Posts Tagged ‘nipple gel’
Friday, October 14th, 2011
Fountain at Schönbrunn Gardens Vienna, Austria
Breast cancer is the most commonly diagnosed cancer in women, aside from skin cancer. Approximately one out of eight, or 12% of all women will develop breast cancer in the United States. Next to lung cancer, breast cancer death rates are higher than any other cancer for women.
A new research report from the American Association of Cancer Research has revealed that breast milk may give reliable insight into a woman’s future risk of breast cancer.
Breast feeding women have been found to release abundant sloughed epithelial cells into their breast milk. Samples can be obtained easily from both breasts painlessly. These epithelial cells can be tested for cancer markers. Approximately 80% of all women will give birth at some point in their lives, making these cells readily available from a majority of women for testing in determining relative risk of the developing breast cancer. Ordinarily, in women who are not breastfeeding, would require aspiration of fluid from breast tissue which is both costly, painful and has a very low yield of cells.
The tumor marker that is being studied is the addition of certain ‘methyl groups’ onto specific genes in the DNA of these epithelial cells. It has been noted that the addition of these methyl groups disrupts normal cell function. Women who have increased risk of developing breast cancer have a high amount of methylation in these epithelial cells.
Also of extreme importance is the fact that the methylation of cells is possibly reversible. This would make it highly desirable to obtain early detection and possible treatment for women that have excessive amounts of these type of cells. Women who have excessive methylation can be followed more closely since breast cancer risk increases with age. The possibility of developing routine breast cancer screening tests for all women after they give birth may be a real possibility for the future since trials from the University of Massachusetts at Amherst, by Dr. Arcaro have demonstrated a safe, accurate and inexpensive way of obtaining this extremely valuable information.
Beaute de Maman has recognized the importance of breast feeding to both the baby and now to mom. Previous blogs on our website www.beautedemaman.com have discussed how breastfeeding can reduce the risk of breast cancer, ovarian cancer, osteoporosis and heart disease in women.
Beaute de Maman’s goal is to provide better and more effective high quality products to enable more women to breast-feed successfully and for longer periods of time, thus improving the health of their infants as well as their own well being. Our nipple gel has incorporated a natural, herbal, anti-bacterial and anti-fungal herb into the product that has antiseptic and anti-inflammatory properties, with the intention of preventing mastitis.
The base of our gel is a natural, omega 3 fatty acid which has been found to be important for brain and eye development in infants. The gel is easy to apply and can be left on the nipple until the next feeding. Beaute de Maman’s nipple gel contains no lanolin, and no animal products.. Our aim has always been to raise the bar on available products for pregnant and breastfeeding women.
Tuesday, August 31st, 2010
As an OB, my patients ask me just as many questions about breastfeeding as they ask about pregnancy itself. I don’t mind at all because it is such an important topic. Over the years, I have scribbled many of these questions in my notebook so that I could research the most current information for new mothers eager to learn how to feed their babies the natural way.
Now, these questions are the basis for this week’s blog which is written just for you, with a completely different mindset and format than all my previous articles. Before writing however, I decided to interview the head lactation consultant, Ms. Renate Abstoss at Stamford Hospital in Connecticut, to get a second opinion and gather her responses. Ms. Abstoss sat for the first International Board Exam for Lactation Consultants in 1985 and has continuously worked in the field since that time in California, New York, Germany, Austria, Switzerland, and Connecticut. She was the first lactation consultant appointed as State Certified Teacher for Bavarian Midwifery schools.
There are probably many variations of responses to these questions so please consider this information helpful, but not absolute. I welcome any additional “pearls” from other lactation consultants or experienced moms so we can share the knowledge and promote the best nutritional health for babies everywhere.
- What are the most common problems that women encounter when pumping?
Dwindling milk supplyis probably the foremost problem that women encounter when pumping milk. This can be attributed to many different factors.
- Infrequent pumping
A working woman should try and pump every 3 hours for 10 to 15 minutes or at least for every missed feeding.
- Inefficient pumping
Pump being used may have inadequate pressure or not enough cycles per minute causing a decrease in the milk supply.
- Lack of breast feeding
Even when mom is home from work, she should try and breast feed the baby to stimulate milk production. For convenience, babies may be bottle fed too frequently.
- Painful nipples
This can be due to a bad pump due to excessive suction pressure, pumping for too long a period of time, or poor latch when the baby does breast feed.
