On your phone recording, you claim that night nursing causes caries on the front teeth. Beside the lack of logic (if one understands the way nursing milk is transferred to baby) I can find a lot of references to this claim being a myth, or, at least, lacking in scientific verification. Even those articles that claim breastmilk to be a factor concede that it is only in combination with other problematic foods that caries arise. Most of the scientific literature I can find claims caries are a bacterial disease that is caught from someone else, and with the antibacterial properties in breastmilk, it would serve, logically, that more breastmilk reduces the incidence of caries.
. Human babies are meant to consume human milk, and babies, when allowed, develop their own pattern of nursing that includes, and requires nighttime feedings. Why would nature kick itself in the bum this way. It simply does not make sense, it is not scientifically proven, and it is irresponsible, in my opinion, to claim it as fact when there is so much out there that disputes the claim, and even those that make the claim concede it’s fallibility.
American Academy of Pediatric Dentistry suggests that it’s the other food in a child’s diet that causes the decay:
http://www.aapd.org/media/pressreleases/breastfeeding-99.asp
Pediatric Dentistry In the News
Breastfeeding and Link to Cavities
Breastfeeding and Link to Cavities
U.S. News & World Report
October 1, 2007
Dr. Paul A. Casamassimo was interviewed by U.S. News & World Report on the link between breastfeeding and cavities. Casamassimo shared that overall literature is unclear on this relationship, but he did point to a correlation between poverty and increased tooth decay, especially among Mexican-American children. The story was posted online on October 1, 2007.
http://www.aapd.org/media/pediatricdentistryarticles.asp?NEWS_ID=834
From Kellymom.com
Per Brian Palmer, "Human milk alone does not cause dental caries. Infants exclusively breastfed are not immune to decay due to other factors that impact the infant's risk for tooth decay. Decay causing bacteria (streptococcus mutans) is transmitted to the infant by way of parents, caregivers, and others" (Palmer 2002).
Up until recently, the only studies that had been done were on the effects of lactose (milk sugar, which breastmilk does contain) on teeth, not the effects of *complete* breastmilk with all its components. Breastmilk also contains lactoferrin, a component in breastmilk that actually kills strep mutans (the bacteria that causes tooth decay). According to a recent article in the March/April 1999 issue of Pediatric Dentistry, "It is concluded that human breast milk is not cariogenic." This study utilized extracted teeth to obtain most of its results and studied children only for determining the pH changes in dental plaque (Erickson 1999). A Finnish study could not find any correlation between caries and breastfeeding among children who were breastfed longer (up to 34 months) (Alaluusua 1990). Valaitis et al concluded, "In a systematic review of the research on early childhood caries, methodology, variables, definitions, and risk factors have not been consistently evaluated. There is not a constant or strong relationship between breastfeeding and the development of dental caries. There is no right time to stop breastfeeding, and mothers should be encouraged to breastfeed as long as they wish." (Valaitis 2000).
In a study done by Dr. Torney, no correlation was found between early onset (< 2 yrs) dental caries and breastfeeding patterns such as frequent night feeds, feeding to sleep, etc. He is convinced that under normal circumstances, the antibodies in breastmilk counteract the bacteria in the mouth that cause decay. However, if there are small defects in the enamel, the teeth become more vulnerable and the protective effect of breastmilk is not enough to counteract the combined effect of the bacteria and the sugars in the milk. Enamel defects occur when the first teeth are forming in utero. His explanation is based on quite a large study of long-term breastfed children with and without caries.
According to this research, a baby who is exclusively breastfed (no supplemental bottles, juice, or solids) will not have decay unless he is genetically predisposed, i.e.. soft or no enamel. In a baby who does have a genetic problem, weaning will not slow down the rate of decay and may speed it up due to lack of lactoferrin.
---http://kellymom.com/bf/older-baby/tooth-decay.html
Dr .Hamlin Replied:
Is your child a current patient here?
I replied “no”
---------- Forwarded message ----------
From: chris hamlin
Date: Fri, Sep 23, 2011 at 3:18 PM
Subject: Re: your phone recording
To: "Drs. Hamlin & Morgan"
Cc: michelle.brenner@gmail.com, pam morgan
Dear Whitney,
All I can say, is that after practicing pediatric dentistry for 35 years and having restored countless cavities on teeth on children under the age of 2, who have nursed at-will, at night, that yes, I am absolutely qualified to say that at-will-night-nursing does cause cavities. Does it cause cavities in all children? No. Nor does drinking sodas all day, cause cavities in everyone who partakes. Not everyone gets lung cancer from smoking. But as a responsible practitioner, taking care of children and helping my parents prevent a preventable disease is part of my mission. And hey, you're allowed to do what you want with your own children - and spread your gospel as you see fit. It just may be job security for me.
