23: cavities, teething, and toddler biting while nursing

Teeth, and all the issues that come with them, seem to pop up alongside breastfeeding concerns throughout the breastfeeding journey.

It's hard not to worry when these are things you hear day-to-day: 
"You'll be ready to wean once they have teeth!"
"You need to stop breastfeeding at night or you will rot their teeth"
"They have teeth now, they are supposed to be eating REAL food!" 

In this episode I'll dip into the science, and provide some practical support for: 

• Breastfeeding a baby with teeth 
• Breastfeeding a teething toddler
• Handling biting
• Oral development
• Cavities & breastfeeding toddlers

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Research Links:
A Natural Age of Weaning by Katherine Dettwyler, PhD

Devenish G, Mukhtar A, Begley A, Spencer AJ, Thomson WM, Ha D, Do L, Scott JA. Early childhood feeding practices and dental caries among Australian preschoolers. Am J Clin Nutr. 2020 Apr 1;111(4):821-828. doi: 10.1093/ajcn/nqaa012. PMID: 32047898.

Law V, Seow WK. A longitudinal controlled study of factors associated with mutans streptococci infection and caries lesion initiation in children 21 to 72 months old. Pediatr Dent. 2006 Jan-Feb;28(1):58-65. PMID: 16615377.

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Chapters

• 0:00 Teeth & Toddler Breastfeeding
• 1:25 Breastfeeding & Teeth
• 5:31 Teething
• 9:57 Biting
• 14:09 Oral Development
• 16:40 Cavities

Transcript

Jenna: Today we are talking about teeth, all things related to teeth and breastfeeding. It seems like once you get through that newborn stage, then you're just worried about teeth all the time, teeth, teething, biting, while breastfeeding. Then you're concerned about cavities and if breastfeeding's and cavities, it's also really normal for parents to worry about breastfeeding a child who has teeth for.

Jenna: Other people to worry about it for you. You know, to hear things like once they have teeth, you're gonna want to Wean them, right? Or that it's inappropriate to breastfeed a child who has teeth because they have teeth. That must mean they eat solid foods, right? And somehow that, that must mean , you need to Wean them.

Jenna: Today we're gonna be covering it all. I'm gonna be dipping into the science, a lot of practical strategies, and really just unpacking this connection between teeth, teething, biting, cavities, and breastfeeding. 

Jenna: So let's just start out with whether or not teeth impact breastfeeding.

Jenna: Is it a problem to breastfeed your child when they have teeth? And the straight up answer is no. Do not affect breastfeeding. They shouldn't. In a normal, ideal kind of latch and situation, the mouth of your child is creating a seal and like negative pressure vacuum inside of their mouth, and then their tongue is gonna extend forward and massage the breast, and that's what's going to stimulate the flow of milk and kind of create that gentle s that's drawing the milk in and back.

Jenna: So, It's not just drawing the milk in and back, but it's actually drawing the, the nipple and the areola. So the breast tissue should be further back than their teeth, which means that the milk isn't really ever touching their teeth, right. It's getting funneled back into their mouth. And the tongue should be cupping that flow of milk and funneling it away from the teeth so the milk shouldn't be touching the teeth.

Jenna: As well. The teeth shouldn't really be involved in the actual act of breastfeeding, either they should be kind of up and out of the way. The jaw should be relaxed and open, and the tongue should be the thing that is doing the work, right? So we wanna see this kind of on their jaw, this gentle rocker motion.

Jenna: So it's moving up and down, but it's more moving forward and backward instead of this like piston motion of up and down, up and down, chomping. . In an ideal, normal breastfeeding situation, the teeth are not involved the teeth that your child gets early on and falls out during childhood are actually called baby teeth or milk teeth.

Jenna: We have always associated those teeth with the time in our lives, in the time in the human life when they are drinking milk. Interestingly, there was research done by a researcher named , Catherine Detweiler. She who's an anthropologist, and she was looking at the kind of natural age of weaning and trying to extract the natural age, the natural biological process of breastfeeding and weaning from.

