Breastfeeding provides numerous benefits to both mother and child, while bottle-feeding and pacifier use can pose certain risks. The document discusses how breastfeeding promotes proper dental, facial, and airway development in infants. It also reduces risks of various health issues. In contrast, bottle-feeding is linked to issues like dental decay, ear infections, and abnormal facial growth. The document advocates exclusive breastfeeding for six months in accordance with major health organizations' guidelines.

1. BreastBreast
Feeding &Feeding &
PacifiersPacifiers
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2. Outline
• History of Breast Feeding
• Evolution of Bottle
Feeding
• Overall benefits of Breast
Feeding
-- to the mother
-- to the child
• Anthropology data on
pre – historic infant skull
• Endorsement of Breast
Feeding by various
organization
• Breast Feeding :
- Infant Dental Decay
- Craniofacial development
- Malocclusion
- Obstructive sleep Apnea
- SIDS & Otitis Media
• Breast Feeding & HIV
• Viruses & infections via
breast milk
• PACIFIERS
• Types
• Hazards

3. ReferencesReferences
• The potential role of breast-feeding & other factors in
helping to reduce Early Childhood Caries. J pub health
dent : 2008 ; mar 31.
• Relationship b/w breast-feeding & bottle-feeding to
craniofacial & dental development. Annal Dent Uni Malaya :
2005 ; 12 ; 9-7.
• Breast feeding ; bottle feeding & non-nutritive sucking ;
effects on occlusion in decidous dentition. Archieves of
disease in childhood : 2004 ; 89 ; 1121-1123.
• Breastfeeding & Early Childhood Caries : a critical review.
Journal de pediatria : 2004 ; 80; (5 suppl) : S199-S210.
• Pacifier use & Early Childhood Caries : An evidence – based
study of the literature. J Can Dent Assoc : 2003; 69(1): 16-

4. ReferencesReferences
• Pacifier use in children : A review of recent literature.
Pediat dent : 2003 ; 25 ; 449-458.
• Effects of different pacifiers on the primary dentition &
oral myofunctional structures of preschool children.
Pediatr dent : 2002 ; 24 ; 552-560.
• Physiologic stability of newborns during cup
- and bottle - feeding. Pediatr : 1999 ; 104(5): 1204-7 .
• www.brianpalmerdds.com
• www.aapd.org/breastfeeding
• Google searchGoogle search

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6. History of breast feeding

7. Introduction of bottle feeding
/ Pacifiers

8. There and back again :
A Breastfeeding Tale
Stamp
Havana
Virgin of the Green Cushion
Paris
Statue
Madrid
HHS Report
United States

9. Legislation
Initial U.S. legislation
conferred the right to breastfeed in
public.
Legislation exempted
breastfeeding women from jury duty
and protected them upon their
return to work.
Some state laws exempt
breastfeeding women from wearing
seat belts or exempt sales taxes on
products used by breastfeeding
women, such as shields and breast
pumps.

10. WHO
Breastfeeding
Recommendations
“…exclusive breastfeeding for six months is the
optimal way of feeding infants. Thereafter infants
should receive complementary foods with
continued breastfeeding up to two yrs of age or
beyond.”
( 2007 )

11. AAP Breastfeeding
Recommendations
“…exclusive breastfeeding is sufficient to
support optimal growth and development for
approximately the first six months of life…
Breastfeeding should be continued for at
least the first year of life and beyond for as
long as mutually desired by mother and
child.”
( AAP, 2005 )

12. Guilt by association :
Position of the AAPD in 1996
• “The risk of potentially devastating
nursing- pattern dental decay exists for
the breast-fed child as it does for the
bottle-fed child”
• Evidence linking breastfeeding and
infant caries remains equivocal (vague,
ambiguous,doubtful,
questionable).

13. AAPD statement in 1999 :
• Breastmilk alone does
NOT cause tooth decay!
BUT
• “ Exclusive breastfeeding ” does not mean
that the infant will be immune from decay.
• Human breast milk is NOT cariogenic

14. Breastfeeding : over all
benefits to infants
• Provides infant with temporary immunity
to many infectious diseases.
• It is economical, nutritionally adequate &
sterile.
• Easily digested
• Breastfed infants grow more rapidly
during the first few mon of life
• Growth spurts occur at about 10 days, 2
wks, 6 wks, and 3 mon ; infant may nurse
more frequently.

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16. Benefits for Mom
• Decreases postpartum bleeding
• Decreases risk of anemia & diabetes
• Helps in weight reduction
• Reduces risk of breast cancer,
• Reduces risk of ovarian cancer
• May reduce risk of endometrial
cancer
• Reduces risk for osteoporosis &
Rheumatoid Arthritis
• Acts as a contraceptive

17. Benefits to Baby
Reduced risks of:
• Otitis media
• Asthma
• Urinary tract infections
• Gastroenteritis
• Allergies
• Childhood Obesity
• Cancer / childhood Lymphomas
• Bacteremia, Meninigitis, Botulism
• Victims of child abuse & neglect

18. Benefits for baby cont.,
Reduced risks of:
• Juvenile Diabetes
• Ulcerative colitis/Crohn’s disease
• Childhood leukemia
• CVS disoders
• Sudden infant death syndrome (SIDS) or “crib
death”
• Obstructive sleep apnea (OSA)
• Long face syndrome

19. Benefits for baby cont.,
• Increases serotonin receptors in the brain
• Enhances brain &
IQ development
• Optimizes mother-infant
bonding
• Enhances strong jaw &
facial development
• Prevents various Malocclusions
& Tooth Abfractions

20. Colostrum
Property
• Antibody - rich
• Many white cells
• Purgative
• Growth factors
• Vitamin - A rich
Importance
protects against infection & allergy
protects against infection
clears meconium; helps prevent
jaundice
helps intestine mature; prevents
allergy, intolerance
reduces severity of some infection
(measles diarrhoea); prevents
vitamin A-related eye diseases

21. Anti-Infective Bio-active
Factors in Breast MilK
• Secretory Ig A
• Lactoferrin
• Lewis factor X
• SLPI ( Secretory Leucocyte Protease Inhibitor )
• α Defensins
• Lysozyme
• Complement
• Mucins
• Prostaglandins
• Interleukins
““ The anti-infective activity ofThe anti-infective activity of
human milk is potentially greaterhuman milk is potentially greater
than the sum of its microbicidalthan the sum of its microbicidal
components”components”
(CE Isaacs, 2004)(CE Isaacs, 2004)

22. Risks of artificial feeding
 Interferes with bonding
 respiratory infections
 Persistent diarrhoea
 Malnutrition
Vitamin A deficiency
 More likely to die
 More allergy &
milk intolerance
 Increased risk of
some chronic diseases
 Overweight
 Lower scores on
intelligence tests
 May become
pregnant sooner
 Increased risk of anaemia,
ovarian and breast cancer
Mother
, World Health Organization, 1993 (WHO).

23. Summary of differences
b/w milks
Human milk Animal milks Infant formula
Protein
correct amount, easy
to digest
too much, difficult to
digest
partly corrected
Fat
enough essential fatty
acids, lipase to digest
lacks essential fatty
acids, no lipase
no lipase
Water enough extra needed may need extra
Anti-infective
properties
present absent absent
World Health Organization, 1993 (WHO).

24. Prehistoric infant
skulls
Anthropology data
Breastfed babies had no decay
for 92,000 yrs
- Wider Palatal arch
- Nice facial forms

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26. Skull form
Healthy Unhealthy

27. Position and action of tongue during
breastfeeding ( Woolridge )

28. Positioning, Attachment and Milk Transfer, Breastfeeding Review, 1989,
Position of tongue while
Breast Feeding

29. Labbok / Hendershot article:
(1987)
• Babies develop a natural habit of
pacifying whilst in the womb
• short duration of breastfeeding may
increase the chances of prolonged
thumb sucking
• Principle finding - the longer the
duration of breastfeeding, the lower the
incidence of malocclusion.
• Bottle feeding leads to a habit of
forward tongue thrusting and a
weakened development of the
orbicularis muscles.
Am J Prev Med, 1987 ;3 (4) : 227-32

30. Obligate nose breathing

31. Transition to potential oral
tidal respiration

32. During Breast Feeding

33. Effect of Bottle Feeding on
Oro facial structures
Eustachian
tube
Separation
of Glottis &
Epiglottis

34. Factors Predisposing Bottle-
fed Infants to Otitis Media
• Lack of IgA immunity from human
breastmilk.
• Bottles propped -infant on back
-regurgitates into Eustachian
tubes .
• Confinement of the space in the
area of the ETs due to the
displacement of soft palate during
bottle feeding.
• Altered ability of the tensor palatini
to fire properly.

35. Muscles involved with the opening
and closing of the Eustachian tube /
Auditory canal
• Lumen opens chiefly when
attachment of tensor veli palatini
muscle pulls wall of tube laterally
during swallow.
• Auditory tube closes by elastic
recoil of cartilage, tissue turgidity
and tension of salpingo-
pharyngeus muscle.
Open eustachian
tube

36. PALATE formation oral
development

37. Tongue position at Rest
Neutral zone

38. Tongue position while
Breastfeeding

39. Tongue position while using a
Pacifier / Bottle Nipple
Abnormal muscle forces winning over bone

41. Suckling vs Sucking

42. Cranio-Facial form
• Skeletal formation
• Development of the airway
• Breastfeeding, for at least one year, is critical for the
proper development of the oral cavity, airway and facial
form
• Breastfed babies have a better chance of being prettier
than bottle-fed babies.
• Excessive sucking is what causes the damage.
• Excessiveness = Intensity + Frequency + Duration

43. Lip and Facial Contours

44. Morphometric formula:
Link between palate height and arch width
• P = palatal height
• Mx = maxillary intermolar distance
• Mn = mandibular intermolar distance
• OJ = overjet
• NC = neck circumference
• BMI = body mass index
P + (Mx - Mn) = 3 x OJ+ 3x (BMI - 25) x (NC/BMI)P + (Mx - Mn) = 3 x OJ+ 3x (BMI - 25) x (NC/BMI)
Annals of Internal Medicine, Oct 15, 1997; 127(8):581-87.

45. Caliper to measure arch
width and palatal height.

46. Modern high palate and narrow arch

47. • Ideal wide palate &
nice “U” shaped
arch of an adult that
was breast fed
• Narrow “V’ shaped
maxillary arch &
high palate of an
adult that was bottle
fed

48. Naturally wide ‘U’ shaped dental
arch with ideal palate height and
width.
Example of a high palate
and narrow arch.

49. “Breastfeeding of the child for more than 40 days may
act preventively and inhibit the development of nursing
caries in children.
• Human breast milk does contain lactose (milk sugar),
which is a potential carbohydrate food source for the
cavity causing bacteria, but the immune boosting
properties of breast milk seem to override this. Breast
milk protects against ALL infectious diseases of infancy,
including dental cavities.
.
Breast feeding : NOT related
to Infant Dental Decay
Pediatr Dent, 1999. Dec; 21(7):409-16

50. “Pooling” : false accuse
against breast milk

51. “Lactose” in Breast milk
false accuse for caries
• in lower intestine - turns to Lactic acid
• L. acid promotes Lactobacillus bifidus
• L. bifidus helps prevent intestinal putrefaction
• “ Cariogenic bacteria may not be able to utilize lactose as
an energy source as readily as sucrose ”
• Strep mutans is highly susceptible to the bactericidal
action of Lactoferrin.
• LF chelates iron, making this essential nutrient
inaccessible to an invading microorganism.

52. Principles invoved in collapse
of airway
Vol of air & time to pass thro should be equal

53. Principles invoved in collapse
of airway
air should pass faster
through a narrow tube
than the larger tube.

54. Breast feeding prevents
Obstructive Sleep Apnea
stoppage / blockage of air flow for
atleast 10 sec in presence of respiratory effort
while sleeping.
Risk factors
 improper feeding
 facial – skeletal abnormalities
 oral & airway obstruction

55. Gravity
• Jaw & tongue are
forward while
awake.
• While asleep,
muscles relax &
gravity can drop
the tongue back &
block off the
airway.
Breast Feeding : Reducing the risk
for
SUDDEN INFANT DEATH
SYNDROME

56. Breast feeding & SIDS
SIDS may reflect a delayed
development of arousal or
cardiorespiratory control...
When the physiologic stability of
such infants becomes compromised during
sleep, they may not arouse sufficiently to
avoid the fatal noxious insult or condition.
leading cause of death among infants
between 1 month and 1 year of age.

57. Breast feeding &
ABFRACTIONS
Stresses resulting
from biomechanical
loading forces exerted
on the teeth (static, as
in swallowing &
clenching or cyclic, as
in chewing)
loss of tooth
substance

58. Breastfeeding reduces
the risk of malocclusions and
tongue thrusts which are
main contributing cause of
abfractions

59. Infant Formula milk
• dissolved enamel mineral.
• Most formulas reduced pH significantly.
• caused dentinal caries by 3.4 wks &
pulpal involvement by 7.2 wks.
• Some formulas supported significant
bacterial growth.
Dr. Erickson won first place, 1997, AAPD
Pediatr Dent, 1998;20(7)(Nov-Dec):395-403

60. Human Breast Milk
• Calcium and phosphorus are actually deposited onto
enamel powder after incubation with Human Breast Milk.
• does not cause a significant pH drop in plaque.
• not cariogenic in an in vitro model, unless another
carbohydrate source is available for bacterial fermentation.
• buffer capacity is very poor.
• supports moderate bacterial growth.

