Dear Michelle,

I wanted to share my story which is similar to Nikki’s. 

My first child, my son, developed severe caries when he was 2 years old. His molars had only been in his mouth for a few months when I looked up into his mouth one day and was shocked to see that they looked “hollowed out”. The dentist blamed night-nursing. I was completely devastated. That was the first thing that came to my mind when I read your email, Michelle, how devastated I was. I felt like a terrible mother. After battling the criticism I faced by extended family for breastfeeding beyond 2 years old, to be told this was all my fault was crushing. We also ate a healthy diet of homemade food but I admit that I didn’t always brush his teeth before nursing him to sleep.I had been told to give my son Iron supplements by my doctor (in retrospect, his levels were “on the low side of normal” and not “low” but I didn’t know this at the time). 

My son had dental surgery and came out with four shiny metal caps on his molars. Following that, I was much more careful about brushing his teeth right before I nursed him to sleep. Nursing during the night ended at just over 2 years when I became pregnant with my second child but he continued to nurse to sleep until his fifth birthday. I found a wonderful paediatric dentist who “sealed” in the deep grooves of his remaining molars to prevent future cavities. He had a couple more cavities after that in his baby teeth during later childhood but nothing major. He is 22 now and his adult teeth are strong and beautiful with almost no cavities. I came to the conclusion that his baby teeth simply didn’t form well in utero. 

My second child, my daughter, had beautiful healthy teeth. I had consumed much more calcium during pregnancy and all was well. Then, I was told again, to give her iron supplements. Within 2 weeks of starting a natural iron supplement, one of her front teeth turned grey and broke in half! She had to have surgery and again I was devastated. I stopped the iron supplements right away. Again, in retrospect, I don’t think she needed them either. I continued to nurse her to sleep and through the night until just after two years old and to sleep until her fifth birthday. She had no more caries after that single dramatic one. I did get her molars sealed as a preventative measure. 

I then had two more daughters. I brushed their teeth before sleep faithfully, healthy diet, no iron supplement. They both nursed through the night until they were two years old and to sleep until their fifth birthdays (The older ones told the younger ones “you get to nurse until you’re 5!” so none of them stopped before then!). And neither had any dental issues at all. I also had their molars sealed. All of my children have strong, beautiful adult teeth. (Ages, 22, 19, 16 and 12 now)

So, was the iron to blame? For both of my older children I used a “natural” supplement that required a dosage of around 2 Tablespoons of this juice/iron suspension. I never used the traditional drops. So the problem may not have been the iron but the “iron in juice”. Although some people believe that iron supplements cause caries, the research does not seem to support this. 

Did night- nursing cause this? No. Nursing with food still on the teeth might have been a problem, but night-nursing on clean teeth did not lead to caries in my family. One problem I have found is that dentists only ask about night-nursing when they see caries. They don’t tend to look into a cavity-free toddler mouth and ask about night-nursing. So they can develop a skewed perception of the relationship between night-nursing and caries. After the experience with my older two children, I made a point of telling my dentists that my younger two also nursed at night just so that they would have some other point of reference. 

It is impossible to know, in retrospect exactly what leads to cavities in some and not in others. This is why we need good research. This is just the story of my family and my four children.

I am glad this mother has your encouragement and support at this time. I hope this is helpful. Please feel free to share this with her if you think it will help her.

All the best
Cecily Heslett, IBCLC (in private practice)
Elora, Ontario, Canada
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