Jenna: Cultural impacts. So she was looking at non-human primates and what their breastfeeding experiences are like, and she was trying to predict from that information. When we would Wean as humans if we were not in, in the cultural, like impact in the cultural, you know, environment that we're in one, she made seven predictions.

Jenna: But one of them I think really applies here. And that was looking at the research of Holly Smith who looked at a group of 21 species of non-human primates. So monkeys and apes, right? And when they weaned, And out of that 21 group, like 21 different species, they all weaned when the , offspring was.

Jenna: Getting their permanent molars. So that happens around age five and a half, six, seven, that these permanent molars erupt in humans. So if we were to use that one kind of source of prediction, teeth actually do have some, some of an impact in the breastfeeding experience in that the eruption of permanent teeth may coincide with a kind of natural age of weaning from breastfeeding.

Jenna: This was actually the case for me, my six. Year old weaned when she was six, while the permanent molars were erupting. So I found that kinda interesting. I feel like that's an interesting tidbit to kind of tuck away. And it might be something to share with people who tell you that breastfeeding your child who has teeth, you know, is going to be a hellish experience for you.

Jenna: So just to recap, no breastfeeding with teeth is not a problem. You do not have to Wean because your child has teeth, and your child will eat complimentary solid foods alongside of the breast milk until they're weaned, whenever that happens, so you don't have to worry about it. Now let's talk about the process of actually getting those teeth teething.

Jenna: So it's normal. As you know, for a teething infant or child to experience some disruption in sleep, it's also normal for them to temporarily have a latch that is less than ideal. So as I was talking about before, when the latch is happening properly, teeth are not involved. But if there's some pain or some swelling, especially this happens with toddlers, when they're teething their like two year molars.

Jenna: It happens that, that inflammation's kind of more around the jaw and it can happen where that latch can get a little bit sloppy or painful. So what can you do about that? Right? They've started to wake up more frequently to breastfeed overnight as a way of coping with the pain, but then their latch isn't as ideal.

Jenna: So perhaps they're not getting the same relief that they should be. Could be, would be if they were latching better as well. You may be in. More discomfort because of this kind of difficult, like not, not proper latch. So the first thing you can do, of course, provide your child with some pain relief. So, That could be, you know, over the counter pain relievers, if that feels good and right for you.

Jenna: Stay away from gels, of course, that contain things like benzocaine or lidocaine. And if you're going to use some quote natural options like homeopathy and those kinds of things, just check out what your, wherever you are in the world, what your of government health. Body says about those things because there are f d a warnings against some of them in Canada, health Canada has made statements about some of these things as well. So just take a look and see whether these things are a safe and b effective, because sometimes they are and sometimes they're not. So just do some research before you start buying some of these natural alternatives.

Jenna: To over the counter pain relief for teething. Because yeah, unfortunately parents can be a vulnerable population that can be kind of preyed upon by people who maybe are not, you know, following the safety protocols and procedures that they should be. Right. So we just wanna. Make sure that you're safe.

Jenna: So I just put that in that caveat, if you're gonna use those things. So you have over-the-counter pain relievers, you have perhaps some natural alternatives. Other things are simply like gum and jaw and cheek massages, right? Like you can get a little bit of coconut oil or a lotion and massage your little one's jaw and neck.

Jenna: You can get your fingers in there and massage their gums as well. You can get teethers, right? Like. Teethers, chewy toys, chewy necklaces, sensory chewy things from, you can buy them on Amazon and lots of different places. Etsy, these places, they sell them. So you can, those are great for helping to relieve some of the tension in the jaw.

Jenna: Help to relieve the pain, right? To get that biting, chewing on that. Those, those spots that are, that are sore, right? And kind of get that moving and working. And then that can be a really great way to relieve some pain for your child, which in turn creates a better latch, which creates more sleep, right?

Jenna: Less pain, also creates better sleep. So that is my little piece of advice for teething and the teething process. Some other things to note just while they are teething is make sure that your child, that you're offering some water during the day. Now of course I'm talking for toddlers, teething molars, not for babies under 12 months.