- Fatigue and exhaustion
The stress of taking care of a newborn along with pressure from work and home can result in exhaustion and fatigue which can decrease the milk supply.
- How do I increase my milk supply?
There are several medications and herbal products available to help with increasing the milk supply. To increase an existing milk supply, one can take two herbal supplements in combination fenugreek and blessed thistle, both of which are available in health food stores and have no known contraindications.The two most commonly used prescription drugs are Metoclopramide and Domperidone both of which were designed as stomach medications but were found to increase prolactin production in the brain. The medication Domperidone, (Motlium) is not approved for use in the United States and the FDA has issued warnings against the use of this drug as a galactagogue because in higher dosages, when given intravenously, Domperidone it was associated with cardiac arrhythmias and cardiac arrest. However, the small dosages that are used when given orally to increase lactation (30–40 mg/day) and for the short duration of three to six weeks does not seem to be a great concern. Patients generally obtain this medication from Canadian pharmacies or from Mexico and Europe where it is over the counter. Studies are now being conducted by ILCA (International Lactation Consultant Association) regarding the safety of domperidone.
Metoclopramide (commonly known as Reglan), used to treat severe nausea in pregnancy, has been known to have a side effect of depression so its use has to be carefully monitored in the postpartum mother. The drug can be detected in breast milk and the long term side effects to infants is unknown.
- How do I treat plugged milk ducts?
Milk ducts that do not drain can cause the milk to back up resulting in a plugged milk duct. Often the the surrounding breast tissue becomes hardened and inflamed. This area can eventually become infected resulting in a mastitis requiring antibiotic therapy. Plugged ducts often occur when:
- Mom misses feedings
- Mom fails to pump frequently
- The breast fails to empty
- Nursing more frequently
- Changing positioning
- Improving the latch of the baby (sometimes a shield is necessary). A lactation consultant would be very instructive in this situation.
- This can be a result of incorrect positioning, inadequate pressure from a pump, or restriction of milk flow from poorly fitting bras or any kind of breast trauma that damages the duct. Fatigue, stress, or failure of the baby to latch on properly can also contribute to this problem.
- Standard Treatment consists of moist heat beforehand for approximately 5 minutes, empty breast as much as possible, cool compresses afterwards, and reduce swelling in between feedings. Massaging the duct towards the nipple may also be helpful. If the plug comes out, it may look like dried milk in a string. One should continue to nurse to fully clear the plug. Apply cold compresses via an ice pack or a plastic bag of frozen peas for approximately 15 to 20 minutes. Fresh cabbage leaves to the area is another herbal remedy that can be used in between feedings to help with engorgement. Cabbage leaves can be left in the bra for approximately one hour until it wilts. It is important to avoid the nipple area when applying the cabbage leaf because the cabbage is caustic and can cause irritation.
- Other helpful treatments include:
- What do I do if the baby does not latch on?
Latch problems can depend upon the situation causing them:
- It may be due to a newborn who is just learning how to latch.
Assistance from a lactation consultant can be very helpful in making sure the baby is latched deeply with a mouth very wide to get all the breast tissue. The baby should be latched well beyond the tip of the nipple. Often latching problems occur because the baby fails to flare the bottom lip.
- Is it due to flat or inverted nipples?
If the problem is due to flat or inverted nipples, a suction device, pump, or nipple shield may be used to avoid engorgement by expressing the milk. This will avoid a lowered or disappearing milk supply. Different lactation consultants and hospitals may prefer one modality over another, however all agree that care has to be taken when using any device that serious trauma or damage does not occur to the nipple.Once the baby is “educated” that the breast is his or her “food supply”, generally the baby will nurse fine. It is helpful to try and get beyond the first few days when only colostrum is present, until the milk comes in. Try and avoid avoid artificial nipples at the very beginning.
- Is the baby not hungry at this time?
- Is there a nursing strike?
A “nursing strike” can occur if a well nursing baby, beyond the newborn period suddenly refuses to nurse. This can occur often after 4 months of age when a mother will state “my seven month old baby just suddenly weaned herself.” These babies are not weaning but are actually facing a situation where nursing has become unpleasant, boring, or painful. Often these infants need to be taught to return to a functional breastfeeding pattern with increased skin to skin contact, trying to nurse in a quiet, calm environment without distractions, such as nursing at night in bed. Bottles should be avoided but spoon or cup feeding with expressed milk is acceptable. If the underlying cause is treated, most babies will happily go back to their normal nursing pattern.
