Why Don’t IBCLCs And Dentists agree?

By Deann Shaffner

It can be very frustrating for parents to hear from a dentist, that breastfeeding at night, or night-nursing, caused your child to have cavities. The health benefits of breastfeeding are widely promoted, but information that it might cause cavities isn’t forthcoming. That’s probably because it is may not be true. It can be confusing for a parent to hear from a professional that has studied lactation to hear from a professional that has studied teeth that they simply do not agree. One argues that night nursing isn’t a valid reason to wean, and the other insists on weaning at night because prolonged night-nursing might cause cavities.

I’d heard rumors about people who experienced situations where the dentist suggested weaning at night, but when it came time for me to experience this first-hand, I was shocked. During a tooth brushing wrestling match with my youngest son who had recently turned 2, I noticed, not just 1, but 3 dark spots! There were THREE cavities on his front teeth. I instantly felt pangs of guilt. How could I have caused this? Then, I questioned if I was brushing his teeth enough? Was he getting too much sugar in his diet? Did I not have a good brand of toothpaste? Whatever it was that caused the cavities, I had to get him in to see a dentist immediately so we could understand our options and treat the problem.

When Liam’s father came back from the dentist, he told me, “Well, Liam has cavities because he breastfeeds at night, so you have to stop nursing him at night or brush his teeth when he is done. I guess breastfeeding is just as bad as drinking a soda before bed.”

I felt so angry, I yelled, “I AM SO GLAD I AM NOT A FIRST TIME MOTHER! THAT IS NOT TRUE!”

Of course, his father looked at me like I was crazy. I was just a mom saying that my dentist, who is well educated in the study of teeth, had no idea what he was talking about. Who the heck am I to question what my dentist said? I knew from all the books I had read, podcasts of IBCLCs I had listened too, that this was a topic brought up often, and it was always discussed as a myth. I knew the resources I had to navigate, to share with other mothers stating that this was not true (like here on Kellymom.com.)

I just kept saying to myself, “breastfeeding does not cause cavities!” But again, how could I KNOW this, but my dentist did not? I knew I had an appointment for myself in the upcoming months and I decided that would be the time for me to address all my questions and offer the information I had at my disposal. I liked and respected my dentist a great deal, even though I was angered by what he said. In the past, he had made our family feel comfortable, even though he was a very young dentist.

I asked my dentist a variety of questions on the day of my appointment. First, I inquired about what sources for education on breastfeeding and tooth decay he had access too. Then, I asked how he knew exactly what caused my son’s cavities? Lastly, I wanted to discuss why IBCLCs and dentists don’t agree.

Before answering my questions, I could interpret that he felt uncomfortable and that he was not expecting this kind of conversation. The direct questioning of his authority surprised him. He explained to me that he did not have any lactation education. He then shared a brief description from a study in 1984, of the relation of night nursing and cavities in the book Dental Caries: The Disease and It’s Clinical Management on pages 344-347. Then, he then also explained that when my son nurses at night, the breastmilk may sometimes pool around the front of the teeth, which may lead to the cavities.

breastfeeding baby

I knew what he was describing was baby bottle rot. This is because when breastfeeding, the nipple goes far enough to the back of the throat, which does not leave much room for breastmilk to go anywhere but down the throat. But, before I could say anything else, he quickly reminded me that he supports breastfeeding and that I just had to brush my son’s teeth throughout the night when he nurses. With my last question on why IBCLCs and Dentists don’t agree, he simply did not have an answer for me. This upset me because I felt concerned about other new parents (this was my second child) might interpret the conflicting information available to them.

The 8th edition of The Womanly Art of Breastfeeding states, “There is no evidence that nighttime nursing causes cavities. Other mammals with teeth nurse day and night, and they don’t get cavities.

Dr. Brian Palmer studied children’s skulls that were thousands of years old. These skulls were preserved prior to the invention of toothpaste. He found almost no evidence of cavities. Why would this be? One reason is that “human milk does not pool around the teeth during nursing; it is pulled instantly toward the throat and swallowed,” (Pg. 241).

A lot has certainly changed over millennia of human life, including diets and how we live. But, what hasn’t changed is a baby’s wiring to breastfeed, and to receive human milk. Can breastfed children get cavities? Of course, but saying breastfeeding alone is what causes problems, is incorrect. In my own experience, my breastfed son, who was also introduced to a variety of milk including soymilk, almond milk, whole milk, and was also eating whole foods, I probably did not brush his teeth as often as I should have been. My other son had nursed for almost 2 years and at 5 he never had a cavity. My Dentist did not ask me about Liam’s diet, but as soon as breastfeeding came up, the issue of cavities was blamed on that. I do not accept that reasoning.

I’m sure in both the professions of IBCLC and of dentistry, the newest scientific information is relevant and accessible. But, how often do dentists actually get updated on lactation research? And, how often are we studying this issue? There are breastfeeding-friendly dentists sprinkled throughout the U.S., but not everyone has the means to visit with one.

If you’re experiencing a recommendation to night-wean in order to avoid cavities, it might be best to look for the most recent research. Then, as with everything else, make as informed a decision as possible. Evaluate what works best for you and your family, and make sure you’re wiping your child’s teeth twice a day, especially at night. No matter how you feed your child, you cannot 100% protect them from cavities. But, you can help prevent them as much as possible. Cavities can happen to any child, but breastfeeding alone is not the answer to why children may develop dental problems.

Congratulations to Deann for a recent press article at Cayuga NewsDecorative Image Only

Deann’s Other Blogs at MOM: 

How Income and Insurance Can Affect Breastfeeding Support For New Moms

Breastfeeding Education Might Not Be What You Think It Is

Gender Disappointment