Many in the U.S. medical community, including U.S. public health officials, pediatricians and obstetricians and gynecologists who deliver babies, agree that “breastfeeding is good. The American Academy of Pediatrics (AAP) believes that breast milk has unique advantages for infant feeding and advocates that mothers should breastfeed to the best of their ability, unless they have a major medical condition that affects the quality of breast milk. Among the many advantages of breast milk are its dental benefits, as it contains a high concentration of protective chemicals and produces relatively little acid in the mouth. This evidence suggests that breastfed babies are more likely to have healthy teeth than non-breastfed babies. However, some studies have reported concerns that breastfeeding, especially overly extended periods of breastfeeding, may lead to early childhood caries. But so far there is no literature that clearly indicates a definite association between dental caries and breast milk or breastfeeding. Early childhood caries is a severe form of early childhood caries that causes rapid decay of dental tissues. Typical clinical manifestations include brown incomplete teeth with pain that appear before the child is 3 years old. These early cavities can also be a lifelong dental health risk for the child. The upper front teeth are usually the first to be affected. The most common location of decay is usually on the back or tongue-facing side of the tooth, so these decays are again difficult to detect. The upper posterior teeth are the second victims, followed by the lower posterior teeth, and the lower anterior teeth are usually not involved. So, what does the statement “breastfeeding is associated with dental caries in some children” mean? Is this just an implication effect as some people claim? Or is there scientific evidence that breastfeeding does increase the chance of tooth decay? And what should moms and dads do about it? To answer this series of questions, let’s review some scientific evidence explaining the development of caries and then compare it to what the American Academy of Pediatric Dentistry has to say for your reference. The formation of dental caries requires both direct interaction between bacteria and the presence of foods or beverages that can be broken down into acids. Children usually acquire this cariogenic bacteria from their mothers by the time they get their first teeth. The development of caries can be divided into an “attack phase” and a “repair phase” of the tooth. Several studies have shown that breast milk is not the best food for cavity-causing bacteria. The buffering chemicals in breast milk can effectively stop the tension of caries and help to repair the teeth. Multiple consumption of sugary foods, even multiple meals, can worsen caries. This is true even if the food does not contain ingredients that help cariogenic bacteria produce acid. Children who are allowed to snack and drink between meals usually develop tooth decay earlier and with more severe decay. Tooth decay progresses fastest at night. This is because our saliva production is greatly reduced at night and at bedtime, and saliva protects our teeth from decay. Therefore, the intake of any kind of food or drink, including breast milk, by children before or during bedtime is the one that accelerates the caries progression. Obviously, for most children, the risk of tooth decay from breastfeeding is very small and the benefits outweigh the disadvantages for many children. However, in certain circumstances, breastfeeding may again greatly limit a child’s ability to prevent tooth decay. Such situations include when breastfeeding occurs: very frequent feedings; repeated nursing throughout the night; and when the little one’s mouth is not cleaned after nursing. The American Academy of Pediatric Dentistry has a very clear position on the issue of breastfeeding: the Academy fully supports breastfeeding, but also highlights the potential caries risks associated with both breastfeeding and artificial formula feeding. The statement of the Medical Association adds that it should be avoided to keep the child on the breast all night before the first tooth erupts. The first milk tooth usually comes in between 3 months and 1 year of age, but most often at 6 months of age. Moms and dads can protect their babies with proper care by cleaning their baby’s teeth and gums with a moistened cloth or soft-bristled toothbrush after each nursing session. Take your baby to the dentist as soon as possible after his or her first milk teeth come in. Teach your baby to drink from a cup (instead of a bottle) by the time he or she is one year old. Make sure your baby is getting the right amount of fluoride. If the drinking water in your city does not contain fluoride, supplement your baby with fluoride after a detailed consultation with a pediatric dentist or pediatrician. You can give your child the benefits of breastfeeding without cavities by following these guidelines: The American Academy of Pediatrics recommends: Breastfeed your child for at least one year. Control the frequency of eating sugary foods when your child begins to have other liquid and solid food intake. This is one of the most important measures that can be taken to reduce your child’s risk of developing cavities. Establish your baby’s sleep routine as early as possible. According to the American Academy of Pediatrics, infants should learn to fall asleep on their own without nursing or gentle patting at 6-8 weeks of age. By 6 months of age, most babies should be able to sleep through the night. It is important to avoid nursing for too long at a time, especially if the child is very sleepy or appears to fall asleep while nursing. In short, mothers and fathers should be aware of the factors that can cause early childhood caries and make sure that their breastfeeding practices bring all the benefits of breast milk to their children and not the disadvantages.