- Is the baby getting sick?
Causes of poor latch can be an undiagnosed ear infection, a urinary tract infection, or an upper respiratory infection. Check with your pediatrician to be sure an illness is not being missed. Maternal stress can also cause this problem.Regardless of the problem, it is important to remove the milk as efficiently as possible if an established supply exists to avoid engorgement which will lower or cause the milk supply to disappear.
If the baby is not latching, it is important to stimulate the establishment of milk production through use of a pump.
- How do I wean the baby when I have decided to transfer to a bottle?
Weaning is the time the baby transitions away from the breast. Time frames for weaning can vary from weeks to months.Slow weaning is always more optimal. Some mothers will use the pump for weaning and stop breastfeeding entirely. One option for weaning would be to reduce the time per pumping, ie instead of pumping for 15 minutes, reduce it to 10 minutes. This can gradually be dropped down to 2 to 3 minutes per session. An alternative way to wean is to increase the interval between pumping sessions, ie from every 3 hours to every 4, 6 or even 8 hours. If desired, one can use ice packs after pumping for comfort. Also, Motrin can be used for anti-inflammatory pain relief. A comfortable, tight bra can also help with support and relief. Nursing pads can be used to prevent excess leakage. A recommended herbal remedy can be drinking 3 cups of sage tea which is available in health food stores. It has a strong and astringent taste so adding honey makes it more palatable. Do not use this if currently pregnant since it has abortive action.
On occasion, sudden weaning becomes necessary. Discomfort is generally greater since the breast continues to make milk and the breast remains engorged. Nursing can be replaced with pumping but only pump the breast to allow comfort and not to completely drain. Increase time frame between pumpings.
Three days of Sudafed can help dry up the milk production. The milk supply decreases as you feed less. The milk quality also changes becoming more salty and colostrum-like which many babies do not like. Consequently, this also helps diminish the nursing.
Tuesday, August 10th, 2010
Earlier this month, which happens to be Breastfeeding Month, the well-known model Gisele Bundchen ignited a firestorm of controversy regarding her opinion that breastfeeding should become a worldwide requirement by law.
Gisele, clearly passionate about being a new mother, may have over-reached a bit, but her heart was in the right place. She retracted her statement a few days later on her own blog, stating that she did not mean to say it should be a law but that she was just being enthusiastic and that the statement was taken out of context by the press and media outlets. I mention this because I think Gisele has advanced an important conversation regarding the workplace and expression of breast milk.
Gisele Bundchen wrote on her blog. “My intention in making a comment about the importance of breastfeeding has nothing to do with the law. It comes from my passion and beliefs about children. Becoming a new mom has brought a lot of questions, I feel like I am in a constant search for answers on what might be the best for my child. It’s unfortunate that in an interview sometimes things can seem so black and white. I am sure if I would just be sitting talking about my experiences with other mothers, we would just be sharing opinions. I understand that everyone has their own experience and opinions and I am not here to judge. I believe that bringing a life into this world is the single most important thing a person can undertake and it can also be the most challenging. I think as mothers we are all just trying our best.”
Last week I wrote about how to safely store your breast milk while working, or away from your baby, for any reason. This week, my article is about the many challenges women around the world face, both cultural and governmental, when trying to breastfeed their babies.
The month of August is Breast Awareness Month. The United States Department of Health and Human Services is sponsoring a campaign to encourage women to breastfeed. Despite all of the articles and books promoting the importance of optimizing infant health by breastfeeding, 70% of women will start breastfeeding immediately after delivery, and fewer than 20% will still be breastfeeding 6 months later. There still exist numerous cultural and legal barriers that make it very difficult for mothers to exclusively breastfeed. Women often feel nervous and embarrassed when breastfeeding in public and this will often result in abandoning breastfeeding.
A well known legal case in 1981 (Dike v. The School Board) is a perfect example of a discriminating situation that breastfeeding mothers may face.
Janice Dike was a grade school teacher in Orange County, florida, who was banned from breastfeeding her child during her free lunch period. She claimed that her breastfeeding did not interfere with her teaching or her other school and work activities. The local court ruled against her, saying that it was illegal to breastfeed at the school. On appeal to the Fifth Circuit Court of Appeals, this decision was reversed. The decision stated that breastfeeding is a Constitutional right that cannot be restricted by the states. However, this ruling was again reversed in the case of Shahar v Bowers (1997) in which the Court stated that the Constitution does not address private conduct but rather that State laws should control a woman’s basic right to breast feed her child.
What are the current laws?
There are Federal laws and State laws that protect the rights of breastfeeding mothers and provide a socially supportive environment. Mothers must be aware of the legislation that exists in their particular state to avoid feelings of discrimination and to alleviate any anxiety they may have in public places. States vary in their protection of women.
- Forty-four states (and the District of Columbia and the Virgin Islands) have laws specifically allowing women to breastfeed in public and private places.
- Twenty eight states (including the district of Columbia and the Virgin Islands) have specific laws exempting breastfeeding from public indecency laws.
- Twenty four states (including the District of Columbia and Puerto Rico) have laws that protect women when breastfeeding in the workplace.
- Twelve states (including Puerto Rico) exempt breastfeeding women from jury duty.
- Five states and Puerto Rico have breastfeeding education campaigns.
- Individual states also have unique laws. Places like New Jersey and Hawaii allow a woman to seek legal recourse if she is unfairly discriminated against for public breastfeeding and states like Missouri allow breastfeeding only in certain locations and times and with appropriate discretion.
- Women are permitted to feed in any federal owned building or property, regardless of state (passed in 1999).
- Only Virginia allows women to breastfeed on any land or property owned by the State.
In my own state, Connecticut, there is a law that protects a woman’s right to breastfeed her child in any public place and employers must allow you to breastfeed or express milk at work, even if it is a very small firm. This means that your employer must allow you to breastfeed or express milk during your meal or break period and your employer must make a reasonable effort to provide a room or comfortable location to do this (not a toilet stall).
In March 2010, President Obama signed the Patient Protection and Affordable Care Act which now requires an employer to provide reasonable break time for an employee to express milk for the purposes of nursing or expressing milk for her child for one year. The employer has no obligation to compensate the employee for this time. The employer must also provide a reasonable space to do this (not a bathroom). An employer of fewer than 50 employees is are not required to do this if it imposes undue hardship. Also, this law is not meant to preempt any state law that provides even greater protection for a nursing employee.
In the past, other bills have been proposed in Congress to try to protect breastfeeding rights that provide for tax incentives for businesses to create lactation lounges for employees, minimum standards for quality control for breast pumps, and tax deductions for breastfeeding equipment and services. However, these proposals have not been passed.
US Policy on Breastfeeding
In the larger arena, in world policy, the United States has not been considered one of the world leaders in policy to promote breastfeeding.
Important international policies in the past included:
- The UN convention in 1989 on the Rights of the Child which was ratified by every country in the world except the United States and Somalia. This convention provided a basis for governments, international agencies and other organizations to formulate programs to provide for supporting, promoting, and protecting breastfeeding.
- In 1989, WHO and UNICEF issued a joint statement entitled Protection, Promotion, and Support of breastfeeding: Ten Steps to successful Breastfeeding that calls on hospitals and health care facilities to adopt practices to encourage and promote breastfeeding.
- 1990, The Innocenti Declaration was created by participants of WHO/UNICEF policy makers meeting on breastfeeding held in Florence Italy that set targets for governments to implement by 1995 for establishing national breastfeeding coordinators and committees and ensuring appropriate maternity services protecting the breastfeeding rights of working women.
- The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991 by WHO and UNICEF to call for action for all maternity services, freestanding or hospital-based, to become centers for excellence in breastfeeding support. Accreditation is granted when a center doesn’t accept free or low cost breast milk substitutes, does not provide feeding bottles or artificial nipples and has implemented the ten step program to support breastfeeding. As of 2007 there were only 56 hospitals and birthing centers in the US holding the BabyFriendly certificate.
- The United States breastfeeding Committee was established in 1998 (USBC) which works on advocacy issues at the Federal level. This is a group of 40 organizations which promote, protect, and support breastfeeding in the United States by focusing on national policy issues. The Committee attempts to promote implementation of the Innocenti goals of 1990 for establishing a national breastfeeding committee.
- In 2001 the United States Surgeon General issued the HHS Blueprint for Action on breastfeeding to encourage, market and support breastfeeding in the community and allow for the health care system of the US to support the training of health care professionals on the basics of lactation counseling and management within hospitals and maternity centers, and to support facilitation of breastfeeding for women who return to the workplace.