Jenna: But if you have, you know, a two-year-old who's teething, some molars, just make sure that they're getting hydrated, right? If they're, if you're not breastfeeding as frequently if it's summertime and it's hot, of course, if you're in Australia or you're listening to this at a different time of the year, it happens to be summer in North America where I am right now.

Jenna: Dehydration can be kind of one of those sneaky areas that can cause your child to have some difficult behaviors, right? Like even if you think about it when you're dehydrated, it's easy to be grumpy. It's easy to have a hard time doing things that you know you should do and that can just put a lot of pressure on your parenting and on that breastfeeding relationship.

Jenna: So keep that in mind. So we talked about whether or not breastfeeding is normal and okay, while your, while your child has teeth, the process of getting new teeth teething, let's talk about biting for a minute. So , it's common for breastfed babies, toddlers to bite occasionally while they're breastfeeding, but it is not the norm by any means.

Jenna: Not every child is gonna experience this at all. So if you're afraid that this might happen it could happen, but it's not a guarantee by any means. And normally this does start to happen before your child is act actually has teeth. And it might start in those earliest teething days.

Jenna: And it can be painful when they have gums like clamping down on on you. But I would say that the more that the teeth that they get in, the less likely biting is to happen. Cuz biting down is not part of the actual latch of breastfeeding.

Jenna: There's no biting involved, right? It shouldn't be involved. So it's not normal for a baby to bite at the breast. Now they can bite at the breast when they're playing. They're just kind of being silly. They're done. They're just, you know, moving their mouth around the breast for fun.

Jenna: They could be sensory seeking, in which case, again, a chewy tube or a chewy necklace or something like that. Teather could really help get that sensory input that they're looking for. It also sometimes happens when. When there is teething and those kind kind of things going on. So pay attention for that as well.

Jenna: But let's talk about what to do when your child bites. So if you Google it, or type in a mom's group or whatever, you're gonna find the people who say, say no loudly, put your child down, walk away, end the feed. That, I don't think that that advice is helpful. First of all, if you're.

Jenna: Breastfeeding a young baby, they might not have any idea what is actually happening, nor have the capacity to relate the No with the biting. And even if they do, Have the impulse control to stop themselves next time. So if you're looking at this purely as a behavior that your child is just biting at the breast and so you have to reason with them or use logic or, you know consequences, like a harsh no and setting them down and walking away, if you're relying on that you're missing the mark because.

Jenna: A young infant, a toddler a child, even up to age four or five, six and sometimes beyond will struggle to stop themselves on their own. Right. So what I would suggest to do is take care of yourself first off. So if you need to end the session because it's painful, like of course end the session, you don't need to keep breastfeeding.

Jenna: Pay attention to your child while they're breastfeeding and notice if there's certain behaviors that they're doing before they. Bite. If bitings become somewhat of a habit and stop, then you know if they're done breastfeeding, if they're kind of coming on or coming off, or you've noticed that they're distracted, just stop the breastfeed.

Jenna: That's okay. if you've noticed that you are getting distracted, keep connection and attention there. Cause it could be that they're looking for that attention and connection. So that's why they bite, because there is some connection and attention that comes afterwards. It's possible, but what's more likely is that they are actually lacking some attention and connection from you, and that is what's leading to some dysregulation and an increase in these kind of difficult or problematic quote like behaviors of biting.

Jenna: So if you wanna deep dive that a little bit more, you can go to episode two of this podcast, start to Stop toddler breastfeeding. And I go through my whole breakdown for dealing with kind of irritating behaviors of the breast, and I would encourage you to apply that to biting. Just the biggest thing to keep in mind is that your child's always doing that the best that they can.

Jenna: So supporting that underlying need is what's important, right? You don't want to put pressure on that need. Exacerbate, that need by removing yourself, removing connection, removing all of that stuff That is actually what they deeply, truly need and desire. So keep that in mind. So we've gone through whether or not you should breastfeed while they're have teeth, the teething process biting.

