implicated in the disease but
>population-based studies do not support a definitive link between prolonged
>breastfeeding and caries.123,140,141,160 Human milk does not cause a
>significant drop in plaque pH, nor does it cause enamel decalcification. In
>fact, in a study using enamel powder, calcium and phosphate were deposited
>onto the enamel when breastmilk was present. When 10% sucrose was added,
>caries developed in 3.2 weeks.41 A recent meta-analysis of the available
>literature suggested a common set of public health recommendations for both
>pediatricians and dentists.140 New practice recommendations included
>encouraging breastfeeding for as long as women and infants wish, encouraging
>water fluoridation, encouraging a consistent mouth care regime and tooth
>brushing as soon as the first tooth erupts, and early dental visits (at the
>latest by one year of age). In addition, if a breastfed infant is ever given
>a bottle, it should never be propped and an infant should never go to bed
>with a bottle containing anything other than water.
>Ref 41: Erickson MR, Mazhari E. Investigation of the role of human breastmilk
>in caries development. Pediatr Dent 21:86, 1999
>Nancy
>Nancy E. Wight MD, FAAP, IBCLC
>Neonatologist, Children's Hospital, and Sharp Mary Birch Hospital for Women
>Medical Director, Lactation Services, Sharp HealthCare
>San Diego, CA, USA
>
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Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet
Independent Consultant
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