Bottle caries

The term "nursing caries" was coined by dentists in the 20th century to describe the type of tooth decay they were seeing in toddlers. Unfortunately, their terminology was flawed as Nursing has long been used to describe breastfeeding and the percentage of toddlers still at the breast was negligible in most western societies where the condition was being observed.

Older babies and toddlers who have developed their upper front teeth are at particular risk of decay, caused by milk pooling behind the teeth while sleeping. This is a functional problem created by children falling asleep with a bottle and continuing to hold it in the mouth while sleeping. The design of teats allows a steady drip to be released because of gravity, even when the child is not actively sucking.

The condition is also - and more accurately - known as "bottle caries".

Breasts are not bottles and nipples are not teats. When a child falls into deep sleep, the breast relaxes and the milk ceases to flow. There is no dripping. There is no pooling.

Breastfeeding toddlers, like other children, can develop tooth decay. They get it because of genetics, diet and dental hygiene factors. They do not get it because they are breastfed. Correlation is not causation.

Research continues and it is important for dentists and parents to keep up to date with the results. But also to understand that breastfeeding itself has a positive impact on oral development and is the biological normal for human children in the early years of life. Breastfeeding and bedsharing - breastsleeping - is culturally and physiologically typical beyond infancy. Rinsing the mouth with water is impractical and unnecessary.

Understanding and supporting #breastfeeding families is important for those working in the field of oral health. Knowing the difference between bottle feeding and breastfeeding is crucial. While bottles and formula should cease after 12 months and feeding to sleep discontinued as upper teeth erupt, the opposite is true for the breastfed child. Care and attention to the diet and good dental hygiene should be the focus, alongside natural infant feeding practice.