Beware! Bottle feeding may not be as "perfect" as you think

gossip

Using a breast pump to extract breast milk and then putting it into a bottle for feeding saves time and effort. The whole family can participate in it, which is more beneficial to the baby's growth!

the truth

There is a type of tooth decay called baby bottle caries

Many people know that tooth decay is a chronic disease that usually only affects a few susceptible teeth over a period of time.

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However, tooth decay can also develop rapidly, often catching people off guard. Among them, there is a type of tooth decay that is common in children. In severe cases, a large number of deciduous teeth can become decayed in a short period of time. This type of tooth decay has many names, such as baby bottle caries (BBC), early childhood caries (ECC), etc.

BBC refers to the presence of one or more decayed, missing or filled tooth surfaces in any primary tooth of a child 6 years of age or younger. Although this type of decay can occur in any primary tooth, the maxillary primary incisors and first primary molars are often the most severely affected, followed by second primary molars and primary canines, which is related to the order in which the teeth erupt.

As the name suggests, baby bottles play a role in the development of BBC. Specifically, regardless of what is in the bottle - breast milk, cow's milk, formula or juice - frequent and prolonged bottle feeding (especially at night when saliva flow decreases) is associated with BBC.

This is mainly related to the way and time the baby holds the bottle. Sometimes some babies will fall asleep while eating from the bottle. The liquid in the bottle will soak the baby's teeth for a longer time, and the nutrients in it will allow caries-causing bacteria to multiply rapidly, leading to bottle caries.

From the perspective of preventing tooth decay, even with breast milk, bottle feeding has a greater risk of tooth decay.

Meta-analysis studies have found that traditional breastfeeding is more effective than bottle feeding in preventing BBC. Therefore, the WHO/UNICEF guidelines recommend that traditional breastfeeding should be encouraged as the sole feeding method for all infants and young children for at least 6 months and as a complementary feeding method until 2 years old.

It is worth noting that tooth decay is a multifactorial disease, and feeding methods are only one of the links. To ensure that infants and young children do not have tooth decay, parents need to make many efforts, such as timely cleaning of teeth, timely use of fluoride toothpaste, and regular pit and fissure sealing. In addition, some studies have shown that even if traditional breastfeeding methods are adopted, frequent breastfeeding, feeding at night, or breastfeeding for more than one year will increase the risk of BBC.

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Bottle feeding

May be related to malocclusion

The growth and development of the oral and maxillofacial area is affected by many factors. Although genetic factors are the main factor, sucking, breathing, chewing, swallowing, speaking and other factors also play a role.

In terms of sucking activities, there are non-nutritive sucking and nutritive sucking . Using a pacifier and sucking your fingers are non-nutritive sucking, while sucking during traditional breastfeeding and bottle feeding is nutritive sucking.

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However, the sucking mechanism of traditional breastfeeding and bottle feeding is different and may differ in the following ways:

① Traditional breastfeeding requires the baby to actively squeeze milk from the mother's breast through the coordinated action of the tongue and facial muscles; while bottle feeding does not require the baby to spend too much effort to drink milk, so the latter does not stimulate the function of the corresponding organs enough;

② Traditional breastfeeding can promote the coordinated development of the maxillofacial system through intensive oral and maxillofacial muscle activity, and the active sucking movement in the process can promote full lip closure and proper tongue position at rest;

③ Traditional breastfeeding can promote physiological nasal breathing and avoid mouth breathing, which helps prevent the development of malocclusion and the formation of bad oral habits; while bottle-feeding is likely to be the cause and contributing factor of malocclusion and bad oral habits (non-nutritive sucking, etc.).

④ The nipple for bottle feeding has a specific shape and is made of a harder material. These features may cause non-physiological pressure on the oral cavity, restricting the normal lateral development of the palate, thereby causing misaligned teeth.

Therefore, existing studies suggest that traditional breastfeeding can reduce the incidence of certain types of malocclusion in deciduous or mixed dentition, and its effectiveness in preventing deformities may be correlated with the duration of feeding (at least 6 months or even up to 1 year old).

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It can be seen that although the new breastfeeding perfectly retains many advantages of traditional breastfeeding and easily solves the problem of working mothers balancing normal work and feeding their children with breast milk, it is still slightly inferior from the perspective of dental disease prevention. Therefore, to truly give full play to the unique advantages of breastfeeding, the traditional breastfeeding method is more reliable! Real breastfeeding is not just about feeding babies breast milk, but more importantly, it is a specific feeding method.

Therefore, it is recommended that all new mothers, if conditions permit, use traditional breastfeeding to feed their children. Of course, if objective conditions are indeed difficult and new breastfeeding is the only option, mothers do not need to worry too much. They just need to pay more attention to the development of their children's teeth, take effective measures (such as taking away the bottle in time, cleaning teeth, etc.), and receive regular dental specialist examinations.

Summarize

Rumor debunked.

There is little difference in nutrition between using a bottle as a breastfeeding tool and direct breastfeeding, but it may affect the baby's dental health, leading to bad oral habits and even tooth deformities. If you must use a bottle, it is recommended to pay more attention to the child's dental development and receive regular oral examinations.

References

[1] Raphael S. Bottle caries and dental neglect[J]. New South Wales Public Health Bulletin, 1999, 10(4): 31-32.

[2] Avila WM, Pordeus IA, Paiva SM, et al. Breast and bottle feeding as risk factors for dental caries: a systematic review and meta-analysis[J]. PLoS One, 2015, 10(11): e0142922.

[3] Meyer F, Enax J. Early childhood caries: epidemiology, aetiology, and prevention[J]. Int J Dent, 2018, 2018: 1415873.

[4] Anil S, Anand PS. Early childhood caries: prevalence, risk factors, and prevention[J]. Front Pediatr, 2017, 5: 157.

[5] Feldens CA, Rodrigues PH, de Anastácio G, et al. Feeding frequency in infancy and dental caries in childhood: a prospective cohort study[J]. Int Dent J, 2018, 68(2): 113-121.

[6] Abate A, Cavagnetto D, Fama A, et al. Relationship between breastfeeding and malocclusion: a systematic review of the literature[J]. Nutrients, 2020, 12(12): 3688.

[7] Narbutytė I, Narbutytė A, Linkevičienė L. Relationship between breastfeeding, bottle-feeding and development of malocclusion[J]. Stomatologija, 2013, 15(3): 67-72.

Author: Fu Rao

Review | Rong Wensheng, Chief Physician, Department of Prevention, Peking University School of Stomatology

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