>       This dentist thinks that *perhaps* the babies who stay attached to
>breast all night long, rather than feed and come off, do lots of fluttersucking.
>This fluttersucking *may* cause the breast to drip a drop of milk every so
>often.  But because it's not a mouthful of milk, the baby does not swallow, so
>the drops accumulate slowly before there is a big enough bolus to trigger a
>swallow.  This allows those drops to bathe the teeth in breastmilk and *may*
>contribute to dental caries.

This is an interesting theory. Once when I, as the LC, was in a mom's hospital room with a nursery nurse to give discharge instructions, the nursery nurse told the mom that for cavity-avoiding reasons, she shouldn't keep the baby latched on all night long. I knew this was a pro-breastfeeding nurse who had nursed her own kids well into toddlerhood, so I was surprised that she'd said this. But before I could jump in, she went on to explain that one of her kids had quite a few cavities at a very young age, which "they" could attribute only to prolonged night nursing. I didn't know what to say except "Hmmm."

However, last year when I took my kids to the dentist -- a new one here in Germany -- she told us that dentists now believe that cavities are linked not to sugar per se but to a bacterium, Strep mutans. She said that people whose mouths are not colonized with the bacteria can leave sugar on their teeth all the time but will never get a cavity, whereas people with the bacteria can get cavities even if they don't eat sugary foods (or maybe it's the other way around), and that you can get your saliva tested to see whether you're cavity-prone.

A website I found said that newborns aren't born with the bacteria but that it can be transferred from caregivers. I'm now wondering whether "bottle mouth" isn't related to the formula (or juice) as much as it is to the bottles and nipples that are handled by the caregiver. Should we go back to telling people to sterilize bottles and nipples, including parents who give expressed breast milk by bottle? Any ideas on this?

Jennifer Herrin, RN, IBCLC
Germany

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