There are many health benefits to breastfeeding, but prolonged breastfeeding could cause severe early childhood cavities.
In a study conducted in southern Brazil, researchers analyzed the effects of extended breastfeeding on the dental health of children. The average number of decayed, missing and filled primary tooth surfaces and severe early childhood cavities were investigated in children aged five years old.
The team gathered data on 1,129 children born in 2004 in Pelotas, Brazil. Pelotas has a public fluoridated water supply. The researchers also gathered data on sugar consumption at ages two, four and five, as well as breastfeeding at three months old, one year old and two years old.
“Breastfeeding is the unquestioned optimal source of infant nutrition. Dental care providers should encourage mothers to breastfeed and, likewise, advise them on the risk,” lead author Karen Glazer Peres told Reuters Health.
The prevalence of severe early childhood cavities for children at the age of five was 23.9 percent. Almost half of the children had at least one tooth surface that was affected.
“General recommendations such as drinking fluoridated water as well as cleaning a child’s teeth with fluoridated toothpaste before going to bed may help to prevent dental caries,” said Glazer Peres. “These approaches are in line with most of the guidelines for practice and policy recommendations worldwide.”
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Children who were breastfed for a minimum of two years had a higher number of decayed, missing or filled teeth. Their risk of having severe early childhood cavities was 2.4 times higher versus those who were breastfed for only a year.
Breastfed children who were fed for 13 to 23 months weren’t affected by cavities. The breastfeeding was an independent risk for severe childhood cavities, even though the researchers collected data on sugar consumption.
Researchers divided groups of children starting at age two into “low sugar consumption” and “high sugar consumption.” Those who were in the low consumption group had sugar less than twice daily or not at all, while those in the high consumption group had sugar more than twice a day.
The sugar consumption was linked to having severe early childhood cavities only when comparing the two groups. Robert Morgan, Chief of Dentistry at Children’s Health in Dallas, Texas, said there’s no doubt that extended breastfeeding causes cavities.
“The issue is not entirely related to breastfeeding. Babies who sleep with a bottle of milk or take a sippy cup of milk throughout the day or night also have an increased incidence of [cavities],” said Morgan, who was not involved in the study. “The real correlation of breastfeeding is perhaps the number of exposures to food and drink that a child has during the day and night due to the ease of access to mom.”
Morgan said a rise in bacteria and decay potential occurs after a baby eats or drinks for almost 20 minutes. Bacterial growth, acid production and decay potential then decreases.
Parents are recommended to feed their toddlers breakfast, lunch and dinner with a mid-morning snack and a mid-afternoon snack, Morgan said. Once a parent brushes the child’s teeth after breakfast and dinner, there are only three exposures to increased decay rate times.
“In my practice, for the mothers who would like to breastfeed for a longer period, we advise them to follow the recommended feeding schedule regardless of the feeding methods, whether breast, bottle or cup – feed and drink a non-water drink no more than five times a day and never at night – and we encourage the brushing schedule (after breakfast and dinner feeding),” he said.