Jenna: So I wanna touch on oral development and function for a second. If you have been hanging around, you'll know that the last two episodes, so that'll be episode, I believe 21 and 22. We're an interview that I did with an oral facial biologist. So we talk all about oral function and development. You can go back and have a listen to those episodes, but, It's just, I wanna touch here and say that breastfeeding is known to support optimal oral development.

Jenna: That means that the act of breastfeeding. Support your child's palette to develop properly, which means not super high and vaulted, but like having just a gentle, gentle slope. And as we talk about in that podcast episode, that palette is the floor of the sinuses, so it will support optimal airway health in, you know, the sinuses as well as even airway passages in the throat and that kinda stuff too.

Jenna: So that's, it's important, right? But if there are oral restrictions, tongue ties, lip ties, optimal latch might be impaired. So if there have been those things in the past, if you have had if your child did have a tongue tie it perhaps they do have a tongue tie. Maybe somebody said, oh, they might have a tongue tie, but it's okay.

Jenna: Just keep an eye on those things. And when it comes to teeth, this is where I'm making this, this connection, is that that. Poor latch. Could be, and poor latch and poor development, right? Like it's not that. Maybe that's caused a p a palette that's really high and all these things that will cause the teeth to become an active player in the breastfeeding when maybe they shouldn't be, right?

Jenna: Like in an ideal situation. So you may have your child unlock and see little lines from the teeth kind of pressing on the breast. You might have some pain. It In these cases, it's also possible that there's an increase in cavities. So I'm gonna get into the cavities in just a second. But with ideal oral function, all of the milk is being funneled away from the teeth as well.

Jenna: The tongue and the palette are working together. So the palette is cleaning the tongue with the, with the swallows. And even when eating solid foods, the, the food, the saliva and everything that's being created and the swallowing patterns are actually cleaning the mouth. But if there's an impairment in optimal development that might not be happening and that can contribute to cavities.

Jenna: So moving into cavities, it is kind of a hot topic for dentists, for breastfeeding moms, for lactation consultants to talk about whether or not breastfeeding. Can cause cavities for a long time, the jury was kind of out on whether or not breastfeeding, like breast milk caused cavities, and there was some research that showed that the lactose in breast milk is cariogenic or creates caries or cavities.

Jenna: The trouble is that. The lactose in breast milk doesn't exist by itself. So there are other components of breast milk as well, and one of them is lactoferrin. And lactoferrin is a healthy bacteria that actually kills the cavity causing bacterias in the mouth. So we've now come to see that breastfeeding.

Jenna: Well, breast milk. Does have lactose in it that could potentially create cavities. The lactoferrin in the breast milk is actually preventative of cavities. So in an ideal situation, breast milk will not cause cavities. Again, if oral function is impaired, other food, these kinds of things will sit on the teeth and it could cause cavities.

Jenna: So when we're talking about what causes cavities, there's a particular type of bacteria that eats the food in, in your teeth right in the mouth, and causes. The pH of your mouth to change and that causes cavities. So we don't want that to happen, right? Like. So some of the ways that you can prevent cavities are by brushing your child's teeth as well, not sharing your saliva with your child, because if you have cavity causing bacteria in your mouth, it could transfer to your child's mouth, but you do not need to wipe your toddler's teeth after breastfeeding at night.

Jenna: Unless there are extenuating circumstances, perhaps your child already has some impairment in their enamel or a condition where their, their enamel hasn't developed properly. And even with that, I would encourage you to take a look at some research, which I will put in the in the show notes here.

, talk with your dentist or whomever. Your child's care provider is that is encouraging you to perhaps wean or wipe their teeth after feeds. , and just look at what the actual evidence is saying and, make considerations and a plan of care. Based on that evidence, not just on, , perhaps myths or concerns that are, are outdated. . 

Jenna: So there was a study done in 2020 looking at Australian preschoolers and looking at that relationship between prolonged breastfeeding and early childhood caries or cavities that happen in early childhood. So the research found that there was no association between breastfeeding beyond a year, and the development of early childhood cavities, which is good news, right?

