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So I set off to do my research, and found that breastfeeding has not been found to cause dental caries. In fact, research studies by the World Health Organization, The American Dental Association, and several dentists including Brian Palmer, DDS and Harry Torney, DDS have shown the opposite, that breast milk actually decreases the level of acid in the mouth and makes the oral environment inhospitable for dental caries to grow.

In fact, study after study supported breastfeeding, even after the eruption of baby teeth, and stated in the same terms, if nursing caused dental caries then all mammals would have rotten teeth. Particularly in Brian Palmer's study, which took an anthropological analysis of dental imprints of fossilized human remains from all over the world (and includes some really cool photos), shows that only in modern humans does dental caries become an issue, as it is absent from early humans. Palmer stated, "It would be evolutionary suicide for human milk to cause decay."

WHAT IS DENTAL CARIES, EXACTLY? Dental caries is an infectious disease caused by an overgrowth of cariogenic (cavity-causing) microorganisms that are part of our normal oral flora. The bacteria Streptococcus-mutans (S. mutans) is thought to be the main culprit. Dental caries has been a serious health problem all over the world for the past two hundred years. Dental care is the largest unmet health care need among children in the United States and the UK.

WHAT CAUSES EARLY CHILDHOOD DENTAL CARIES? Three factors cause dental caries in children:

• Vulnerable Teeth.

Certain variables can make a child's teeth more susceptible to S. mutans and to decay, and even start in utero. Maternal issues during pregnancy including anemia, fever, lead exposure, high levels of anxiety/stress, or use of antibiotic medication may cause developmental defects in the baby's tooth enamel, known as hypoplasia. Preterm birth has been cited as a cause for hypoplasia as well, a finding which lessened my personal guilt. Also, babies born by cesarean, born small for gestational age, or from parents who smoke cigarettes are at increased risk for dental caries. Genetics can also play a part.

• Low pH, High Acid.

Saliva simultaneously breaks down the bacteria and keeps it at a healthy level, as long as oral pH level is within normal range. But, the lower the pH in the mouth, the higher the acid, creating an environment in which S. mutans is able to break down fermentable carbohydrates to use for energy, leading to demineralization and etching of the teeth. All cereals, bottles or sippy cups containing anything but water, and pediatric medications, and sugary snacks contributors to a highly acidic environment. Fruit juices are more acidic than are whole fruits. Formula has been found to lower oral pH levels. Even diet sodas are high in acid because of the carbonation.

• Overgrowth of Bacterias

S. mutans is at the top of the list of the many cariogenic bacterias that infiltrate the mouth to cause cavities. At birth, a baby's mouth is sterile, however by about the second day of life is colonized by cariogenic bacteria from the mother, father, or siblings. As I mentioned above, in this way, dental caries is known as an infectious disease. Family members can take a medication called Xylitol to reduce oral bacterial levels, thus reducing the chances for transmission. This medicine is actually available as a chewing gum!

CAN BREASTFEEDING PREVENT DENTAL CARIES? Yes! I found lots of evidence that supports breastfeeding as a preventative to cavities. Human milk strengthens baby teeth, because it contains the right levels of minerals calcium and phosphorus. Immunities in human milk have been found to inhibit the growth of bacteria, maintaining a healthy oral environment. Also, the actual mechanics of breastfeeding promotes a healthy pH in the mouth. When a baby breastfeeds, the nipple is drawn deep into the mouth, bypassing the teeth, and milk is swallowed directly without pooling in the mouth. (The mechanics of nursing also contributes to good orthodontic development and saves money down the road on braces.) Nighttime nursing and nursing on demand is not a cause of dental caries, but many dentists discourage nighttime nursing and tell moms to brush their babies teeth after each nursing, just for good measure, in combination with eliminating sugary snacks and drinks. Our dentist did not recommend this. If you are worried about the milk pooling in your baby's mouth after he falls asleep, and don't want to wake him up at 3 am with a toothbrush, then you can lay your baby on his back to sleep, ensuring that his last mouthful is swallowed.

KIERAN'S BEAUTIFUL TEETH I am lucky to have found a pediatric dentist who supports breastfeeding and never advised me to wean Kieran; he confirmed my fears that perhaps Kieran's prematurity was a factor, and that the sippy cups of juice were too, but that breastfeeding certainly was not. Kieran was admitted to the hospital, and the dentist successfully repaired the cavities while Kieran was under general anesthesia. He advised me on Kieran's diet, to feed Kieran scrambled eggs and a banana for breakfast instead of cheerios and juice. He also gave me tips on brushing Kieran's teeth, to use my finger from my other hand to hold down Kieran's tongue because he tends to push the toothbrush away with his tongue, and to hold his cheek away as I'm brushing his upper molars. This way I won't miss any spots. And, Kieran's next dental check-up was one hundred percent perfect, beautiful teeth, no cavities!