For woman facing discrimination, complaints can be filed with the National Alliance for Breastfeeding Advocacy (http://www.naba-breastfeeding.org/).
The LaLeche League International (LLLI) is also a valuable source for breastfeeding legislation. In addition, www.ncsl.org is a good resource for reviewing your particular states legislation on breastfeeding.
Breastfeeding a newborn infant is considered a mother’s basic human right, to provide for a child’s right to proper nutrition, health and care. The various countries have their own cultural, social, economic, and political norms, but basic protection guaranteed by government is essential to support women’s rights in this area. With recent legislation under President Obama, the United States is finally trying to catch up by providing legal and social support to improve national objectives for increasing the percentage of breastfeeding to 75% at birth, 50% at 6 months and 25% at one year of life.
Even in the US, we have such a long way to go in terms of acceptance of this very natural and beautiful practice. Please take the time to learn the facts so you can participate in conversations about breastfeeding law, whether you be at work, in a social situation, or even while helping others learn how to successfully breastfeed. If you are a physician or lactation consultant, please know that this is the most recent research available.
If anyone has any more suggestions to help mothers breastfeed longer, please post them in the comments section below and let’s get a conversation going about this very controversial topic.
Tuesday, August 3rd, 2010
Renate Abstoss IBCLC
While life does sometimes becomes a juggling act, most of us have learned how to keep all the balls in the air. For a new mother with a job outside the home, however, the simple desire to continue breastfeeding her baby may seem impossible.
Don’t give up!
It’s a well known fact that breast feeding has significant benefits to both mother and baby. I have written several previous blogs addressing these benefits. Just last week I wrote about how 60% of the 4 million pregnant women in America are currently employed and that the majority of these new mothers will want to return to the workforce soon after delivery. This should not be a deterrent for promoting optimal infant health and therefore, it becomes extremely important for women to be encouraged to continue to breast-feed their newborns in a convenient way while still carrying on their daily work lives. Since women are not available for demand feeding, it is vital they know how to use a breast pump and how to store milk so that another caregiver can provide milk for the newborn. The blog this week will deal with the proper way to store breast milk.
What is the length of time that I can store milk?
Breast milk storage follows the rule of 3:
- Freshly pumped breast milk at room temperature (77 degree F or 25 degree C) should be used within 3 hours.
- Freshly pumped breast milk that is refrigerated (39 degree F or 4 degree C) should be covered and used within 3 days.
- Freshly pumped breast milk can be frozen (4 degree F or -16 degree C) for up to 3 months. (Check your home freezer for temperature—freezers may run as low as 0 degrees F and deep freezes may run at -10 degrees F.)
Can I refrigerate or freeze milk after it has been sitting out for the 3 hours?
No. One cannot follow one step after the other. The milk is at the end of its shelf life after one of the above 3 steps is followed. However, if small amounts of milk are pumped at a sitting, it is possible to put the freshly pumped milk in the refrigerator to cool and then immediately add it to frozen milk in order to obtain the accumulated 4 oz. feeding. The milk will often freeze in layers and needs to be shaken before use. Shelf life is determined by the older milk in the container. Some sources suggest using the milk for longer periods of time, but often the taste of the milk deteriorates due to breakdown of flavonoids, which may cause the baby to reject the milk. The taste deterioration occurs before the milk becomes contaminated due to elevated bacterial counts.
What guidelines should I follow for freezing milk?
Similar to the way food stock is rotated in a supermarket, the newest milk should be placed in the back of the freezer where it is colder and older milk moved to the front, as a reminder to use it first. Dates should be placed on the container. If frozen for storage in a day care center, place the baby’s name on the container. Freezing in small allotments of 2 to 4 oz. is recommended since it takes less time to defrost and less is wasted if the baby is unable to finish the feeding. Leave room at the top of the container when freezing since liquid expands when frozen.
Disposable bags with freezer ties are fine to use since they take up less refrigerator space. Less expensive generic bags are just as good as brand name bags. It is a good idea to double bag the milk to eliminate and risk of contamination due to leakage. Several smaller bags can be placed in a larger zip lock bag. Plastic or glass storage containers can also be used, but there is risk of breakage. Avoid containers that have BPA.
How do I reheat the refrigerated or frozen breast milk?
