Wednesday, June 04, 2008

Dental Care for the little ones

My little one has turned 2 ½ years old and is still nursing, with no signs of stopping. I’ve been weaning little by little using the La Leche League, “Don’t offer, don’t refuse” method. Sometimes I’ve been known to try a little distraction to see if she really feels like nursing. That’s led to some interesting mommy-toddler conversations like,
“Not now. Do you want some (cow’s) milk?”
“No. Nummies.”
“You want some foods?”
“NO! Nummies! Nummies in rockin’ chair NOW!”

The problem we have is that she loves to nurse herself to sleep. Another is that she has many caries, aka cavities, aka bottle mouth. Of all the “I nevers” I’ve had as a mom-I’ll never co-sleep, I’ll never nurse a toddler, I’ll never give in to a temper tantrum-I would probably say my most emphatic was, I’ll never have a child with bottle rot. And she’s never really had a bottle, so why the cavities?

From what I’ve read and from my own earlier experiences with breastfeeding, breast milk is supposed to be protective of teeth. Indeed, when I first breastfed 17 years ago, I didn’t think it was possible for breastfed babies to get cavities. The July/August 2002 issue of Mothering magazine notes that only recently have studies of ECC(early childhood caries) distinguish between breastfed and bottle fed infants. Of note in the article is that some studies indicate that a strain of bacteria, Streptococcus mutans, may be responsible for tooth decay in infants. The bacteria are colonized and benign in adult mouths and passed to the baby by sharing food, cups, etc.

Other studies have shown that while breast milk alone offers protection from cavities, combining breast milk and sugary substances can actually hasten tooth decay. The American Academy of Pediatric Dentistry put out a press release in 1999 saying this:
Researchers concluded that breast milk prohibits acid and bacterial growth in the mouth. However, breast milk has a "low buffering capacity" and does not buffer the addition of acid. When breast milk is alternated with sugar, the rate of caries development is faster than that of sugar alone.

According to Burton L. Edelstein, DDS, MPH of the Columbia University College of Dental Medicine, ECC is an especially rapid form of tooth decay. It usually starts behind the teeth, so it can be hard to spot. So what can a breastfeeding mom do to reduce the chance of ECC? Some suggestions from Dr. Edelstein:

You can take steps to protect your child's teeth through proper care:
Clean your baby's teeth and gums with a damp cloth or a soft toothbrush after each feeding.
Take your baby for his or her first visit to the dentist as soon as the first tooth erupts.
Teach your baby to drink from a cup by his or her first birthday.
Make sure your baby is getting the right amount of fluoride. If your town does not have fluoride in its drinking water, ask your pediatric dentist or pediatrician about fluoride supplements.

You can give your child the benefits of breast milk and help avoid tooth decay if you follow these guidelines:
-Breastfeed your baby for at least a year, as recommended by the AAP.
-As your child begins to have other liquids and solids, limit how often he or she consumes foods that contain sugar. This is one of the most important things you can do to reduce the risk of cavities for your child.
-Establish sleep routines early in your baby's life. According to the AAP, by age 6 to 8 weeks babies should learn how to get to sleep on their own without being rocked or fed. By age 6 months, most babies should be able to sleep through the night.
-Avoid long periods of breastfeeding, particularly when your child is very sleepy or falling asleep at the breast.

More links, if you're interested: