“World Breastfeeding Week”, the theme of which is “Working Mothers, ‘Feed’ Love Persistence”. The purpose is to advocate enterprises and institutions to provide good breastfeeding conditions and facilities for female workers, to encourage working mothers to insist on breastfeeding habits, and to promote breastfeeding among lactating working mothers. New mothers always receive a variety of information about breastfeeding. Some argue that mothers should insist on breastfeeding on demand and at night, which is conducive to increasing milk secretion and increasing the number of feedings when breast milk is insufficient; opponents argue that breastfeeding, especially long-term breastfeeding, may lead to caries in younger children. Which view is correct? The American medical community believes that breastfeeding is the best way to feed infants and toddlers, and public health officials, doctors who care for babies and deliver them all agree on this. The American Academy of Pediatrics (AAP) believes that breastfed babies have “unique advantages. They say mothers should breastfeed unless medical conditions prevent it. Among the many benefits of breastfeeding may be the impact on teeth. Breast milk has been found to contain high levels of protective chemicals and to produce relatively little acid in the mouth. These facts suggest that breastfed infants should have an advantage in terms of dental health. However, there are reports and studies that raise concerns that breastfeeding – especially long-term breastfeeding – may lead to caries in younger children (ECC). In contrast, other dental studies have shown no link between caries and breast milk or breastfeeding. Early childhood caries is a type of carious disease that causes rapid decay of dental tissue. Typical clinical manifestations of severe early childhood caries include brown, incomplete teeth that appear before the child is 3 years old and are associated with pain. These early cavities can also set the child’s dental health at risk for the rest of his or her life. 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, making these decays 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 it 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 mothers and fathers do about it? To answer this series of questions, let’s first review some scientific evidence explaining the development of caries, and then let’s compare the statements of the American Academy of Pediatric Dentistry for your reference. The formation of dental caries requires both direct bacterial interaction and the presence of food or drink that can be broken down into acid. Children usually acquire this caries-causing bacteria from their mothers by the time they get their first teeth. 2. The development of caries can be divided into the “attack” and “repair” phases of the tooth. Several studies have shown that breast milk is not the best food for carious bacteria. The buffering chemicals in breast milk can effectively stop the tension of caries and help the tooth repair. 3. Multiple consumption of sugary foods, even multiple meals, can aggravate the caries. This is true even if there are no ingredients in the food that can help carious bacteria to produce acid. Children who are allowed to eat snacks and drink between meals usually develop tooth decay earlier and the decay is more severe. 4. The fastest progress of tooth decay is at night. This is because our saliva production is greatly reduced at night and during sleeping time, and saliva can protect our teeth from caries. 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. 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 risk of cavities in 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 teeth usually come in between 3 months and 1 year of age, but most commonly at 6 months of age. Moms and dads can protect your baby with proper care: 1. Clean your baby’s teeth and gums with a moistened cloth or soft-bristled toothbrush after each nursing session. 2. Take your baby to the dentist as soon as possible after his or her first baby teeth come in. 3. Teach your baby to drink from a cup (instead of a bottle) by the time he or she is one year old. 4. Make sure your baby gets the right amount of fluoride. If the drinking water in your city does not contain fluoride, supplement your baby’s fluoride after a detailed consultation with a pediatric dentist or pediatrician. By following these guidelines, you can give your child the benefits of breastfeeding without the cavities: 1. The American Academy of Pediatrics recommends that you breastfeed your child for at least one year. When your child starts to have other liquid and solid food intake, control how often he eats sugary foods. This is one of the most important measures that can reduce your child’s caries. 3. Establish your baby’s sleep routine as early as possible. According to the American Academy of Pediatrics, infants should learn to sleep on their own without nursing or patting at 6 to 8 weeks of age. By 6 months of age, most babies should be able to sleep through the night. Avoid nursing for too long at a time, especially if your 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 behavior will bring all the benefits of breast milk to their children and not the disadvantages.