Jenna: You know, for many decades people kind of had theories about whether or not breastfeeding did cause cavities or didn't cause cavities. And you'll still find a lot of dentists and people who work in the dental field and industry suggest that breastfeeding does cause cavities and that you do need to do things like wipe your child's teeth after they've had a breastfeed at night, however, And like I said, we know that the lactoferrin in breast milk is protective against cavities, and we have research now to show that breastfeeding does not cause cavities in children.

Jenna: So I hope that that is beneficial for you and supportive for you. Now, if you are struggling with brushing your toddler's teeth and doing all of those things, that's kind of like another conversation. But in the same way that I'll talk about biting and difficult, challenging behaviors that happen with our kids, it's important to keep the conversation and the time that you're together brushing teeth positive, right?

Jenna: That is really, really important. And always look for that need. What is going on underneath? Is it a lack of autonomy? Do they feel like, you know, you're just shoving this brush in their mouth and they don't have any say over it? Is it. You know, discomfort. Is it uncomfortable for them to brush their teeth?

Jenna: Does the toothpaste taste bad? Is the, you know, like do you brush too rough? All of those things can be considered if you're struggling with brushing your toddler's teeth. The best tip that I have ever been given or given to anyone is to pretend that there's something really silly in your child's mouth.

Jenna: It is a wonderful way to get them to open their mouth really wide, to be really playful and it will allow you the space in their mouth to kind of look in and see and get all those little bits brushed. So that's my little, my little quick piece of advice for you. I hope that you really, really enjoyed this episode of Start to Stop toddler breastfeeding.

Jenna: So we've covered, breastfeeding is normal with teeth. It is not a problem. You do not have to Wean just because your child has teeth. We talked about. Going through that teething process and understanding that when your child is teething, it could be disrupting sleep, it could be causing a poor latch, and so you want to be mindful of that and support yourself and your child through that process.

Jenna: And then we talked about biting how biting could be. From sensory seeking or playing or kind of being bored at the breast. And it's important to take care of yourself, but also don't expect logic and reasoning or consequences to be making an impact on your child in, in a positive way, or to be the thing that kind of stops the biting from happening.

Jenna: And go and check out episode two if you want some more support with navigating that kind of challenging behavior at the breast. You also talked about oral function and development and how breastfeeding is supportive for oral function and development. But if oral function is impaired, then it is possible that there could be more cavities happening, and so you'll want to optimize that oral.

Jenna: Function and you can go back and listen to the last couple episodes, which was an interview that I did with Jenny, the Orofacial biologist, and get some more support for that. And then lastly, we talked about cavities and whether or not cavities, cause, or sorry, breast milk causes cavities and we know that it does not.

Jenna: We have researched to show that it does not cause cavities and that the lactoferrin in breast milk is actually protective against cavities. And we, we've known for a long time that breastfeeding under a year is protective against cavities. It's always been that beyond a year. That's been a little bit of a question mark.

Jenna: But now we have the evidence to say that it does not cause cavities. And we know actually from longitudinal. Studies from children from 21 to 72 months. This was a study that was done in 2006, that lack of oral hygiene and consumption of sugar containing snacks and enamel hypoplasia were significant factors for cavities, not breastfeeding.

Jenna: So that was some research that's a little bit older but still pretty, pretty exciting and, and helpful to see. So if. Eating habits with your child. Then go back and listen to the interview that I did with Kristen Parks, the I B C L C and registered pediatric dietician. That's the picky eating episode.

Jenna: You will be able to scroll back on your podcast player and find that episode too. Okay, so I hope that you enjoyed this Walk through teething teeth. Biting cavities and breastfeeding. If you enjoyed this episode, please share it with some friends. Give me a subscribe and leave a comment if, if you would like.

Jenna: I, I love to see those on whatever podcast player that you are using. That is all from me today. I cannot wait to talk with you again next week.