Sincerely,
Dr. Chris Hamlin
Board Certified by the American Academy of Pediatric Dentistry
Fellow, American College of Dentistry
Fellow, International College of Dentistry
Past President of the Tidewater Dental Association
Adjunct Professor, MCV-VCU School of Dentistry
AND A COLEAGUE OF HERS REPLIED:
Forwarded message ----------
From: Dr Michael Hechtkopf
Date: Fri, Sep 23, 2011 at 8:54 PM
Subject: RE: your phone recording
To: Chris Hamlin
Cc: michelle.brenner@gmail.com, cribaby@gmail.com, t brown
I agree with Dr. Hamlin. I have seen many cases of breast nursing decay. It is the constant suckling and flow of (human) milk over the dentition that causes the decay. The oral cavity has bacteria that uses the breast milk as a nutrient source, producing acid which decays the teeth. If the baby if fed, teeth cleaned, and baby put back in the crib [separated from the breast or bottle], the dentition should be all right.
-Dr M J Hechtkopf
---------- Forwarded message ----------
From: Whittney
Date: Mon, Sep 26, 2011 at 2:54 PM
Subject: Re: Fwd: your phone recording
To: "Drs. Hamlin & Morgan"
Do you have empirical data to back your opinion up?
From: chris hamlin
Date: Mon, Sep 26, 2011 at 3:15 PM
Subject: Re: Fwd: your phone recording
To: "Drs. Hamlin & Morgan"
Dear Whittney,
Unfortunately, this is not an opinion - when it is confirmed by patient history and experience. I'll be sure to use your email address to include you in the loop of the peer reviewed literature on the subject.
Sincerely,
Chris Hamlin, DDS
I replied with 2 links:
http://www.ada.org/3143.aspx
http://www.naturalchild.org/guest/lisa_reagan.html
And she replied:
Dear Whittney
I think it is safe to say that you have your convictions and the pediatric dental community has ours. You will be as successful changing my view as I would be changing yours. So I'm not going to spend any more time on this subject with you. I do not expect everyone to embrace everything I have to offer, and I can accept that. It's obvious that both of us are passionate about the well being of children, and that is important. I am fortunate that I don't have to save the world, just helping my patients have the best dental health has always been foremost in my mind.
I wish you luck on your mission and hope that you have a great day!
Sincerely,
Chris Hamlin, DDS
My intended response ( not yet sent if you have advice):
Since you do not wish to engage in an acedemic discussion or provide any evidence for you position, I wll say my peace and leave you alone.
I am simply floored. I am floored that you were refered to me with high regard, and can not even take the time to provide evidence for your opinion. You are practitioner of a medical art. This comes with the assumption that you engage in evidence based practice, and provide evidence based advice. At best you have correlation, at worst you are destroying children's healthy future with anecdote. It would be just as prudent to conclude that apple's and apple products cause ECC . I'd be willing to bet all of your patients with ECC were exposed to apples. In fact since 99% of children were exposed to apples and there is quite a mix of children who were bottle fed and breastfed, the likelyhood of apples being the culprit is statistically much higher than breastmilk.
Neither you nor your college seems to understand basic psysics, or the mechanism of transfer of human milk from a human breast. The nipple is beyond the front teeth when a child nurses, and the milk could only pool at the back of the mouth, if it pooled at all ( which it does not because the breast doesn't transfer milk unless the child suckles except in the early weeks or rare circumstances). Breastmilk never touches the front teeth, especially when a child is lying down at night and gravity is in play. Since those that make this claim are often refering to decay in the front teeth, the basic logic is completely lost.
I am a desperate mother looking for real answers so that I can mitigate the actual cause of my child's problem. I am a scientist, I look for evidence based advice and practice. I would necessarily assume that since the pediatric dental community doesn't provide this advice based on scientific evidence that it does not provide any advice based on more than anecdote, and I lack the resources to conduct real science to answer this question myself. It's truely a sad state of affairs.
Do you realize the far reaching health benifits that nursing and nursing on demand provide for a child's overall health. It would be easy to provide you with research on this, but all you have to do is look for yourself. The reduction of risk of diabetes and obesity alone are worth it, but it goes so far beyond that that I could fill a book. Children who are fed natural food and learn to listen to thier bodies needs rather than a clock suffer so much less (in both the physical and mental realms) than thier counterparts through thier entire lifetime that I can't fathom advice in any other direction.
It also floors me that, though the AAP, the WHO AND the ADA advise otherwise, the AAPD, and it representatives continue to insist on providing vulnerable mothers with advice that counters all good science and reason.
I am sure you are a good person, doing the best you can to be a good advisor, so I emplore you to take the time to learn about the potential consequences of your advice, and to update your position on this matter to engage in evidence based practice, and provide evidence based advice.
I, and most of the community of science and reason will continue to "preach the gospel" as we see fit, but I assure you, that it will not create business for you since the evidence is that some children get caries in spite of breastmilk, but most are protected from disease ( including ECC) by it. Couple that with the fact that when I am "preaching the gospel," I will be sure people konw your position on this matter, and since I run with a cohort that demands evidence based practice, if they do need help, they will surely not seek it from your practice.
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