Breast-Feeding Doesn't Contribute to Cavities

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The concern over breast milk and cavity risk was corroborated in part by a 2005 study in rats that showed that human breast milk is more likely than cow's milk to encourage cavities.

Pediatrician and breast-feeding advocate Dr. Ruth Lawrence, a co-author of the animal study, acknowledged that the results fueled the fire of those in opposition to night nursing.

Letting a baby sleep with a bottle of anything other than plain water carries a greater risk of encouraging cavities than night nursing, said Lawrence, who says she would use the current study to reassure nursing mothers.

However, American Academy of Pediatric Dentistry (AAPD) spokesman Paul Casamassimo was more cautious.

"The literature in general is not clear in a relationship between breast-feeding and dental caries, but reports and a few studies have found relationships," he said.

Although the AAPD does not have a policy statement about breast-feeding, Casamassimo said the academy tries to educate parents to minimize the risk of cavities from any food or beverage.

Breast-feeding aside, Iida argued that pediatric dentists and public health practitioners should direct oral health efforts toward parents in low-income households, smoking mothers and Mexican-American households.

Casamassimo argued that the correlation between poverty and increased risk of cavities is well known and may explain, in part, the increased risk for Mexican-American children as well.

"The poverty correlation with caries is longstanding, consistent and believed to reflect a combination of lack of health knowledge, limited access to care, poor diet, perhaps poor prenatal care, and inadequate self-care," said Casamassimo. "Simply being Mexican-American reflects the fact that they are often among our poorest, and thus reflect the above factors."

Maternal smoking was also strongly tied to cavities risk in infants, but the analysis did not offer insight into the root of that relationship.

"As the [study] author points out, mothers tend to smoke before, through and after pregnancy, and thus the child may be poorly developed in utero and during early life, leading to increased risk for caries," said Casamassimo, who suggested that smoking may affect the child's immune system or possibly support bacteria in a mother's mouth that can be passed on to the child. "Smoking may be a surrogate measure of some factor not necessarily noted in the study. In other words, there may be a health contribution to caries susceptibility that is not measured or even known."

Preventive dental care is important for toddlers, said Iida, as the data shows cavities can grow as soon as there are teeth. One in 10 of the 2-year-olds in the study already had a cavity. Among the 5-year-olds, nearly half (44 percent) had had at least one cavity.

More information

For more about healthy teeth for children, visit the American Academy of Pediatric Dentistry.