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My kid who's 5 months old is being bottle fed since past 4 months.

Yesterday, a doctor warned us against various diseases caused by bottle feeding.

I know about the tooth decay caused by prolonged bottle usage.

We use a good quality sterilizer. So, in our case, the baby getting ill by dirty bottle is a rare possibility, IMO.

Assuming the bottle is 100% sterilized, what are diseases that my kid can catch by bottle feeding and what are the ways to avoid/minimize them while continuing bottle?

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what is in the bottle? expressed milk, formula, plain cow's milk... ? –  Chrys Nov 8 '13 at 12:34
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I would change the doctor. What is the point of saying it to parents of 5 months old. It is almost impossible to switch to breastfeeding at this point and there are no other alternatives –  jny Nov 8 '13 at 14:41
    
@Chrys formula. –  TheIndependentAquarius Nov 8 '13 at 15:02
    
@jny This is not our regular doctor. I do NOT even intend to switch to breastfeeding, but he said that feeding with a bowl and a spoon is an option. –  TheIndependentAquarius Nov 8 '13 at 15:03
    
@Chrys Go-go juice? –  SQB Dec 24 '13 at 18:21
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2 Answers

5 months old is far from "extended" use of the bottle! Now that I've seen this question, your other question also makes a lot more sense.

There is evidence that indicates babies fed with breast milk are less likely to develop early childhood caries (cavities), as well as a number of other diseases. Many breast-fed babies also use bottles while mom is away. It is likely the difference is not in the use of the bottle, but in the milk served through the bottle.

However, breast milk is not an option for everyone and since your child has not been on breast milk for this long already, I don't understand why your doctor would be so insensitive as to point that out now and not give you ideas for other kinds of prevention of these issues. Many people will talk about "baby bottle tooth decay" but the problem is not really with the bottle, rather it is with oral hygiene.

There are also problems related to mouth shape and alignment as well as alignment of the teeth the American Academy of Pediatricians points out as possibilities when bottle use is continued after 18 months!! Again, why your doctor would encourage you to do away with the bottle at this point is strange unless there is some special circumstance about your baby with which we are not aware.

I believe in listening to doctor's advice!! However, Doctors are humans and do make mistakes too Therefore, I strongly recommend, getting a second opinion Find a doctor with whom you are comfortable enough to ask questions and who will then give you answers.

In regard to the tooth decay issue:

Pediatric dentists recommend against extra night-time feedings (including with breast milk) or unlimited access to drinks of any kind other than water because:

Frequent night time bottle feeding with milk is associated with, but not consistently implicated in, ECC. Breastfeed- ing greater than seven times daily after 12 months of age is associated with increased risk for ECC.

My Child's dentist and hygienist recommended wiping her teeth and gums with a gauze square after each feeding (even the night-time ones) to wipe away the bacteria that cause decay as well as those that cause gingivitis.

You mention that you use a sterilizer, but humans have bacteria that lives in our mouths and is just there too. Even kissing baby introduces germs into the mouth and so since they are there, good dental hygiene will keep their over-population (and resulting maladies) at bay. The following is an excerpt from the same previously quoted article and also applies.

Oral hygiene measures should be implemented no later than the time of eruption of the first primary tooth. Cleansing the infant’s teeth as soon as they erupt with a soft toothbrush will help reduce bacterial colonization. Tooth- brushing should be performed for children by a parent twice daily, using a soft toothbrush of age-appropriate size. Flossing should be initiated when adjacent tooth surfaces cannot be cleansed with a toothbrush

Because having a relationship with a Dental care professional can be so helpful in a child's dental health and emergence of good habits in this matter the AAPD also recommends finding a "dental home" by the time your child turns one. You aren't at the stage yet, but meeting with a pediatric dentist, may help to put your mind at ease - even now.

The initial visit should include thorough medical (infant) and dental (parent and infant) histories, a thorough oral examination, performance of an age- appropriate tooth brushing demonstration, and prophylaxis and fluoride varnish treatment if indicated. In addition, assessing the infant’s risk of developing caries and determining a prevention plan and interval for periodic re-evaluation should be done. Infants should be referred to the appropriate health professional if specialized intervention is necessary. Providing anticipatory guidance regarding dental and oral development, fluoride status, non-nutritive sucking habits, teething, injury prevention, oral hygiene instruction, and the effects of diet on the dentition are also important components of the initial visit. Oral hygiene:

The quotes above are cut from this article.

Finally: One can find discussion about how use of bottles and pacifiers can cause misaligned adult teeth, but all of what I can find online refers to this as a problem for kids that continue use after 18 months at the earliest. Even the AAP doesn't specify what these problems actually are though. The most specific statement in this regard that I found was on the Colgate Page! and said:

During a child's first few years, sucking habits probably won't damage his or her mouth. But frequent and long-term sucking can cause problems. This is especially true if the habit continues after baby teeth start to fall out. Long-term sucking can cause:

The top front teeth to slant out
The bottom front teeth to tilt in
The upper and lower jaws to be misaligned
The roof of the mouth to be narrower side to side

Boldfacing is my addition because I wanted to highlight how late we are talking about here. 5 months is very soon to be worried about sucking habits causing alignment problems down the line.

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It is difficult to assess bottle risk as separate from formula risk, because formula is delivered by bottle, where breast milk generally is not. Therefore the results of studies on either may or may not be generalized to both.

Some points to consider regarding bottles in particular:

  • Some germs are not killed by boiling. Sterilization may not be enough protection if your water source is suspect to begin with.
  • Most bottles are made of plastic, and many plastics contain BPA. Studies are suggesting a connection between plastic toxins and asthma, allergies, and eczema. Look for BPA-free products.
  • In areas of the world where infantile diarrhea is prevalent, a combination of factors, including bottle use, are cited as contributors.
  • If you are considering moving from bottle-delivery of formula to spoon or cup, you may find the spoon or cup easier to sanitize, since they are not as deep as a bottle. Also plastics can scratch, making them harder to clean than other materials. Remember that it is very hard for germs to survive on a clean, dry surface, so part of the cleaning process is to ensure complete air drying.

Disease that could be related to absence of breast milk, substitution of formula, or use of bottle:

From a 2010 meta-analysis citing 80 sources and studies regarding infant feeding options:

  • Formula-fed infants are more likely to develop an infection in the first year of life, including influenza, Streptococci, E. Coli, cholera, giardia, rotavirus, and herpes simplex 1.
  • Formula-fed infants face an increased risk (about 2.8 times) of gastroenteritis and diarrhea.
  • The risk of hospitalization in developed countries for respiratory infection is 3.6 times higher for formula-fed children, and it is higher than that in developing countries.
  • Not breast-feeding may also increase disease risk through exposure to foreign antigens in the formula.
  • Asthma rates are 1.7 times higher for formula-fed babies where a family history exists, and 1.4 times where there is no family history of asthma.
  • There is a 1.7 times greater risk of atopic dermatitis.

While the increased risk in many cases may be small, especially in cases where general risk is low, the cumulative risk of all these factors might be the cause of your doctor's concerns. Again, it is hard to say whether the risks are formula-related, bottle-related, related to the absence of breastmilk, or some combination of the three.

Citation:

Stuebe A, Schwarz E. The risks and benefits of infant feeding practices for women and their children. Journal Of Perinatology: Official Journal Of The California Perinatal Association [serial online]. March 2010;30(3):155-162. Available from: MEDLINE, Ipswich, MA. Accessed November 10, 2013.

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