Postpartum Interventions

At postpartum visits with the mother, focus on the following:

  • Promote breast feeding
    • Children who are breast fed are less likely to develop caries than those who are bottle fed, especially if there is ad lib use of bottles and sippy cups.
    • Breastfeeding has multiple other proven health benefits.
    • The American Academy of Pediatrics recommends that breastfeeding should be exclusive for the first 6 months of life and should continue to at least age 12 months or beyond, as desired by mother and child.
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  • Promote high dose xylitol gum or chlorhexidine rinse programs for mom until child is age two.
    • Xylitol can help decrease transmission of caries causing bacteria from mom to child.
    • If chlorhexidine is used, use only for brief periods of time (i.e. weeks) to reduce the risk of tooth staining.
  • Ensure children are not put to bed with a bottle.
    • Teeth are at highest risk overnight when saliva levels are low.
  • Gently clean infants' gums and teeth after breastfeeding, then brush twice daily with fluoride toothpaste once teeth erupt (AAP and AAPD recommendation).
  • Recommend children see a dentist at 12 months of age.

References

Gomez SS, Weber AA Effectiveness of a Caries Prevention Program in Pregnant Women and Mothers on Their Offspring. Int J Pediatric Dent 2001;11:117-122.

Guideline on Infant Oral Health Care. AAPD. Revised 2014.

Lynch H, Milgrom P. Xylitol and dental caries: An overview for clinicians. Journal of the California Dental Association. March 2003.

Salone LR, Vann WF, Dee DL. Breastfeeding : An overview of the oral and general health benefits. JADA 2013; 144(2):143-151.

Clark MB, Slayton RL; AAP Section on Oral Health. Fluoride use in caries prevention in the primary care setting. Pediatrics. 2014 Sep;134(3):626-33.