This month, Amaris is excited to feature expert insight from our Pillar Mom, Dr. Wendy Zhu.
Congratulations on making it this far on your breastfeeding journey! No matter how we choose to feed our babies, us moms always want what’s best so that they can grow healthy and strong. We sacrifice so much - our time, energy, sleep, all to nourish our little ones. For the first six months of life, babies are completely reliant on us for nourishment, whether from our bodies or a bottle. This will continue throughout the baby's first year of life and beyond. Around the six month mark, many babies also begin developing teeth. So, what can we do to keep them clean and healthy?
Let’s be honest, being a mom is already hard enough. The last thing on my mind during those early months was brushing my baby’s teeth in the middle of the night. I’ve been a practicing dentist for over a decade, but I only recently stepped into motherhood for the first time. Before my son was born, I fully believed I’d follow all the “rules”. In a perfect world, we should brush after anything we eat, and ideally wait 20–30 minutes before doing so to protect enamel while the mouth is still acidic. Sounds simple, right? But now that I have a son, that idea feels completely laughable. He’s 11 months old and has never slept through the night. There was even a stretch where he breastfed hourly, all night, every night. The thought that moms should wait 20 minutes after every feed and then brush their baby’s teeth? It’s just not realistic. At that point, all I wanted was as much sleep as I could get…which wasn’t much at all.
What I would recommend for breast/bottle feeding:
The easier you can make things for yourself, the more likely you are to actually stick with them. After feeds, try to quickly wipe your baby’s teeth with a burp cloth once they unlatch. I know we don’t want to wake a sleeping baby, so keep it quick and as discreet as possible. You can even use your sleeve or whatever is most accessible to you. The goal is to avoid any milk from pooling around the teeth, which can contribute to decay over time.
It’s a common misconception that breastfeeding doesn’t cause cavities. While breastmilk does have many protective properties (like Lactoferrin - a component that can kill the bacteria that causes tooth decay), it still contains lactose, a natural sugar, and any sugar has the potential to contribute to tooth decay under the right conditions. The overall risk depends on a few factors.
First, how many teeth your baby has. In my experience, the most susceptible areas tend to be the upper front teeth near the gums. We see less decay in the lower teeth because saliva tends to pool there, helping to buffer acids and naturally protect those surfaces. Because of this, I’m often more focused on gently wiping the upper teeth than worrying about the back or lower teeth early on.
Another factor is your baby’s latch. With an effective latch, milk is directed toward the back of the mouth, bypassing the teeth and flowing toward the soft palate. But real life isn’t perfect and latch can vary, my son’s certainly did. Things like oral ties, facial tension, or even your baby’s mood that day can impact how milk flows and whether it lingers around the teeth. Ideally, we want to minimize milk sitting along the front surfaces of the teeth.
When you can, aim for a thorough brushing in the morning, and even more importantly, at night. Nighttime brushing is more imperative because saliva production naturally decreases during sleep, which means less protection against bacteria. When you combine bacteria, sugar from milk, and a drier mouth, it creates the perfect environment for tooth decay. As bacteria feed on lactose, they produce acid as a byproduct, and that acid is what gradually breaks down enamel.
Does breastfeeding influence infant oral development?
In my opinion, breast and bottle feeding are typically in shorter durations and not enough to affect the teeth position negatively. It helps stimulate baby’s oral muscles which is imperative for proper growth. On the other hand, pacifiers were made to imitate the breast and offer comfort to a sleeping baby. The concern with pacifier use is the time and duration it stays in baby’s mouth, which is substantially relative to feeding. Some babies who use pacifiers will have them in their mouths all night. We term pacifier and thumb sucking as “non nutritive” habits and these can definitely create orthodontic problems over time. The forces from the sucking motions can exacerbate a narrow, high arched palate, affect proper tongue position, and flare the developing teeth. For this reason, we recommend weaning off pacifier use around 18 months. If there is flaring of the baby teeth in infancy, we generally see good results after weaning where the teeth return to their correct position. It is a much broader issue when we are attempting to wean pacifier or thumb use in a 7 year old with adult teeth. This may warrant extensive orthodontic treatment in order to correct teeth alignment.
How can you care for your own teeth as a breastfeeding mom?
Many times we hear that the baby will suck the life out of your body, including your teeth! There is a bit of truth to this. Pregnancy and breastfeeding prioritize baby’s growth over your own health. For this reason, we recommend additional dental cleaning visits during pregnancy, and not to forgo comprehensive care during this time. Pregnancy gingivitis is definitely a real thing. The gums can become extremely swollen and bleeding due to the rampant hormones in your system. Even myself, a dentist, experienced uncomfortable dental symptoms during my pregnancy and postpartum. However, we cannot completely blame the baby. After all, dental issues like gingivitis and cavities all stem from a common cause, bacterial inflammation. Yes, our hormones exacerbate the problem, but this unfortunately means we have to work diligently to avoid further risk. It is recommended to brush twice and in circular motions along the gums, as well as nightly flossing. The inflammatory response is just our bodies reacting to the bacteria.
A common misconception is that breastfeeding will leach calcium from our teeth in order to feed our baby. The truth is, our teeth are completely developed when we are just kids, so they really don’t change much in composition for the remainder of our lives. But calcium is an important component in our bones and this is what supports our teeth, thus we do need to supplement as needed. I tried to remember to take a post-natal supplement every day during this time, as well as clean up my diet with more nutritious foods. I know as moms we tend to prioritize our babies and put ourselves last, but we need to remember to take care of our bodies too. If we have neglected our health, that’s okay, as this is just another passing season in our lives. We survive motherhood where nothing is perfect, our house is a mess, and our kids drive us crazy sometimes. My son won’t let me brush his teeth, ever. Maybe one day, he will. Everything will be fine!
-Dr. Wendy Zhu, DDS