61. Breastfeeding &Working women
• Use Expressed breast milk
• Expressed breast milk can be stored for 8 hrs at room
temp., in a cool place & 72 hrs in refrigerator
• Use cup & spoon
• Policies for encouraging Breast feeding by providing
Lactating room at work place
• I.H.S Lactation Worksite Policy the first
national government policy
• Wet nursing

62. Cup feeding as an alternative
• Cup-feeding was found to be an effective alternative to
bottle feeding
• giving breastfeeding newborns nutritional supplement
by cup is a safe alternative to administering it by bottle.
• Refrigerated or frozen, breastmilk separates.
• Heat breastmilk in warm water--
never microwave breastmilk.
• Thawed breastmilk can be kept in fridge for 24 hours.
Do not refreeze.
WHO 2001

63. HIV Transmission via Breast
Feeding : Myth / Reality
• 45% risk of mother to infant transfer
• Exclusive breast feeding to 6 mon.,
however NOT associated with
increased risk of transfer
• WHO advises : “ exclusive breast
feeding for HIV +ve mothers for the
first 6 mon., unless replacement
feeding is acceptable, feasible,
affordable, sustainable, & safe
( AFASS ) in which case avoidance of all
Breast Feeding is recommended ”.

64. Article taken from News Straits
Times, Malaysia - 17 April 2001.

66. Viruses via Breast Feeding
Virus
Transmitted
Virus NOT
Transmitted
CMV Hepatitis B
HIV Hepatitis C
HTLV - 1 Rubella
HTLV - 2 West Nile Virus
HSV - 1

67. Drug Transfer Into
Breast Milk
Acyclovir excretion into milk is concentrated
Albuterol excretion into milk is negligible
Aminoglycosides most excreted into milk
Amitriptyline excreted into milk but effects on
infant are unknown, may be of concern
Caffeine excreted into milk but acceptable
when not used excessively
All were rated “Compatible” with breast-feeding!

68. Breastfeeding the Infant
with Special Needs
Downs syndrome
• Hypotonia (weak suck,
poor head control,
tongue protrusion, poor
lip closure)
• normal tongue
placement & strengthens
jaw muscles used to co
ordinate sucking &
swallowing
Congenital heart disease
• Require more frequent
feedings
• Upright or semi-upright
positioning
• Mothers must be aware
of signs of fatigue during
feedings ― increased
respiratory efforts,
sweating & falling asleep

69. Cleft lip –palate infants
Complete clefts pre - clude feeding
– breast feeding not possible
– a soft, large bottle with large hole is
required
– a palatal prosthesis may be
required
Incomplete cleft / cleft lip
– a dancer hold position ;
–modified football
hold positioning

70. Breastfeeding the Infant
after Cleft Repair
• In some infants, sucking is discouraged for
a time post op
• Post op feeding may be via spoon, syringe
or a squeeze bottle

71. Human breastmilk kills
cancer cells !!
• Catharina Svanborg of Lund, Sweden
• The cancer killer is one of the most
abundant proteins in breast milk - alpha-
lactalbumin, which helps to produce
lactose.
• Stomach acid may be the key to its
activation.
Discover magazine, June, 1999, 68-75.

72. To Pacify or NOT to
Pacify……

73. Pacifiers / Dummies
Physiological Conventional

74. Pacifier hazards : dental
Primary dentition
 anterior open bite
 posterior cross bite
 Cl И primary canine
relationship
 Upper inter canine
width
 overjet
Oral Myofunctions
 Lip incompetence
 Lip entrapment
 Muscular tonicity of
tongue & lips
 Narrow hard palate

75. Pacifier hazards : general

76. Protective effect of Pacifiers
on SIDS / Cot Death ??
•
Times UK 2005
• Reduction in infant face
down
• Improved airway
• Reduction in GE reflux
• Increased arousal

77. More Controversy…

78. Lets put MOUTH back into the BODY !

79. Breastfeeding trulyBreastfeeding truly
is the best andis the best and
cheapest form ofcheapest form of
health “ insurance.”health “ insurance.”
‘SOUL FOOD for the baby packaged
with LOVE ’

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