1 Introduction, and advantages of breastfeeding

2 Normal swallow and effects

3 Deviate swallow and effects

4 Caution!

5 Dummies, pacifiers and comforters

6 Cranial bones move!

7 Cranial Strains and birth

8 Temporo-mandibular disorders

9 Orthodontic implications

10 Summary

1 INTRODUCTION:

There seems to be general agreement among today’s health care professionals that breastfeeding provides the best possible start for any baby. The advantages of breast milk over formula milk are unassailable, and claims that formula milk might be better than breast milk may well be open to ridicule and accusations of vested commercial interest.

The advantages to the baby of breast milk are usually quoted as follows:

1 It contains all the right nutrients, in the right proportions, and at the right temperature.

2 It is easily digested by the baby

3 Aids mother/child bonding

4 Builds immunity against respiratory and gastro-intestinal infections

In addition, the advantages for the mother are:

1 It costs nothing

2 Helps the uterus to contract

3 Reduces risk of bleeding

4 Gives a degree of contraception

5 Reduces risk of osteoporosis, and various cancers

6 Gives a feeling of achievement and satisfaction.

It will be noted that all the above advantages for the baby refer almost exclusively to the quality of breast milk. Only the bonding suggests something beyond the physiology and biochemistry of mothers’ milk, in this case, the skin-to-skin contact between mother and infant that is so crucial to the bonding process.

But there is a great deal more to all this than bio-chemistry. I refer to the physical effects of suckling. Studies ^1,2,3 have shown that a suckling infant uses significantly higher muscle force to obtain the milk from a human breast than he/she does from a bottle and artificial teat. These studies indicate that the former requires 20 to 60 times more effort than the latter. These higher forces, even at the lower end of the scale, are now regarded as having highly significant effects on the growth and development of the facial and dental structures.

In addition to this, suckling at the breast requires a very different use of the tongue and lips when compared to bottle-feeding.

Breast fed children tend to have wider and longer upper jaws, providing adequate space for the teeth to fit in and grow properly without crowding or impaction. A correctly developed upper jaw will usually permit and encourage the lower jaw to develop normally as well (provided the parents’ genes allow a normal jaw relationship). The overall result would seem to be that fewer breast fed children require orthodontic treatment. This reduces dental costs to the families and community, as well as to the NHS.

2 THE BREASTFEEDING (NORMAL) SWALLOW AND ITS EFFECTS:

Breastfeeding involves the infant in using his/her tongue and lips correctly from day one; the lips provide a suction seal onto the firm softness of the breast tissue of the areola; the tongue grasps the nipple and drags it into the depths of the mouth, stretching it until it reaches the soft palate.(see figure 1) This way the lacteal sinuses (which contain the initial milk) are pulled into the mouth so that the gum pads and the tip of the tongue can initiate the “milking” process. The tongue then sends a wave of peristalsis-like compression backwards towards the pharynx. The mandible (lower jaw) rocks slowly back and forth to aid, and synchronize with, this process. The milk enters the pharynx and is swallowed as the peristaltic wave continues down the oesophagus.The rocking back and forth of the mandible also mixes the milk with saliva and the oral enzymes so that the digestive process has already started by the time the milk reaches the stomach, reducing the risk of colic.

So there are four primary advantages coming directly from the physical process of breastfeeding:

1. the lip and facial muscles and bones develop normally

2. the tongue functions correctly, which leads to a normal adult swallow

3. the tongue action develops the maxilla (upper jaw) into a wide enough structure to contain all the teeth comfortably within its arch. (Figure 2)

4. any remaining post partum cranial distortion will have a chance of correction.

All the above advantages are due to the physical muscle effort required by the baby to feed, and the pull of those muscles on the facial and cranial bones. A study carried out in Yugoslavia in 1991⁴ concluded that “Suckling encourages normal development of the alveolar processes and adjoining structures” (refers to the tooth-bearing bone and the jaws themselves), and that “it is important to recognize the influence of unfavourable factors (refers to bottle-feeding) in the growth and development of the oral and facial structures, as well as the influence of favourable factors, such as breast-feeding”.

It is interesting to think that we swallow about 2000 times in every 24 hours, excluding eating! When we swallow as adults, our teeth normally touch together with a contact pressure of between 2-5 pounds (our teeth and jaw muscles are capable of delivering 100 pounds!). This means we apply the weight of something like a single decker bus against our teeth and jaws every day, even if we do not eat anything! This gives some idea of why it is so important to grow up with the teeth in the right position.

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