Milk that has been frozen or refrigerated can be reheated to room temperature by putting it in a cup of hot water or in a bottle warmer. Refrigerated milk may take about 5 minutes to reheat and frozen milk may take about 20 minutes. Frozen milk left in the refrigerator to thaw takes approximately 12 hours. Never microwave frozen or refrigerated breast milk. This will destroy some of the beneficial properties of the milk. In addition, microwaved milk may be unevenly heated which could be potentially dangerous to the newborn. Milk that has been defrosted may appear layered due to the fact that the fat content will rise to the top. You may want to mix the milk by shaking before feeding to the baby.
Where do I get further information on storing pumped milk?
The La Leche League has a website that reviews storage guidelines. Guidelines may vary depending upon the lactation consultant. Also, the Human Milk Banking Association of North America (HMBANA) is a non-profit organization that sets standards and operates human milk banks in Canada, Mexico, and the United States. They provide information to the medical community on the storage of human milk and also serve as a resource for both potential milk donors and recipients for mothers that are unable to provide breast milk. We must keep in mind that there are new mothers who for one reason or another are not able to breast feed (gender, medications, illness, decreased supply, adoption/surrogate birth, etc.) and want the best nutrition and immunity protection for their baby.
Renate Abstoss IBCLC
Born and educated in Austria, Renate sat for the first International Board Exam for Lactation Consultants in 1985 and has been continuously certified and worked in the field since that time. She is currently the Lactation Consultant at The Stamford Hospital, a position she has held since 1997.
Tuesday, June 22nd, 2010
We all love to watch an adorable baby sucking on a bottle, but breast fed babies, although less likely to develop cavities compared to formula fed babies, can develop baby bottle syndrome when feeding is done on demand.
Until recently, a child would only visit the dentist after dental disease occurs. Sadly, some children with decay developed pain, infections, abscesses, chewing difficulties, malnutrition and low self esteem. Others experienced malocclusion, poor growth, difficulty in speech, bruxism (grinding) and decay of the permanent teeth. Delayed treatment was expensive and often children required general anesthesia and/or frightening restraint for needed repairs.
As if these outcomes were not terrible enough, many people have had to endure mouthful’s of fillings, crown’s and bridges later in life as the conditions worsened over time. I suppose this all may seem better than the infamous wooden teeth of the George Washington era, but honestly, not by much.
Now that dentistry has, thankfully, shifted to prevention of cavities by proper oral hygiene and treatment with antibacterial and tooth protecting substances, I thought it would be important to write an article focused on oral care guidelines for the newborn infant. This very new information, based upon many years of research, will crown my series of blogs focused on dental guidelines focused on pregnant mothers (and how to avoid gingivitis and periodontal disease and their possible associations of poor obstetrical outcomes). Now it’s time to turn to the babies.
But my baby has no teeth yet!
Not true! Although a baby is born without visible teeth, development of two sets of teeth has begun in earnest by the 6th week of gestation. By the time the baby is born, both the primary and permanent teeth are present below the gums in an early developmental stage.
Now that you understand that all your baby’s teeth are “in there”, it’s clear why early preventative care will help prevent traumatic dental care issues from cropping up any time during life.
What will a good dentist do?
Believe it or not, children should be visiting the dentist by 1 year of age and be seen twice a year after that. Dentists should discuss diet, provide oral hygiene instructions and detailed directions for fluoride intake. They should also offer behavioral recommendations including the use of pacifiers, the ramifications of thumb sucking and the prevention of baby bottle syndrome.
Will my baby’s diet affect her teeth?
Nutrition continues to play an important role in prevention of tooth decay. Cariogenic foods such as crackers, teething biscuits, fruits and fruit juices, sweetened and acidic soft drinks should be limited. Carbohydrates, broken down by the enzymes in saliva along with bacteria in the mouth leave acid residue that dissolves the tooth enamel. Gums and newly erupted teeth should be cleaned after eating these types of foods. Dairy foods, especially aged cheese, can be protective.
Is flouride good or bad for my baby?
Fluoride use, which prevents tooth decay by increasing the density of the enamel, helps the teeth resist acid dissolution and is recommended after birth to limit cavities (caries).
Fluoride content of water should be tested and fluoride given by 6 months of age if the water is not supplemented or if the supplementation is less than .6 parts per million. Excessive intake of fluoride is not recommended because it produces mild dental fluorosis. This can also occur when children swallow large amounts of toothpaste that is supplemented with fluoride.
Fluoride use during pregnancy is controversial, with broadly divergent opinions.
