Does breastmilk cause cavities? Do I need to night wean?

Were you told by your dentist to night wean your breastfed baby for concerns of it causing cavities? Extensive research has proven that there is no link between breastfeeding (nighttime or otherwise) and cavities. Breastfed babies can get cavities, though, so good dental hygiene is still needed.

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What can cause cavities are nighttime bottles and not brushing teeth before bed once baby is eating solid foods. Bottles allow liquids to pool in baby’s mouth and sit on baby’s teeth for long periods of time. Breastmilk doesn’t pool in the same way because milk only flows when baby is actively sucking. When baby is latched appropriately to actually express breastmilk, it enters the baby’s mouth behind the teeth. If the baby is actively sucking then he is also swallowing, so breast milk doesn’t sit in baby’s mouth like it can with bottles. Sugars from table foods can sit on the teeth and bacteria in saliva uses these sugars to produce acid, which in turn causes tooth decay. Actively brushing baby’s teeth twice a day helps reduce these sugars from sitting on the teeth.

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One Finnish study could not find any correlation between cavities and breastfeeding among children who were breastfed for up to 34 months (Alaluusua 1990). In 2013, Lavigne found, “that there was no conclusive evidence that prolonged breastfeeding increased the risk of early childhood cavities.” Valaitis et al stated, “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).

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So no need to night wean for cavities… but if you need the sleep I completely understand.

Why should I see an IBCLC or lactation consultant

If you broke your foot you wouldn’t go to your local nail salon to have your pedicurist look at it. Yes, they work with feet. I just wouldn’t trust their expert opinion on whether I need a cast or some physical therapy. If my car engine was making smoke and my gauges were outside the appropriate ranges, you wouldn’t go to the car wash to have it looked at. Yes, they work with cars. I just wouldn’t trust their expert opinion on whether my engine block is cracked or not. So why when we’re having lactation problems do we turn to mom groups or even pediatricians? Yes, moms have babies. Yes, pediatricians work with babies. But neither are the experts in lactation (ok, occasionally a pediatrician will seek additional training, but honestly it’s rare). To become a board certified lactation consultant, you need to take advanced college level coursework specifically in human lactation. You need to spend hundreds to thousands of hours being directly mentored by someone who already is board certified. And you have to pass a FOUR HOUR board exam. To be board certified. IBCLCs spend thousands of dollars and years of their lives training to become experts in breasts, babies, and feeding. If you’re struggling, please find the correct help. There’s a lot of bad information out there that may inadvertently sabotage your breastfeeding journey without you even being aware.

What is that stench?!?

Do you feel hot, sticky, sweaty, sopping wet and a little stinky? Welcome to motherhood. It does get better. There is an actual biological point to leaking from every pore and that weird stench that accompanies it. Not all of our senses are developed at birth. It would overwhelm our littles too much to go from a dark, wet environment to such a bright, crazy world to actually have every sense developed like ours. Their vision isn’t great and they have no depth perception. But they have a fully developed sense of smell. They have been getting to know your odors since their womb days. Your amniotic fluid was constantly changing in its scent based on what you ate and drank and your unique hormone combination. All that leaking you’re doing postpartum has a similar scent which serves to orient your baby back to you. Your body odors are familiar to your baby and it makes them feel safe and secure that they are with their birth person and not someone else. Your leaking smells also stimulate their hunger, which is why baby may constantly root when on your body even if they aren’t hungry. Did you know that the breast secretes an oil from those little bumps on your areolas that smells just like amniotic fluid? This helps baby locate dinner when they are ready to eat. Showering is normal, but avoiding the use of scented products can actually be very helpful and calming for your baby. While you may find your body odor unbecoming, know that to your baby it makes you feel like home.

Photo credit Lauren Archer
@loveofalittleone

Coffee while breastfeeding

An average cup of coffee contains 95mg of caffeine, but some types contain over 500mg. That’s important to be aware of when breastfeeding as it’s generally considered safe to drink up to 300 mg per day— about 2–3 cups of coffee or 3–4 cups of tea.

The caffeine content of coffee depends on many factors, such as:

• Type of coffee beans: different varieties of coffee beans naturally contain different amounts of caffeine.

• Roasting: Lighter roasts have more caffeine than darker roasts.

• Type of coffee: caffeine content can vary significantly between regularly brewed coffee, espresso, instant coffee and decaf coffee.

• Serving size: “One cup of coffee” can range anywhere from 30–700 ml (1–24 oz), greatly affecting the total caffeine content.

