The role of human milk in caries development

Early childhood caries (ECC) is a common infectious disease among infants and toddlers. It was initially labeled "baby-bottle tooth decay" given its association with bottle-feeding. Based on two case-reports in 1977 that breastfeeding may also be responsible for caries development, the name changed initially to "nursing caries" and later to ECC. However, few studies have addressed breastfeeding's role in caries development. In addition, no study has shown any association between breast milk and caries, which would be counterintuitive given breastfeeding's protection against infection, human milk's numerous antimicrobial components, and the negligible caries frequency among children in cultures where breastfeeding on demand typically continues for 18 to 36 months. Despite lack of evidence linking breastfeeding to caries development, these papers led the American Academy of Pediatric Dentistry to caution against ad libitum breastfeeding after eruption of the first teeth.

The objective of this project is to understand how human milk and its components affect viability, colonization and caries development produced by the major pathogens responsible for early childhood caries. We hypothesize that human milk and its components not only have nothing to do with development of early childhood caries, but that they protect against colonization and plaque formation and the progression of infection to tooth decay.

Our preliminary data indicate that fresh human milk, but not pasteurized human milk, inhibits growth of Streptococcus mutans and Streptococcus sobrinus, inhibits biofilms formation and sucrose induced decay of enamel surfaces. Data also shows that fresh human milk does not induce caries in a rat caries model.

This work is done in collaboration with Dr. Daniel Smith at the Forsyth Institute in Boston.

More information about breast-feeding, human milk and caries...