Tooth Calendar Blog
No Falling Asleep with a Bottle: Preventing Baby Bottle Tooth Decay
When a baby falls asleep with a bottle, milk sits on the teeth and cavities start up front. Why it happens, the feed-clean-sleep routine, and early signs.
At a glance
- Don't put your baby to bed with a bottle
- Always clean the teeth after night feeds
- A white band or brown spot up front? See a dentist
If your baby falls asleep fastest with a bottle, that habit can be hard to change. But once teeth start coming in, it's a good time to take a look at bedtime feeding. Here's why bottle-related cavities happen and how to prevent them.
Milk lingers on teeth during sleep
Milk, formula, and breast milk all contain sugar. While your baby is awake, saliva keeps flowing and rinses the mouth. But saliva slows down during sleep. So when a baby falls asleep with a bottle, milk or formula left in the mouth stays on the teeth for a long time, and bacteria in the mouth use that sugar to make acid that dissolves the teeth.
Cavities caused by sleeping with a bottle or falling asleep while feeding are often called bottle rot, or early childhood caries. They start on the upper front teeth close to the gums (including the outer surface facing the lips), and they spread fast. Because they start near the gums and don't hurt at first, they're often found late. For several reasons, including protection from the tongue and saliva, the lower front teeth are less often affected, and these cavities usually start on the upper front teeth.
At first, a dull, chalky white band or spot appears on the upper front teeth near the gums. At this stage, there's no hole yet, so fluoride can stop it from getting worse. Left alone, it turns brown and the tooth starts to break down.
Breastfeeding itself is recommended. But once teeth are in, nursing whenever your baby wants all through the night can be a cavity risk factor. This doesn't mean you need to stop feeding. It means making cleaning after feeds a habit.
Feed, clean, then sleep
Try setting your bedtime routine as "feed, then clean, then sleep."
- Use the bottle only at feeding times. Don't put your baby to bed with it.
- Only breast milk, formula, or water goes in the bottle. No juice or sweet drinks. Even with water, if your baby gets used to needing a bottle to fall asleep, switching to a cup later is harder.
- When the feed is over, clean the teeth with gauze or a toothbrush. If teeth are in, use a rice-grain smear of fluoride toothpaste.
- After cleaning, help your baby fall asleep without food, by holding, singing a lullaby, or patting.
- From around the first birthday, gradually cut back on night feeds.
Cutting back on night feeds little by little, rather than all at once, is easier on both baby and parents. When your baby wakes, try patting them back to sleep before offering a feed, and slowly reduce how much they drink at a time or how many times they feed. Babies who eat enough during the day also tend to ask less at night.
If your baby falls asleep while feeding, gently take the nipple out and softly wipe the teeth with clean gauze. Even if you can't clean them perfectly, just clearing some of the milk off the teeth helps.
Every now and then, gently lift the upper lip and look at the outer surface of the front teeth where they meet the gums. Cavities can form on other surfaces too, so if anything looks unusual, have a dentist check it.
Frequently asked questions
Can breast milk cause cavities?
Breastfeeding is recommended for babies. But once teeth are in, frequent nursing through the night without cleaning can raise the risk of cavities. Make cleaning after feeds part of the routine.
Once we're off the bottle, is there nothing to worry about?
Giving up the bottle helps a lot, but carrying around a cup of sweet drinks and sipping often can also cause cavities. Keep an eye on what your child drinks and how often.
Should I wake my sleeping baby to clean the teeth?
There's no need to wake your baby on purpose. Gently wiping the front teeth with gauze while they sleep already helps a lot.
How long can night feeds continue?
It varies from baby to baby, so there's no set date. Gradually cutting back from around the first birthday is recommended, and as long as you're feeding at night, always clean the teeth afterward.
I see a white band. Can it be reversed?
An early cavity, before a hole forms, can be stopped from getting worse with fluoride. The earlier it's found, the simpler it is to manage, so have a dentist check it right away.
See a dentist right away if
- The area of the upper front teeth near the gums has turned white and dull
- You see a brown or black spot on the front teeth
- The front teeth near the gums look yellowish or rough
- A tooth looks chipped or broken
- Your child seems to hurt when eating something cold or sweet
English ebook · Dentist Ingyoon An
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Sources
The information in this article is for general educational purposes and does not replace professional dental care. Talk to a dentist about your child's condition.