Dear all,

I am concerned about an article that was printed in Advance for Nurse
Practitioners, a publication often distributed at no cost to NP's
nationally, in the August 1996 edition called Baby Bottle Tooth Decay. The
author is Sally Peters. The subtitle is Strategies for Treatment and
Prevention.

Several times in the course of the article, it is stated that BBTD is
associated with "long periods of bottle or breastfeeding". Bottle and
breastfeeding are treated as equally contributive. The mechanism for the
put forth by the author is:

"During sucking, the bottle nipple or breast nipple rests against the
child's palate, while the tongue covers the lower incisors, which are
protected by the tongue.  For caries to result, the bottle must be filled
with a fermentable carbohydrate, a liquid that can be metabolized to
lactic acid by bacteria in dental plaque .... Fermentable carbohydrate
liquids include juice, milk, soda, breast milk, formula, Kool-Aid,
sweetened tea, or other sweetened liquids. The only liquid suitable for
leaving in the bottle overnight or during naptime is water."

While the article does discuss some sound ideas about preventing BBTD via
hygiene, and limiting consumption of sweetened liquids, etc., it also
promotes early weaning from the bottle (by six months), and by implication
(since breast and bottle are treated as equal risks) from breastfeeding.
NO mention appears anywhere of any of beneficial effects on dental health
or otherwise from breastfeeding.

I plan to respond to this article, and would encourage others to do the
same, especially if you can get access to the entire text of the article.
The editor of the journal is Michelle Perron Pronsati.  Comments can be
addressed to Advance for Nurse Practitioners, 650 Park Ave. West, King of
Prussia, PA 19406-4025. or by email to: [log in to unmask]

Ione Sims, CMN, IBCLC