Is breast feeding a likely cause of dental caries in young children?
1979; Elsevier BV; Volume: 98; Issue: 1 Linguagem: Inglês
10.14219/jada.archive.1979.0028
ISSN1943-4723
Autores Tópico(s)Breastfeeding Practices and Influences
Resumoi^ ^ d v isn rv boards o f organizations that advocate unrestricted, at-w ill breast feeding and notably La Leche League International have received calls from their members regarding recent reports o f “ nursing caries” in young children. It seem s that dentists w ho recognize the pattern have suggested that the mothers discontinue nursing as a means of prevent ing further decay. The mothers, o f course, want to take their dentist’s advice and yet it is against all that they believe to be best for their children. The syndrom e characterized by a rampant caries pattern beginning with the maxillary anterior teeth and eventually affecting the posterior teeth in a healthy, bottle-fed infant or toddler has been de scribed as “ nursing bottle m outh” by Fass1 and by others.2 T w o recent reports3,4 attribute a similar caries pattern in eight children to total breast feed ing. Is breast feeding also an etiologic agent in this caries pattern? In unrestricted breast feeding, a child, sleeping in the same bed or at least in the same room w ith the mother, nurses at w ill during the night; he suckles w hen necessary and sleeps betw een feedings. The m other’s breast is both the nourisher and the pac ifier. A t-w ill, unrestricted breast feeding allow s the mother and baby to obtain necessary rest, yet to m aintain bodily closeness and sufficient suck ling to ensure an adequate m ilk su pply and con tinued suppression of ovluation. If the mother is counting on breast feeding to delay her return to fertility, she has no alternative but to practice unrestricted breast feeding, includ ing at-w ill feedings throughout the night.5 It has been sh ow n 5 7 that suppression of ovulation as sociated with nursing cannot be achieved if suckl ing is discontinued for long periods (such as during the night) or is interrupted by supplem ental feed ings. The reports linking early caries patterns and atw ill nighttim e nursing propose that m ilk stagnates on and around the teeth w hen the child falls asleep. This, in turn, enhances plaque formation, becom ing a causative factor in the evolving caries pattern. From a physiologic view point, how ever, the scenario just described probably does not happen in the nursing infant. A dditionally , behavioral and epidem iologic studies suggest that nighttim e, unre stricted nursing is a desirable and natural part of total breast feeding. A t this tim e, evidence supports hum an breast feeding as the m ost sound practice, physiologically and psychologically, for infants and it w ould seem ill-advised to recom m end its discon
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