• One cup of brewed coffee (8 oz) contains about 70–140 mg of caffeine, or about 95 mg on average

• One shot of espresso is generally about 30–50 ml (1–1.75 oz), and contains about 63 mg of caffeine

• Instant coffee usually contains less caffeine than regular coffee, with one cup containing roughly 30–90 mg

• Decaf has about 0–7 mg per cup, with the average cup containing 3 mg

Want to enjoy a coffee alternative that gives all the feels while still being breastfeeding supportive? My two breastfeeding friendly favorites are @wearerasa and @milkstabrew.

Nipple Damage

Nipples and penises have a lot in common. From an anatomical, cellular level, they are both made of the same elastic, erectile tissue. They erect and evert with stimulation. They can crack, bleed, and blister, but they can never toughen up or callous. And neither one should ever crack or bleed.

Babies mouths have two areas: the hard, bony palate up front and the soft palate at the back, just in front of where that little hangy downy uvula is. One of the reasons a nipple erects, everts, and stretches is to help to get it in the safe zone where the palate is soft.

When a baby is latched correctly, the nipple tip stretches back to where the palate is soft, then the tongue massages the nipple to express milk. If baby has a shallow latch, the tongue pinches the nipple tip against the hard roof of the mouth and causes damage. This also happens when there is a tongue tie where the tongue is restricted in its movement. Instead of the middle of the tongue massaging the nipple, the the tongue is anchored to the floor of the mouth and it flicks the nipple, or the middle of the tongue where the restriction is pinches the nipple against the bony palate.

Nipples are perfectly designed to withstand breastfeeding. Other than temporary tenderness in the first few days, there should be no pain or damage. If you do get damage, they should heal quickly (within 24-48 hours) if you can get a consistent deep latch.

Moist wound healing is most effective to heal a nipple. Tips to heal a damaged nipple:

💡Keep breast milk on the nipple. Using a washable breast pad can help keep milk on the nipple

💡Nipple balms/butters, coconut oil and lanolin can help keep the nipple from sticking to clothing and feel soothing

💡Breast gels

💡A 20 second saline rinse once or twice a day

💡Soak the nipple in an Epsom salt bath, either in a bowl or Haakaa filled with warm water

💡A prescription for Dr Jack Newman’s All Purpose Nipple Ointment for severely damaged nipples

💡Silverette cups for persistent damage

💡Temporarily use a nipple

💡Schedule a lactation consultation time get to the root of the damage

Silverette Cups to heal moderate to severe nipple damage

Where did my milk go?

What can cause a late onset decreased milk supply?

1.The mother is pregnant again. Milk supply decreases during pregnancy. Domperidone will not work when the mother is pregnant.

2.The mother is taking some hormonal birth control method (pill including progestin only pill, IUD, etc)

3.The mother is breastfeeding on only one side at a feeding or “block feeding” (several feedings in a row on the same breast, used to treat “overabundant milk ejection, “overabundant milk supply”). I have posted on “block feeding” previously.

4.Some medications other than hormones can decrease the milk supply (antihistamines for example).

5.Can an emotional shock decrease the milk supply? Possible but unusual in our experience.

6.Blocked ducts/mastitis as well as any febrile illness may decrease the milk supply.

7.The use of bottles more than occasionally can very much decrease the milk supply.

8.”Overdoing it”. It’s time that others do most of the usual chores that fall on women’s shoulders.

9.An “abundant milk supply” associated with a less than “ideal” latch. In this situation, the milk flows into the baby’s mouth with little participation of the baby. The baby may often choke while breastfeeding, especially when the mother has a milk ejection reflex. A tongue tie is a common cause of a baby having a less than “ideal” latch and can be a significant cause of late onset decreased milk supply even if neither the mother or the baby had problems early on.

This problem of late onset decreased milk supply and accompanying symptoms is typically the problem of the mother who once had an abundant milk supply and milk supply may still be quite good, but less than it once was.

