baby’s head at a different angle. In addition, a frenum attachment can cause difficulty swallowing. Once the attachment is released, tongue placement and the proper swallow of milk can take place. At one time midwives kept one fingernail long and sharp to “clip” the frenum if the attachment was too tight. Today, the pediatrician often does this as soon as possible after birth. Bottle nipples allow milk to flow freely, which encourages the child to stop the continuous flow of milk with the tongue so as to not choke on the rapid flow of milk. This may result in a tongue thrust, which can exert a great deal of force to change the shape of the mouth and placement of erupting teeth. The milk can also pool in the mouth and if there is teeth erupted, pooling around these teeth can result in decay. 3. How long is breastfeeding helpful? The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life, after which “infants should receive nutritionally adequate and safe complementary foods while breast-feeding continues for up to two years of age or beyond.” The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first six months of life. The AAP states, “breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.” This addresses the nutritional aspect but there are other needs that are met by breastfeeding for longer periods of time. It is nurturing as well. Those needs are harder to define. In times of illness breast milk may be the only food the infant or child may be able to toler-ate. The list of benefits from nursing includes prevent-ing obesity, a lowered risk of; heart disease, type 1 diabetes, multiple sclerosis, asthma and allergies. Research suggests that nursing may also play a role in preventing ulcerative colitis, Crohn’s disease and some childhood cancers. A child led weaning is usually the best choice for all. Not many argue when a child of the age of two or even three years old is walking around with a bottle, but if that same child were being breast fed, there may be raised eyebrows. Yes, this child now has teeth and there are precautions that must be taken as for any child with teeth. breast milk. But, when just a small amount of sugar was added to the breast milk, that mixture was worse than a sugar solution when it came to causing tooth decay. This emphasizes the importance of good oral hygiene. A study by Dr. Norman Tinanoff showed that breast milk itself does not cause cavities as much as previously thought. He believes that the milk proteins in breast milk protect the enamel on the teeth and that the antibacterial qualities in breast milk stop the bacteria from using the lactose in breast milk the same way as regular sugar. Dr. Tinanoff also showed that five minutes of breastfeeding lowered the pH level to only slightly more than rinsing with water. There are studies showing that xylitol, disables the bacteria causing tooth decay. Xylitol is naturally occur-ring, found in birch bark and corncobs and sweet tast-ing. There are various ways to use this for a child from infant drops (Spry) to xylitol mouth wipes (Spiffies). The enzymes found in breast milk may also have positive effects. The milk enzymes include: factor, which allows for the growth of • Bifidus beneficial bacteria; keeps the PH in the gut low; and supports an "unfriendly" environment for the growth of bacteria. • Lactoperoxidase aids in the destruction of strep. • Oligosaccharides aid in obstructing antigens from attaching to the gastrointestinal tract. 5. How does breast milk contribute to dental decay? Breast milk actually includes ingredients that fight decay. As mentioned, the component lactoferrin kills streptococcus mutans. The enzymes, lactoperoxidase and lactoferrin reduce the oral bacterial counts. Lactoperoxidase also protects the child’s intestinal tract from infection. What can cause decay are enamel defects, high carbohydrates in the child’s diet, and the oral hygiene of the mother and infant, especially involving the presence of strep mutans. Milk pooling does not occur with breastfeeding, as the milk does not release unless the infant/child is actually sucking and swallowing. If human milk is provided by a bottle, pooling can occur. Bottle-feeding is a risk factor, even with human milk. When the child has teeth there are often other foods involved other than breast milk. The sugars in these foods combined with a lack of proper oral hygiene is what is usually responsible for caries. There are a number of dentists and researchers who do not believe that breastfeeding, even at night, causes dental caries. In a study led by Dr. Harold Slavkin, DDS, "Population-based studies do not support a definitive link between prolonged breastfeeding and caries." Dr. Constantine Oulis and colleagues concluded that breastfeeding may "act preventively and inhibit the development of nursing caries in children." Dr. Harry Torney looked at 107 children who had breastfed for at least two years (about half were still nursing at the time of the study). His results indicated there is no evidence to support the view that prolonged; on-demand breast-feeding is likely to lead to dental caries. 4. What in breast milk decreases the potential for decay? Breast milk may actually help prevent decay. One component found in breast milk is lactoferrin. Lactofer-rin kills streptococcus mutans, the bacteria that causes decay. According to studies conducted by Dr. Brian Palmer, “Human milk alone does not cause dental caries. Infants exclusively breastfed are not immune to decay due to other factors that impact the infant’s risk for tooth decay. Decay causing bacteria (streptococcus mutans) is transmitted to the infant by way of parents, caregivers, and others.” A study by Erickson indicated that breast milk alone had a pH similar to water and did not cause tooth decay and another experiment showed that teeth became stronger when immersed in 30 November/December 2011 JAOS
Journal of the American Orthodontic Society November-December 2011: Page 30
