The latest advice on breastfeeding
The UK has one of the lowest rates of breastfeeding in Europe.[i] While 73% of UK mothers breastfed their new-born babies in 2015/16, this reduced to 43% when their child was 6-8 weeks. Why is this relevant to you? Just under a quarter of children aged 5 years have dental decay in England. In addition, almost 9 out of 10 hospital tooth extractions in 0 to 5-year-olds are due to decay.[ii] As breastfeeding is believed to have an impact on decay in children, it’s important for dental professionals to consider the links.
Dr Radhika Aggarwal from Windsor Road recently returned to the practice following maternity leave. She is therefore ideally placed to discuss the latest recommendations and advice on the topic in light of World Breastfeeding Week – held on 1st to 7th August 2019.
Benefits of breastfeeding
The main benefit of breastfeeding is that it reduces the risk of nursing (baby bottle) caries (decay). This occurs when the bottle with formula milk, expressed milk or juice (not water) stays in the baby’s mouth for a long period of time – like during naps or at night time. It causes a prolonged acid attack on the teeth, which can lead to extensive caries.
In 2018, the Scientific Advisory Committee on Nutrition (SACN) published its report on ‘Feeding in the first year of life’.[iii] As a result, policy advice with regards to breastfeeding has not changed. About oral health, it concluded that breastfeeding children up to 12 months of age offers a decreased risk of dental caries.
There is a misconception that breastfed babies don’t get decay at all. If babies are being fed on demand, very frequently caries can develop as breast milk still contains sugar. In rarer situations, nursing caries can develop in children who engage in on demand breastfeeding. In particular, this occurs if laying down while feeding at night. As a result, good oral hygiene, even from a very young age, is essential.
There is a lot of information for expectant and new mums on the NHS dental website.
With support from the Chief Dental Officer (CDO) for England, the Dental Check by One launched two years ago. The aim is to spread the message that ‘baby teeth matter’ and it encourages a dental visit soon after baby teeth first appear, or before their first birthday. This examination often includes giving preventive information to parents or care givers. A letter sent by the CDO to all dental professions in September 2017 also supported the benefits of breastfeeding.[iv] It recommended it as the best nutritional option for babies, particularly for those requiring extra attention if they have special needs or are at a high risk of caries.
It is important for dental teams to offer preventive advice to expectant mothers and help instil good habits from the beginning. This should include information on:
- How to clean a baby’s gums
- Toothbrushing techniques when the first teeth erupt
- Softness of brush bristles
- Fluoride content and amount of toothpaste
- Diet advice at weaning age – around 6 months
Health visitors and midwives are also very good sources of information with regards to dental care for children. Therefore, expectant or new parents can speak to allied healthcare professionals for further information.
Whether to breastfeed is a very personal decision for new mothers. For some it’s plain sailing, while others face challenges and therefore adapt their plans. Having just become a new mother myself, my advice would be to do what’s best for the individual – mummy guilt is a very powerful emotion! As dental professionals, I think it’s important that we present the facts and support our new mum patients in any way we can.
About the author
Radhika Aggarwal qualified in 2003 from Kings college (GKT). She has been working with Rodericks as an Associate Dentist since 2010. Over this time, she has worked at the Wallingford and Marylebone practices and is currently at Windsor Road dental practice.
Having been with the company for a while, she was given the role of a patient interest trainer in 2007. Later she was appointed as a Clinical Advisor for Rodericks. She was looking after teams in Westminster, Marylebone, Kensington, Coulsdon, Cookham, Pond House, Windsor Road, Queensmead and Aldershot.
She has taken maternity leave recently after the birth of her second child and has been travelling with her young family. After returning to work part time in May 2019, she is looking forward to getting back to clinical work with an interest in short term orthodontics.
[i] Royal College of Paediatrics and Child Health. Resources. Breastfeeding in the UK – position statement. Published November 2017. Modified June 2019. Click here to visit the Royal College of Paediatrics and Child Health website. [Accessed July 2019]
[iv] NHS England. CDO letter to dental professionals. 25 September 2017. Click here to read the CDO letter to dental professionals. [Accessed July 2019]