Teething and Breastfeeding
You might shudder at the thought of breastfeeding a teething baby. All of those tiny, sharp teeth... ouch! Or maybe you've wondered if breastfeeding a baby with teeth is even possible or recommended?
Typically, babies start teething within the first year. Baby's first tooth usually erupts by six months of age (though every baby is different and your baby might get their first tooth later). Remember, breastmilk or formula is the main source of nutrition for babies up until one year old. So it is extremely common for babies with teeth to be breastfeeding!
Signs of Teething
All babies react differently to teething. Some babies will be fussy but others will carry on as if nothing is happening! Every baby is different but there are some signs of teething that are common in many babies:
low-grade fever
drooling
fussiness
cheek rubbing or ear pulling
biting or gnawing
If your baby has teething pain, they may want to breastfeed more frequently because they find it comforting, or they might want to breastfeed less frequently because they are dealing with sore gums and feeding is uncomfortable for them. It's hard to know what your little one will do until they are going through it.
Pain Relief + Fussiness at the Breast
If baby's gums are sore and they seem to want to breastfeed less frequently than usual or are fussy at the breast, you might want to try helping them relieve the pain a bit before nursing.
My favorite tip for pain relief before nursing is to numb their gums a bit before latching them. I like recommending a frozen wet washcloth for this. To make a frozen washcloth, soak a washcloth in some breastmilk, and then pop it in your freezer. When it is frozen, you can offer it to them to chew on, and the cold will feel soothing to baby's mouth. It’s cold but still soft and chewable. You can try other cold teething toys as well- you can experiment and see what baby seems to like best!
Another thing to try if baby is hesitant to latch is initiating your letdown and getting your milk to start flowing with your breast pump before latching. This makes the breastmilk more immediately available to baby because they don't have to do all of the faster sucking that they normally do in the beginning to get the milk to start flowing.
You can also talk to your baby's pediatrician about pain relievers and if they are recommended for your baby
“Will breastfeeding a baby with teeth be painful for me?”
While it might sound scary to breastfeed a baby with teeth, hopefully you find this reassuring: if baby's latch is good and your nipple is in the back of their mouth (where it should be with an optimal latch!) you will not feel their teeth while they are nursing. Especially the lower teeth- the tongue sticks out over the gum line during nursing, so it will cover up those bottom teeth!
If your baby has been compensating for a poor latch and biting down with their gums at all while feeding, you may feel their top teeth when they come in. This is one of the many reasons why it is important to work on the basics of an optimal latch from the very beginning of your breastfeeding journey.
If you do feel baby’s teeth, focus on positioning (their head should be tilted slightly back, chin in contact with the breast, and nose free) and reach out to an IBCLC for more personalized recommendations.
“What if baby bites me?”
Unfortunately, there are times when your baby might bite while nursing. The good news is that because of the mechanics of breastfeeding, it isn’t possible for them to swallow and bite at the same time.
The best way to help avoid being bitten is to pay close attention to your baby while nursing them. Often, a baby will bite when they are done with their feeding- either to get your attention (I know, I know, nursing is a great time to look at your phone) or just to play. So if you are paying close attention to when baby stops swallowing and seems to be finished with the nursing session, you can unlatch them before they have a chance to bite.
Other times that your baby may bite are when they are looking for more flow- they’ve been breastfeeding for a bit and they want the milk to flow faster. A solution here is to switch them over to the other breast when you sense they are becoming frustrated but before they have a chance to bite. Again- we need to pay attention to our baby’s behavior at the breast!
If baby does bite, it’s ok to tell them “no” and to unlatch them and end the feeding. But try to stay calm. A reaction due to anger or pain on our part may startle baby and could contribute to a nursing strike- when baby refuses the breast for long periods of time. If a bite causes nipple damage, rinse the area with saline (or soak it for a couple of minutes in saline- a shot glass works great for this!) and cover it with nipple balm, Medihoney, or Silverette. Again, reach out to an IBCLC for help.
Breastfeeding + Cavities
Despite what some people might tell you (even some dentists who are not up to date with the latest research!) breastfeeding alone does not cause cavities.
A 2015 editorial by L. Paglia in the European Journal of Paediatric Dentistry stated, “There is lack of evidence that human milk is cariogenic; other factors, such as oral hygiene, may be more influential in caries development than on-demand breastfeeding.” A 2019 study found that “Breastfeeding until the age of 1 year is not associated with an increased risk of dental caries, and may even provide protection” (Branger 2019) and beyond one year, it is difficult to determine how other factors such as eating habits, socioeconomic factors, and dental hygiene play a role in cavity development in addition to breastfeeding taking place.
If you’re worried about cavities, you can wipe baby’s teeth with a damp washcloth after feeding to remove any milk that might be left behind.
I hope this makes you more confident about breastfeeding a baby with teeth! I know it can be scary, but it really is completely normal. Let me know if you have any more questions
References:
Paglia L. Does breastfeeding increase risk of early childhood caries? Eur J Paediatr Dent. 2015 Sep;16(3):173. PMID: 26418916.
Branger B, Camelot F, Droz D, Houbiers B, Marchalot A, Bruel H, Laczny E, Clement C. Breastfeeding and early childhood caries. Review of the literature, recommendations, and prevention. Arch Pediatr. 2019 Nov;26(8):497-503. doi: 10.1016/j.arcped.2019.10.004. Epub 2019 Nov 1. Erratum in: Arch Pediatr. 2020 Apr;27(3):172. PMID: 31685411.
https://www.chla.org/blog/rn-remedies/your-infant-teething-know-the-signs-and-symptoms