The opinions range from “absolutely not” to “absolutely, positively yes” based on studies, some of which are interpreted to find that there is great benefit provided by the use of fluoride supplements during the pregnancy, to commencing fluoride use with the eruption of the infant’s teeth, to those who express the greatest concern about the generation of fluorosis and other undesirable or even dangerous conditions. Please consult your physician and your dentist for the recommendation in your individual case. Be sure to tell those you ask whether you live an an area that has a fluoridated water supply or well water.
Pacifiers and Thumb Sucking
Pacifiers have both advantages and disadvantages. Pacifiers, which exert less abnormal pressure on the teeth than a thumb or other fingers, might prevent thumb sucking and thereby reduce the risk of developing severe malocclusion (overbite) and abnormal growth patterns of the structures that support the teeth (the maxilla and the mandible). If thumb sucking continues after the permanent teeth have erupted, it has an even higher probability of causing permanent damage. Pacifier use can be controlled in a child in contrast to an appendage such as a thumb. Pacifiers have also been associated with a reduced incidence of SIDS.
It has been shown that long term use of pacifiers can cause dental problems. Misalignment of the teeth or malocclusions have been reported when infants use them beyond the age of 4. There is also a higher risk of otitis media with their continuing use. Limiting the use of pacifiers to the first 6 months or limiting their use to sleep times is recommended. Continuous use of pacifiers may also stunt speech development.
There is little evidence that orthodontic pacifiers are any better than conventional ones.
Choose pacifiers made of a more durable substance like silicon rather than latex, and be sure that the pacifier is made in one piece to avoid smaller parts from being detached and swallowed.
Pacifiers have not been associated with cavities but pacifiers should not be coated with sweets. Contrary to popular belief, pacifiers do not shorten the duration of breast feeding.
What is Baby Bottle Syndrome?
This syndrome that results from excessive baby bottle use is characterized by the development of severe tooth decay with pain and infection leading to extractions and extensive dental treatment. Bacteria in the mouth use milk and other sweetened beverages for metabolism and create an acidic environment in the mouth causing the destruction of tooth enamel and creating cavities. Children suffering from baby bottle syndrome feed poorly and often fail to thrive. The damage initially appears as white lesions on the teeth and then later progresses to brown or black discoloration. When the damage is severe, the crowns break down and permanent teeth may also be damaged. Malnutrition, with deficiencies in calcium and Vitamin D, may also lead to tooth enamel defects which predisposes the teeth to caries. The overall incidence of baby bottle syndrome varies from 3% to 6% in the general population but can go up to 72% depending upon the population. The teeth most affected are the maximally and mandibular primary incisors followed by the primary molars.
Breast fed babies, although less likely to develop cavities compared to formula fed babies, can develop baby bottle syndrome when feeding is done on demand. Breast milk does not support the growth of bacteria, doesn’t lower the acidity in the mouth and is therefore not as destructive. This is another reason why all mothers should be encouraged to breast feed their infants. Proper use of nipple gels, such as the Beauté de Maman Nipple Gel, will heal the chapped, sore breasts that often prevent women from continuing breast feeding.
Summary of DOs and DON’Ts of Proper Infant Dental Care
Things to Do
- Mouth cleaning in infancy should be part of a daily routine.
- Clean gums, newly erupted teeth, (after 6 months of age) and tongue, with clean washcloth, piece of gauze, or very soft moist toothbrush after feedings and before bed.
- Clean mouth with toothbrush or washcloth after giving sweetened medications.
- Introduce solid foods after 6 months of age and avoid cariogenic foods.
- Bottles should only contain plain water if being given for naps, bed or pacifier.
- Schedule first dental visit after the first year of life.
- Encourage breast feeding, especially for the first 6 months of life when fluoride is not recommended.
Things NOT to Do
- Do not allow the infant to sleep or nap with a bottle filled with juice or milk.
- Do not dip pacifiers in sweet or sweetened foods such as honey, sugar, or juice—sugars will feed bacteria in the gums, causing tooth decay even before teeth have erupted. Do not give fluoride supplementation till 6 months of age-the American Dental Association does not advocate use of fluoride at this age because there is an increase of fluorosis (white spots on the teeth) in infants who are supplemented.
Like so much about having a new infant in the house, dental care may seem daunting. My advice to new parents is to find yourself a reputable dental professional, carefully follow the advice given, and then watch your baby’s teeth arrive sparkling, white and pain free.