Bottle feeding and tooth decay
Can bottle feeding damage your baby’s teeth?

Breastfeeding has been widely acknowledged as the best possible nutrition for your baby, and should not be substituted for formula if possible. However, if you are unable to breastfeed, or are using a bottle for any other reasons, it is vital that you have all the information you need to keep your baby safe and healthy.

Tooth decay is now at epic proportions in little ones with more than 30% of under fivers suffering from the condition, according to the experts at The Children’s Hospital at Westmead. A big culprit? Baby bottles filled with milk.

The revelation has prompted The Children’s Hospital at Westmead to issue a warning to parents to put an end to bottle feeding.

“Professer Widmer, head of dental services at Westmead, says, "Ideally, children should go straight from breast to cup, avoiding bottles altogether."

Although warnings have been issued against giving children sweet drinks in bottles, this is the first time experts have included milk – formula, cows and breast milk - on the list of prohibited drinks.

The reason is that bottle feeding milk, particularly overnight when the bottle may stay in your child’s mouth for long periods of time, allows lactose - a sugar found in milk - to pool in the mouth and combine with plaque on teeth to cause cavities. As such, prolonged bottle feeding at night is a recipe for dental caries (which are cavities caused by bacteria) - the most common chronic disease of childhood. If left untreated, dental caries can cause pain, serious infections and abscesses.

While lactose is present in both formula and breast milk, breastfeeding presents fewer dental problems because young children who are breastfed are not generally put to bed on the breast.

Breast milk offered in a bottle, however, can create the same dental problems as formula in a bottle because it is the sucking on the bottle of milk for an extended period of time that can do the damage.

Tooth decay due to bottle feeding is sometimes called Baby Bottle Dental Caries (BBDC) or Baby Bottle Syndrome, and is easily recognised by the trademark decay found behind the front teeth and lower back teeth. The decay pattern associated with BBDC occurs in these places because this is where the bottle is positioned when it is held in the mouth for long periods of time.

When teeth decay it can be necessary to remove them – often under general anaesthetic. Premature loss of baby teeth can cause problems for children as they learn to chew and swallow food properly and develop speech, as well as guiding the permanent teeth in the correct position, which can result in expensive orthodontic visits later in childhood to correct.

Breast is best for your child’s teeth

When it comes to your child’s teeth, breast is best because it keeps the amount of time milk is in your child’s mouth to a minimum.

How to minimise the risk of bottle feeding

If breastfeeding isn’t possible for you, keep in mind these bottle feeding tips:

  • Never allow your child to fall asleep with a bottle in her mouth – this is the major cause of cavities associated with bottle feeding
  • Take the bottle away from your child when she has finished drinking – don’t let her carry it around to sip on, or hold it between her teeth when she isn’t drinking
  • Offer water instead of milk if she wants a comfort feed
  • Never offer sweetened drinks such as cordial or fruit juice in a bottle
  • Transition her from a bottle to a cup early so that you can get rid of bottle entirely by 12 months

How to keep your baby’s teeth cavity-free

From the moment that first baby tooth erupts through the gum, your child is capable of getting holes in her teeth so it is extremely important that you begin good dental practices early to create good lifelong habits in your child, including:

  • Start brushing her teeth as soon as they erupt. If you struggle to get a toothbrush into your baby’s mouth, try using your finger inside a damp clean cloth to polish each tooth instead. Your child’s teeth should be brushed twice a day every day.
  • Keep sugary foods to a minimum
  • Keep snacking between meals to a minimum. While this may be hard to do with young children who like to graze, you can restrict snacks to a tooth-friendly variety of snacks including cheese, raw veggies, fruit, or plain yogurt.
  • Take your child for regular dental check-ups. Experts recommend two dental checks before the age of three and a half, regardless of whether there are any obvious dental problems.
  • Include fluoridated water in your child’s diet. Fluoride is the single biggest protector of teeth.


Pay attention to any changes in your child’s teeth – early detection of cavities can save a lot of problems later

Kidspot is dedicated to the promotion of breastfeeding as the best possible start in life for babies as well as being good for the health and wellbeing of mothers.

The World Health Organization recommends that infants start breastfeeding within one hour of life, are exclusively breastfed for six months, with timely introduction of adequate, safe and properly fed complementary foods while continuing breastfeeding for up to two years of age or beyond. Source:

Breastfeeding provides babies with the best nutrition and is preferred whenever possible. Good maternal nutrition is ideal for breastfeeding. You should be aware that reversing a decision not to breastfeed may prove difficult. Partially introducing formula could negatively affect your milk supply. Social and financial implications should be considered when selecting a method of feeding. Professional advice should be followed before using an infant formula. Proper use of an infant formula is important to the health of the infant and should only be used as directed.

If you’re worried about breastfeeding, your Well Child nurse or PlunketLine can help.

Last revised: Friday, 18 July 2014

This article contains general information only and is not intended to replace advice from a qualified health professional.

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