Prolonged Breastfeeding
Vru authors hv studied th effects f breast milk n Infant's deciduous teeth
. Whlt m hv m t th conclusion tht breastfeeding u caries, thr hv concluded tht breastfeeding vn protective gnt caries. A review f th literature shows th tw schools f thought. Th findings f th convinced f n association r follows.
1. Position f th American Academy f Paediatric Dentistry (AAPD): In 1996 th AAPD stated that, "the risk f potentially devastating nursing-pattern dental decay exists fr th breast-fed child t d fr th bottle-fed child." It g n t that, "Ad libitum nocturnal breastfeeding huld b avoided ftr th frt primary tooth begins t erupt."
2. Hackett t al (1984) quoted vrl reports frm th U.K. nd U. S. A. whh suggested tht undr rtn rare conditions, breastfeeding m u rampant dental caries. Th gave experimental evidence suggesting tht human milk possesses greater cariogenic potential thn bovine milk. Th prevalence appears vr lw nd td wth breast r bottle feeding whh h continued fr t lt tw years f age, n mn occasions durng th day nd night.
3. Don Gardner t al (1977) reported based n observing caries n infants wh mothers wr adamant but breastfeeding, tht breast milk ln r wth carbohydrates, n b cariogenic. Th recommended mothers discontinue nursing n th child n drink frm cup (approximately 12-15 month). Th authors vn felt th wr th frt t mk link btwn breastfeeding nd caries.
Fr th thr school f thought th r thr findings:-
1. Irwin Mandel (1996) stated tht 1gG nd 1gA whh retard Streptococcus mutans (one f th major cariogenic organisms) r present n breast milk.
2. Arnold R. t al (1977) stated tht Streptococcus mutans highly susceptible t th bactericidal action f lactoferrin whh present n breast milk
3. Weerheijm (1998) concluded tht prolonged demand breastfeeding d nt lead t higher caries prevalence.
4. Weber t al (1986) demonstrated b ultrasonographic studies tht milk nrmll expressed nt throat whlt breastfeeding, nt rund teeth n th mouth.
5. Bruerd t al (1989) studied prehistoric skulls n Native American Communities nd compared thm t modern Native Americans. A decay rate f 57% w observed n modern times compared t 1.4
n th skulls. Th concluded tht babies wr breastfed fr 92,000 years bfr th advent f caries nl but 8,000-10,000 years ago.
In Ghana, thr hv lw bn anecdotal tales but n association btwn prolonged breastfeeding nd burnt teeth. However, thr hv nvr bn n studies dn t find ut th truth r otherwise.
Th objective f th study w t find ut f thr n association btwn prolonged breastfeeding nd dental caries nd th nature f uh n association.
MATERIALS AND METHODS:
A case-control study w dn ung pretested questionnaire. Mothers f children btwn th ages f 18 months (one case - exposure 12 months) nd x years wh hd ll thr deciduous teeth intact nd wr coming t th dental clinic fr th frt time wr interviewed nd th children examined. Mothers f 46 children n ll wr interviewed. 28 f th children wr cases whlt 18 wr ud controls. A case w defined rampant caries f th anterior teeth wth r wthut posterior teeth involvement. Exposure t sweets, w defined th tkng sweets nd sugary foods nd r wr gvn frequent medications n th form f syrups whlt bng breastfed. Prolonged breastfeeding w defined n breastfeeding ftr th upper anterior teeth wr thrugh (1 year). Mothers wr asked but hw long th breastfed thr children for, whthr th children wr l bng gvn frequent sweets nd sugary foods ll wth feeding bottle nd whthr th children wr gvn frequent medication n th form f syrups nd suspensions durng th period f breastfeeding. Othr data collected w th gender f th children, th age t whh caries started appearing n th mouth nd th teeth involved. A 95% confidence interval w established fr th vru groups.
RESULTS:
Th mothers f 46 children wr interviewed md u f 28 cases nd 18 controls. Th average age f th children w approximately 4 years nd 3 months n bth cases nd controls nd th age range w btwn eighteen months (one case exposure 12 months) nd x years. Th average duration f breastfeeding n cases w 23 months whlt tht n th controls w 17 months. All th mothers breastfed day nd night. Caries rdng t th mothers, occurred lmt immediately ftr thr upper anterior teeth started appearing, tht approximately but whn th wr 1 year f age. Th gender comprised 16 females nd 12 males n th cases nd 10 females nd 8 males n th controls. Thr w fair distribution f sexes n exposed nd unexposed cases nd controls. 35% f th children wr exclusively breastfed whlt 65% wr bng bottle fed r bng gvn sweets r syrups n association wth breastfeeding. Th average DMFT fr cases w 6 whlt tht fr controls w 0.
LIMITATIONS OF THE STUDY:
1. Controls wr ll difficult t find, n n Ghana, patients d nt visit th clinic unl thr problem. Th thrfr stretched th study vr 3 years bfr nugh data uld b collected.
2. At th time f ng th children exposure t th risk hd lrd occurred. Recall uld hv bn problem fr th mothers.
3. It wuld hv bn uful fr u t lk t children wh wr mnl bottle-fed. Unfortunately, tht l nt common n Ghana.
RECOMMENDATIONS AND CONCLUSION:
Breast milk protective gnt caries fr th frt 18 months vn n children wh r l tkng sweets nd sugary substances. However, ftr 18 months, th protective effect lost. Sm reasons hv bn suggested fr furthr studies t b conducted. Th conclusion reached tht breastfeeding ftr 18 months n association wth sugars uld b cariogenic. Furthr work nd t b dn ung larger samples t establish whthr exclusive breastfeeding uld lead t Dental Caries. It recommended hwvr tht weaning huld b dn rund 18 months t b n th safer side n but 65% f mothers dd nt exclusively breastfeed.
by: George Daisy
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