Megan Davidson-Eales
219 Walsh Street.
Mareeba. QLD. 4880.
31/3/2002
Dear Editor,
I am writing to express my disappointment with regards to the article "The rotten
state of our children's teeth", published in today's Sunday Mail. Although I found the
subject to be important and pleased to see your publication offering advice on dental
care for infants and children, I was disturbed by your advice not to breastfeed after
12 months of age.
As a midwife and breastfeeding mother, I had not heard of a strong association between
breastfeeding beyond one year of age and the development of dental decay. After
reviewing recent literature I believe that to suggest cessation of breastfeeding by 12
months of age is poor advice based on unfounded information.
Whilst current literature does confirm that the development of rampant dental caries
does occur in breastfeed babies, it is usually found in children who have nursed for 2
to 3 years and who have spent long stretches at the breast, however, these cases
represent a small percentage of young children. (Lawrence and Lawrence, 1999. Riordan
and Auerbach, 1998. Brams and Maloney, 1983. Gardner et al 1977 and Kotlow, 1977) It
should be noted that overall breastfeed babies have less dental decay than do those
who are fed otherwise (Al-Dashti et al, 1994. Tank and Stovick, 1995. Riordan and
Auerbach, 1998.)
Dental caries are thought to be an inherited trait, therefore, breastfeeding toddlers
who develop dental disease, probably represent a group who are more susceptible, and
therefore it could be argued that some breastfed children develop caries not because
they were breastfeed but in spite of it (Riordan and Auerbach, 1998.).
I am interested to learn what information the author, Elissa Lawrence, based this
statement on, as the World Health Organisation has published findings regarding the
benefits of breastfeeding into the second year.
In the area of orofacial development breast feeding has been found to have
"immeasurable impact" (Riordan and Auerbach, 1998.). Breast feeding has been found to
prevent malocclusion, (which is associated with both speech and dental problems). A
study under taken by Adamiak (1981) found that the longer the duration of
breastfeeding, the lower the incidence of malocclusion anomalies. This finding was
confirmed by Labbok and Hendershot's analysis of the Child health supplement of the
1981 National Health Interview Survey, which found an increased duration of
breastfeeding was associated with a decline in the proportion of children with
malocclusion. "This trend was found to be constant for all variables tested and
remained even when adjusted for age and maternal educational level as a proxy of
socioeconomic status" (Riordan and Auerbach, 1998:624.).
Lawrence and Lawrence (1999) state that the breastfeeding benefits for the older
infant have been scientifically evaluated, for example a study conducted on middle
class infants between the ages of 16 and 30 months in the United States revealed a
decrease in the number of infections and improved overall health compared to those
infants who were no longer breastfed.
"Unfortunately, many mothers are driven to "closet feeding" by insensitive,
uninformed relatives and friends, even physicians. Closet nursing is nursing privately
at home in secret and propagates ignorance about breastfeeding duration. * Thousands
of normal healthy children are breastfeed until they are 3 or 4 years old. The
benefits of human milk continue. Research documents health protection and improved
development for at least 2 years. It has not been evaluated beyond that except for the
positive emotional and bonding experience associated with long term nursing."
(Lawrence and Lawrence, 1999:346).
The benefits of breast feeding longer extends to the mother, such as a decreased risk
of developing osteoporosis and premenapausal cancer, and are to numerous to be listed
in such a short communication.
I believe that breast feeding is such an important social, emotional and health
influence on the child that it should not be undermined by such unsubstantiated
advice. I demand that the Sunday Mail retract the advice to cease breast feeding and
instead replace it with scientifically based recommendations. In the case of infants
with a family history of dental enamel problems, consideration should be given to
fluoride treatment as well as regular dental reviews. Lawrence and Lawrence (1999)
state that tooth susceptibility is genetically programmed and children with a strong
family history of caries may need fluoride supplements whilst breastfeeding.
To counteract the negative publicity, regarding breastfeeding after the age of one,
inflicted by your publication, I am urging the Sunday Mail to research the benefits of
breastfeeding into and beyond the second year (as recommended by the World Health
Organisation and the Royal College of Australian General Practitioners) and publish a
well researched, enlightened and encouraging article.
Sincerely,
Megan Davidson-Eales.
Registered Midwife, Registered Nurse, BNSc, MaNSc and proud breastfeeding mother of an
11 month old who will be breastfeed as long as he desires.
Adamiak, E. (1981) Occlusion Anomalies in Preschool Children in Rural Areas in
Relation to Certain Individual Features. Czas Stomat. 34:551-5.
Al-Dashti, A., Williams, S., Curzon, M. (1994) Breastfeeding, Bottle Feeding and
Dental Caries in Kuwait, a country with low-fluoride levels in the water supply.
Community Dental Health. 12:42-7.
Brams, M. and Maloney, J. (1983) "Nursing Bottle Caries" in Breastfed Children.
Journal of Paediatrics. 103:415-416.
Gardner, D., Norwood, J., Eisensen, J. (1977) At will Breastfeeding and dental Caries:
Four Case Reports. Journal of Dentistry For Children. 44:186-91.
Kendall-Tackett, K.A. and Sugarman, M. (1995) The Social Consequences of Long Term
Breastfeeding. Journal of Human Lactation.11:79.
Kotlow,L. (1977) Breastfeeding: A Cause of Dental Caries in Children. Journal of
Dentistry For Children. 44:192-93.
Labbok, M. and Hendershot, G. Does Breastfeeding protect agianst Malocclusion? An
Analysis of the 1981 Child Health Supplement to the National Health Interview Survey.
American Journal of Preventative Medicine. 3:227-232.
Lawrence, R and Lawrence, R. (1999) Breastfeeding: A Guide for the Medical Profession.
Mosby, Sydney.
Prentice, A. (1991) Breastfeeding and the Older Infant. Acta Paediatr Scand Suppl.
374:78.
Reamer, S. and Sugarman, S. (1987) Breastfeeding Beyond Six Months: Mother's
Perceptions of Positive and Negative Consequences. Journal of Tropical Paediatrics.
33:93.
Riordan, J. and Auerbach,k. (1998) Breatfeeding and Human Lactation. Jones and
Bartlett, London.
Sugarman, S. and Kendell-Tackett, K. (1995) Weaning Ages in a Sample of American Women
Who Practice Extended Breastfeeding. Clinical Paediatrics. 34:642.
Tank, G. and Stovick, C. (1995) Caries Experience of Children of One to Six Years Old
in Two Oregon Communities. Journal of the American Dental Association. 70:101.
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