Breastfeeding and lactose, dairy, food intolerances and allergies

Lactose is the number one sugar in breastmilk. It is the protein in cow’s milk that is difficult to digest for some babies. Human milk has human protein. It is easily digested by the stomach and absorbed in the intestines. The protein of cow’s milk is shaped different and not easily absorbed by the stomach and intestines as it’s designed to be absorbed by calves. It can sometimes make babies gassy or have poops that have bloody or mucous in them. Cow’s milk sensitivity or allergy can cause colic-like symptoms, eczema, wheezing, vomiting, diarrhea (including bloody diarrhea), constipation, hives, and/or a stuffy, itchy nose. Which can also be signs of other things. You could always try decreasing your dairy intake. Baby’s symptoms will usually begin to improve within 5-7 days of eliminating a problem food. Baby may not improve immediately, however, especially if the reaction is to a food that has been a regular part of your diet. Sometimes symptoms get worse before they begin to improve. It usually takes 2-3 weeks to see an improvement.

If baby is sensitive to dairy, it will not help to switch to lactose-free dairy products or put your baby in formula, which is cow protein based.

While culture may dictate what you can and cannot eat while breastfeeding, science does not. Most babies have no problems with anything that you eat. It’s generally recommended that you eat whatever you like, whenever you like, in the amounts that you like and continue to do this unless you notice an obvious reaction in your baby.

There is no list of “foods that every nursing person should avoid” because most of us can eat anything we want, and because the babies who are sensitive to certain foods are each unique – what bothers one may not bother another.

Babies’ guts are also constantly developing. So what bothers them as a newborn may not bother them the closer they get to a year.

Unless there are known food allergies in your family history or your baby is having severe reactions to what you think you may be eating, there’s no need to restrict what you eat. Remember: fussiness and gas is normal for a young baby, and is not usually related to foods you eat. If your baby is sensitive to something you are eating, you will most likely notice other symptoms in addition to fussiness, such as EXCESSIVE spitting up or vomiting, colic, rash or persistent congestion, crying inconsolably for long periods, or sleep little and wake suddenly with obvious discomfort. Other signs of a true food allergy may include: rash, hives, eczema, sore bottom, dry skin; wheezing or asthma; congestion or cold-like symptoms; red, itchy eyes; ear infections; irritability, fussiness, colic; intestinal upsets, vomiting, constipation and/or diarrhea, or green stools with mucus or blood. Fussiness that is not accompanied by these other symptoms and calms with more frequent nursing is probably not food-related.

Comparison will steal your peace

Too often we look around to see what everyone else is doing and it makes us feel incomplete, incompetent, like we’re doing something wrong or not doing enough. We see the success of others in parenting, sleep training, their milk supply, pumping, whatever, and it makes us feel like we’ve failed. Comparison is the number one way to have your joy and peace stolen. Stop looking at Becky over there with her oversupply and thinking your normal supply is inadequate for your content and growing baby. Stop looking at Gina over there whose baby has slept through the night since two months and thinking there’s something wrong with your happy child. Stop comparing your tiny but mighty that looks like the rest of your flock to my giant giraffe babies that look like the rest of my herd. You’re not getting a grade. Breastfeeding is not a pass/fail activity. Trust your baby. Trust your body. You’ve got this.

Do I need to wean when baby has teeth?

When a baby is latched correctly, their tongue comes over the gums (and teeth) to cup the nipple and breast. If a baby is latched deeply, they physically cannot bite the breast. They may bite while unlatching or if they slide down the breast because of distraction or behavior. Never fear, you can safely continue to nurse once baby starts teething. I can’t guarantee you won’t get bit, but that’s another post.

Pumping Log: pumping for a toddler

As  babies grow, there needs for milk also change. During the first year of life, after one month of age, babies need 20 to 30 ounces of milk per day. This need does not change until your baby reaches the first year milestone. From 1 to 2 years, babies need approximately 15 to 25 ounces of milk per 24 hour period. They get the rest of their nutrients from solid foods taken right from the table. Interestingly enough, infants need more calories but less protein than toddlers. Toddlers need fewer calories, but more protein in those calories. Just as your child’s nutrient needs to change, so does your breast milk. I have noticed a big drop in my pumped milk supply even though my daughter is still nursing. My daughter still nurses voraciously when she wakes up, kind of nurses when I get home, and usually nurses once in the middle of the night. When I’m home all day with her she does fewer nursing sessions and is SO easily distracted by herself and the environment. But she’s growing, is still having good wet and dirty diapers, and is happy!!! She is like a solid food vacuum.  She LOVES all kinds of berries, fruit, peas and carrots, beans, pasta, cheese and yogurt, chicken, beef, pork, and eggs.  She eats a nice variety with good toddler portions. Happy Pumping!!!

Wednesday: two pump sessions. Approx 4 ounces.

Thursday: 3 pump sessions, approx 6 ounces

Friday: Two pump sessions, approx 4 ounces