I have two young children, both with tooth decay. Both were born at home and both were breastfed for a year. My girls have experienced other problems as well, such as intestinal and bowel problems, skin eruptions, low weight gain and allergies all the things which breastfeeding is supposed to prevent. We live a healthy lifestyle and I always treat them homoeopathically. However, I did have dental treatment while breastfeeding. Could this be the cause? LM, Leitrim, Ireland........
The problems your daughters are experiencing may or may not be related. A rare, but recognised problem with some breastfed children is the appearance of dental caries in the primary teeth, often referred to as "nursing caries". Although the cause is thought to be linked with extended breastfeeding, particularly night nursing, there is very little research to verify this. Certainly there is little in the breastfeeding literature to explain why some nighttime nursers get cavities and others do not.
The likely explanation is the difference in the vulnerability of individual children's teeth and the environment they live in.
Because you have had extensive dental work, it is possible that the bacteria which causes dental caries was passed from you, the caregiver, to the infant when the first teeth erupted. The tooth is essentially a hollow piece of bone with an enamel cap. Cavities appear when acid producing bacteria etch away the enamel coating. While many types of cavities appear in the rough or grooved surfaces of teeth, nursing caries tend to develop on the smooth surfaces. This decay pattern is believed to be infectious, passed on by saliva to saliva contact.
If the mother has a history of extensive dental decay, she could easily pass on this "bad" bacteria by sharing spoons, cleaning pacifiers with her mouth, or allowing her saliva to come into contact with her infant's teeth in any other way (Ped Dentistry, 1994; 16: 110-16; Scant J Dent Res, 1990; 98: 193-6). The percentage of individuals carrying these very high acid producing bacteria is only 20 per cent, so it's likely that at least 80 per cent of infants can and do sleep at the breast without developing caries.
If your child does have high acid forming bacteria in the mouth, the best treatment is careful management of the oral flora. From a dentist's point of view, this means careful attention to brushing even these primary teeth, particularly if you don't wish to limit nighttime feeding. Once they erupt, you should try to brush or wipe your child's teeth with a damp cloth after each feed or a minimum of three to four times a day.
A mother who has had extensive dental work may wish to consult her own dentist to help her limit the amount of high acid forming bacteria in her mouth, thus protecting her child further.
Other elements influence a child's vulnerability to caries. In utero exposure to toxins, particularly lead, has been shown to predispose a child to the early appearance of dental caries whether or not he is breastfed.
There is a great deal of literature on prenatal exposure to lead and the eventual appearance of dental caries in children. Lead exposure in the womb has been linked to a weakening of the teeth and a predisposition to dental caries in both animal and human models (Nat Med, 1997; 3: 956; Ped Dent, 1992; 14: 158-66). Among other places, lead is stored in the bones and in the mammary glands; thus a vulnerable tooth may be under attack from within and without. Lead levels in teeth have long been considered a reliable indication of the body's total lead index (Nature, 1972; 235:111; Arch Environ Health, 1975; 30: 483-6; J Ped, 1960; 60: 224).
If you believe that lead may be a problem, you can control the amount of lead your child ingests now. Remember that children are more affected by toxins than adults. While adults absorb an estimated 5 to 10 per cent of ingested lead, children absorb up to 50 per cent.
Make sure you run the tap a couple of minutes before you use the water (especially important in soft water areas, where lead is washed off greater quantity); consider having any old lead piping changed to a copper type; try to avoid going out with your child on heavily polluted days; boost your intake of protective minerals, such as zinc, kelp and apple pectin; and if you can, eat organic fruits and vegetables (never the ones sold on busy, polluted roadsides).