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Lactation Information and Discussion <[log in to unmask]>
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Mon, 12 Aug 2002 06:41:49 -0400
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This from an old note of Nancy Wight's (MD)...I had saved it. Isn't it great?

Kathleen

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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