Pergunta:

Existe o tal cárie de mamadeira, mas agora a minha pediatra falou de cárie de peito, e que tenho que ter cuidado com as mamadas noturnas do meu bebê de 1 ano e meio. Fiquei pensando, a natureza é tão sábia, como pode isso acontecer, logo com o leite materno? Será que a minha pediatra esta bem informada?

Resposta:

Podemos confiar na sabedoria da natureza sim! Que bom que existe o site da Liga do Leite que nos traz alivio nesta questão controversa. Amamentação noturna não causa cáries e até funciona como prevenção. Infelizmente esses estudos são pouco conhecidos. Vou tentar de fazer um resumo do seguinte artigo em Inglês que esclarece os fatos.


Examining the Research
Dr. Joyce Sinton and her colleagues did a comparison of research on feeding methods and dental caries in an attempt to discover why studies disagree about whether breastfeeding contributes to dental caries. Overall, their comparison indicated that many of the studies that showed a link between breastfeeding and caries had contradictory findings and weak methodology. Most of the articles found by the researchers were not included in the final comparison because they were simply "case studies." This means that they were descriptions of one or more breastfed children who were observed after cavities had already been identified. These studies assumed that the decay was caused by breastfeeding, but offered no proof. The researchers stated that excluding these studies resulted in excluding most of the "classical" articles on the subject.

The remaining studies were carefully compared. One possible source of conflicting results is that the studies often didn't consider other potential factors in dental caries, such as the fluoridation of water supply or the child's diet other than breastfeeding. The studies also used imprecise definitions for both "breastfeeding" and for the effectiveness of parents' dental health practices. For example, babies who were both breastfed and fed formula on a regular basis might be considered breastfed in one study and formula-fed in another study. Confusion about such definitions often gives misleading research results, since exclusive breastfeeding leads to different results than mixed feeding. It's just plain bad science to use such imprecise definitions.

Não existem estudos bem feitos que provem uma relação entre amamentação e cáries.

More information comes from two different studies in which researchers compared the effects of modern-day artificial baby milk (formula) and human milk on some factors believed to contribute to dental caries. Their studies showed vital differences between human milk and most formulas. First, they found that human milk does not significantly lower the pH in the mouth, while almost all brands of artificial baby milk did. The bacteria that is thought to significantly contribute to decay, Streptococcus mutans (S. mutans) thrives in a low pH. Second, most formulas supported significant bacterial growth, while human milk supported only moderate bacterial growth. Third, formulas were found to dissolve tooth enamel (the outer layer of teeth), while human milk actually deposited calcium and phosphorus into enamel (a process known as remineralization). Researchers also concluded that human milk is not cariogenic (does not cause cavities) unless another source of carbohydrates is available for bacteria to feed on. Most artificial baby milk formulas tested were cariogenic (Erickson 1999).

Leite humana não baixa o pH na boca por isso os bacterias do caries não podem crescer. Formula (mamadeira com Nan) sim baixa o pH e por isso deixa crescer os bacterias que causam cáries. Nan (e tais) dessolvem os dentes. Leite materna remineraliza os dentes (deposita calcio e fosforo no dente). Leite humana não causa cáries. Só junto com carbohydratos (açucares) na alimentação da criança.

As stated previously, human milk appears to remineralize enamel. Since human milk adds calcium and phosphorus to (remineralizes) the teeth and does not lower pH levels, it appears to make children's teeth stronger and help prevent cavities.
Several components of human milk may also protect against the development of caries. IgA and IgG have the potential to retard streptococcal growth;Streptococcus mutans is highly susceptible to the bactericidal action of lactoferrin, a major component of human milk.


Leite humana fortalece os dentes das crianças e diminui o crescimento das bacterias que causam cáries. Amamentação é prevenção de cáries.

The mechanics of breastfeeding make it unlikely for human milk to stay in the baby's mouth for long. During breastfeeding, the nipple is drawn deep within the baby's mouth, and milk is literally squirted into the back of his mouth. The suckling process includes a swallow and the nursing child must swallow before he can go on to the next step. In contrast, baby bottles can drip milk, juice, or formula into the baby's mouth even if he is not actively sucking. If the baby does not swallow, the liquid can pool in the front of the mouth around the teeth. The artificial nipple is very short, so the liquid in the bottle is likely to pass over teeth before being swallowed.

O mecanismo de amamentar e dar a mamadeira e completamente diferente. O leite humano não tem muito contato com os dentes por que o bico do seio esta mais fundo na boca que um bico de mamadeira. Com a mamadeira o leite tem muito mais contato com os dentes, o que pode causar cáries.

Dry mouth is another factor that can increase the incidence of early childhood caries. Saliva, which helps maintain normal pH, is not produced as much at night, especially among those who breathe through their mouths. This is one reason why brushing the teeth before going to sleep helps prevent dental caries. An infant or toddler who nurses often at night continues to produce saliva, which may help combat dry mouth.

Amamentação noturna ajuda a prevenir cáries por que a criança continua produzindo saliva, e não fica com a boca seca. A saliva ajuda a manter o pH baixo e impede o crescimento das bacterias. De fato, o mais vezes a criança mama durante a noite, o mais ela produz saliva, o maior é a prevenção de cáries.

According to Dr. Palmer, genetics is not the only factor to consider in preventing caries. There are also things that parents can do to help prevent caries before their baby is even born. Four factors that can contribute to a higher rate of dental caries, as described by Palmer, include maternal stress, especially bereavement stress; a reduced intake of dairy products; a medically diagnosed illness in the mother; and antibiotics taken by the mother during pregnancy.

As causas que contribuem a cáries, além de fatores genéticas, alimentação ruim da criança e falta de escovar os dentes, são nutrição insuficiente da mãe durante a gravidez, estresse durante a gravidez, e se a mãe tomou antibioticos durante a gravidez.

Para ler o artigo inteiro http://www.llli.org/NB/NBSepOct02p164.html

E esse livro é muito interessante também http://www.amazon.com/Cure-Tooth-Decay-Cavities-Nutrition/dp/0982021305/ref=sr_1_1?ie=UTF8&s=books&qid=1265682537&sr=8-1


Boa noite e boas mamadas noturnas,
beijos,

Tamara www.kepina.com www.slingando.com