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Ask Dr. Sears: Nursing Caries

Q: My son was diagnosed at thirteen months with nursing caries. I have cut down his nighttime feedings to one or two. I have also been wiping and brushing his teeth, day and night. My question is, what else should I do? My son is not ready to be weaned and neither am I, but I want to protect his teeth.

A: It's good that your child's dentist detected this problem early, and you are wise to seek remedies to prevent further tooth decay. Erosion of the teeth enamel is much more common with nighttime bottlefeeding, but it does also occasionally occur in breastfed babies. When babies fall asleep, saliva secretion decreases, so they lose the natural rinsing action of saliva that they have during daytime feeding. The sugars in the milk bathe the teeth during the night and eventually can cause tooth decay. Nursing caries are more prevalent in babies who enjoy frequent nighttime feedings. I dub them, "all night suckers." Try these tips to continue letting your baby enjoy the health and developmental benefits of breastfeeding, yet protect his precious teeth from decay.

Lessen night feedings. It's common for toddlers to increase their number of night nursings. They get so busy during the day and forget to nurse, so they make up for it at night. Purposely increase the number of daytime feedings by nap nursing -- choose a couple times during the day when you are the most tired, and lie down and nurse your baby. Toddlers also get distracted easily during daytime nursing. So, take your baby in a dark, quiet room and get down to the business of nursing. Ease him into a feeding pattern that helps him learn that daytime is for feeding and nighttime is for sleeping.

Tank up baby with a before-bed feeding. Make the last feeding of the day a big one. Give your baby a feeding of solid food later in the evening. Mashed avocado is a filling food for babies because it is high in healthy fats and fiber. Besides nursing your baby to sleep, consider awakening your baby just before you go to bed for another tank-up feeding.