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Abstract ing at will night time nursing, is common9 and children are
Purpose: The objective of this study was to determine the car- not usually weaned until between 18 and 36 monthshave
ies-related risk associated with human breast milk (HBM). reported extremely low rates of caries among children.10, 11
Methods: First, the plaque pH of 18 children (1224 months) These investigators reported caries incidences of 1.2% and
was monitored before and after a five-minute feeding with HBM 0.5% among children of Eskimo and Samoan cultures, respec-
to determine the pH drop and minimum pH obtained. Second, tively. Other studies have suggested that HBM is less cariogenic
Streptococcus sobrinus 6715 was cultured for 3 hr in HBM, and than glucose and sucrose.12, 13 Therefore, this study sought to
the increase in the number of colony forming units (cfus) and the determine the acidogenic and cariogenic potential of HBM.
culture pH was measured. Third, HBM was incubated for 24 hr
with powdered enamel to determine the solubility of mineral in Methods
the absence of bacteria. Fourth, HBM was mixed with acid to
determine the buffering capabilities. Finally, enamel windows Breast milk donations
were created on extracted premolar crowns (N=33) that were colo- HBM donations were collected after informed consent was
nized with Mutans Streptococci and incubated with HBM. Caries obtained following the guidelines of the University of Min-
was assessed visually and radiographically for 12 weeks. nesota Human Subjects Committee. Mature breast milk was
Results: One- and two-way ANOVAs of these five assays dem- collected by mothers who were still nursing a child (childrens
onstrated that HBM did not cause a significant drop in plaque ages ranged from 12 weeks to 2 years). The milk samples were
pH when compared to rinsing with water; HBM supported mod- collected into sterile plastic beakers after gentle manual expres-
erate bacterial growth; calcium and phosphate were actually sion of breast tissue. When necessary, the sample was then
deposited onto enamel powder after incubation with HBM; the transferred to sterile tubes for further transport. All samples
buffer capacity of HBM was very poor; and HBM alone did not were stored on ice until used. Sterile distilled water and sterile
cause enamel decalcification even after 12 weeks exposure. How- 10% sucrose were used as control solutions.
ever, when supplemented with 10% sucrose, HBM caused dentinal
caries in 3.2 weeks. Dental plaque pH changes after infant breastfeeding
Conclusion: It is concluded that human breast milk is not cari- Children (N=18) between the ages of 12 and 24 months
ogenic. (Pediatr Dent 21:8690, 1999) who were still breast feeding were used in this study. Follow-
ing completion of a medical/dental questionnaire for health
E
arly childhood caries (ECC) is a serious oral history, parental informed consent was obtained according to
health condition that affects about 6% of chil- the guidelines of the University of Minnesota Human Sub-
dren younger than three years of age. Baby bottle tooth jects Committee. The inclusion and exclusion criteria for
decay (BBTD), a manifestation of ECC, is associated with pro- subjects were normal, caries-free children in good general and
longed and frequent daytime, naptime, and nighttime bottle oral health with no dental anomalies.
feedings.1, 2 Recently, we have reported that most infant for- All sampling was performed between 10:00 AM and 10:30
mulas are acidogenic 3, 4 and do support in vitro caries AM. Parents were asked to abstain from oral hygiene for their
development.4 child for 24 hr and to avoid giving their child any foods, ex-
Prolonged and excessive breastfeeding also has been sus- cept water, for 2 hr prior to sampling. Supragingival plaque
pected as a causative factor in ECC.57 However, controversy was sampled from maxillary buccal surfaces. Alternating sur-
exists regarding the cariogenicity of HBM. HBM has a higher faces were sampled prior to feeding to provide the prerinse
carbohydrate content and lower calcium, phosphorus, and plaque control. The remaining sites were sampled after one
protein levels than bovine milk, thus making it potentially min of suckling or feeding with control solution. No site was
more cariogenic. Furthermore, the oral microflora of breast- sampled twice. Plaque was then dispersed in 50 l deionized
fed children is no different from bottle-fed children. 2, 8 In water and the pH monitored for one hr as previously de-
contrast, studies examining the incidence of dental caries in scribed.3 The positive control in this study was plaque collected
primitive cultureswhere on-demand breastfeeding, includ-
Data presented as mean SD.
Data previously reported.4 Significantly different from water (P<0.001).