> I'm having the same problem with my 20 month-old daughter, Emma. Bottle
> mouth among breastfed babies seems to be common enough to warrent
> further study.

This was discussed in late June - check the archives. I posted on a
study done by Dr Harry Torney, a dentist from Ireland. He
presented at the LLLI Conference in Chicago in July 1995 (the audiotape is
excellent) and I understand a copy of his thesis is in the LLLI Library.

He found no correlation between early onset (<2yrs) dental caries and
breastfeeding patterns such as frequent night feeds, feeding to sleep,
etc.  He is convinced that under normal circumstances, the antibodies in
breastmilk counteract the bacteria in the mouth that cause decay. However,
if there are small defects in the enamel, the teeth become more vulnerable
and the protective effect of breastmilk is not enough to counteract the
combined effect of the bacteria and the sugars in the milk. Enamel defects
occur when the first teeth are forming in utero.

His explanation is based on quite a large study of long-term breastfed
children with and without caries. I find it more plausible than the "milk
pooling" theory, which I think is just a good explanation someone came up
with to try to explain why breastfed toddlers generally have less caries -
as they do. Personally, I think some breastmilk inevitably works its way
round the mouth anyway, just as sweetened drinks, drunk through a straw,
inevitably spread their taste throughout the mouth.

Yes, we do need more studies.

Ros Escott BAppSc IBCLC
Tasmania, Australia
Mother of a breastfed child who developed early dental caries.