Saturday, January 25, 2014

My Dentist Asked Me If I Breastfeed

Or maybe not.
My youngest turned two in December, and so the stage of my life where my boobs are daily food dispensers is near the end. Which is perhaps why I decided to finally get this off my chest. (No pun intended.)

The first dental cleaning I had after having my first baby, my dentist asked if I was breastfeeding. I answered yes. He stated, "That's good. It's much better for the babies." Then on to him saying other pleasantries while I have stuff crammed in my mouth and think, that was kind of weird. 

I'll be honest. I initially felt an involuntary twinge of pride. These days there's no end of articles and books droning on about the health benefits of breast feeding. And while overall breastfeeding has been easy for me, I did suffer some nasty soreness and cracking during the initial couple weeks. But is that really enough reason for feeling some kind of feminine pride?

In reality, I was just lucky. Luck that my and my kids' biology went along with my plans. More than that, nobody pressured me to do it. I personally preferred breastfeeding because it was cheaper, I'm home with my kids, and work flexible hours.

I discovered just how much I hate pumping when I worked a summer job. I ended up just letting the milk build up and giving my daughter a big feeding when I got home. If I had a full time job outside of the home, I doubt I would have nursed as long as I did. After all, cloth diapers are cheaper, too, but I gave up that annoying bullshit after less than six months.

Unless there's a dental reason to ask (which as far as I can tell, there's not), my dentist really shouldn't be asking his patients about breastfeeding. How would he have responded if I'd said no?

There are all sorts of reasons why women choose to not breastfeed or to quit early on, many of which they might not want to discuss with anyone. She might have flat or inverted nipples, not produce enough milk, need to go back on medication for a chronic illness, experiencing physical pain from cracked nipples. Maybe she's suffering from postpartum depression that is exacerbated by having a kid or plastic pump suckling on her tits every few hours. Maybe she can't get over feeling weird about pumping at work. Maybe she just wants to go back to drinking a perfectly responsible amount of coffee, beer, and eating junk food. All legitimate, and more importantly personal reasons for not breast feeding.

Bottom line, it's nobody's damn business.

I'm not mad at my dentist for asking. I know he meant well. That he asked and then praised me for making the "right" choice means he's read some of the before mentioned articles/books on the topic. Good for him. The mistake he made is in blurring the line between what is a legitimate basis for public policies, and what is a legitimate basis for personal judgement of individuals.

I'm also not mad at lactivists who argue for public policies that support breastfeeding mothers. For example, making lactation consultants accessible to all new mothers, insisting that employers provide time and an appropriate place for nursing mothers to pump, and ensuring that women are permitted to breastfeed in public. These and more are all important protections for women who choose to nurse.

It's also important to remember that it is a choice, and while the health benefits of nursing are well established, they are actually rather paltry, at least among middle and upper class people in the first world. Dr. Amy Tuteur drives this point home rather firmly in her blog post Does Breastfeeding Matter? 

Yes, babies in the third world died when their mothers were convinced to use formula. Formula isn't safe for families living in unhygienic conditions. Yes, there are correlations between higher infant death rates and formula feeding, but only where there are also racial and/or economic correlations.

It's wrong to convince every formula-feeding mother with access to clean water and easy sterilization methods that if her kid has allergies, or gets colds often, or has any kind of delays, that she might have prevented it by breastfeeding. Other environmental factors and genetics play much larger roles in infant health and development.

I like this simple list of benefits of both choices found on WebMD, with the conclusion:

Whichever way you choose to feed your baby -- breast milk, formula, or a combination of both -- the most important thing is that your baby is well fed, well cared for, and loved. So ditch the mommy guilt!

Of course that's harder to do when random people in your workplace, family, or your dentist start expressing their opinions about mothers' personal choices. Limit lactivism to issues of public policy, and leave individuals to make their choices without guilt.


  1. We just found a new dentist and this question was on the new patient intake form. I answered "No, why do you ask?" But, my husband was the one who took the children to the dentist, so I still don't know why they asked.

    I plan to ask them though. If if has something to do with mouth shape, that's legit, but if they think that bottle feeding automatically means that babies carry bottles around constantly and sleep with bottles (which I know is bad for teeth), then they should just ask that. I'll find out. My children seem to have bad teeth---it is not clear how much of that was less than stellar dental hygiene on our part and how much is predisposition. The children are identical twins, and they have cavities on the same teeth in the same places on the teeth, implying that some genetics are at play here. Also, they were a little premature, and there may be some correlation between prematurity and bad teeth. I am curious to see if the dentist tries to pin any of it on formula feeding, or labels us "bad parents" who of course can't be trusted to maintain proper dental hygiene if we didn't care enough to even breastfeed the children. I have no reason to think she will do that, but clearly the mere presence of the infant feeding question (my children are 5 btw) has me suspicious.

  2. That IS a very odd question for the dentist to ask! I would have said "does it matter" (okay, in my MIND I would have said that!!)
    I breastfed my first son for 8 months (and hated it the whole time), until he was diagnosed with cancer. Sadly he died 13 months later (a person on the "does breastfeeding matter blog" said that BF will protect them against cancer...year so much for that theory!)
    My second child was born 1 week before what would have been my sons 3rd birthday. Because 1. I didn't like it anyways, and 2. I was an emotional mess, I didn't even TRY to BF her! She has been very healthy! Nothing more than a little cold here and there.
    My 3rd child, has Down syndrome, and was born with a hole in her heart. I thought I would give it a try again to give her a little extra help. As with many children with DS she had a hard time latching. Because she was in the NICU for 2 weeks, we really didn't have a lot of time to work on it, so I pumped for her. Then she needed increased calories. I pumped for over 4 weeks, until one day I woke up and just couldn't do it any more! (my other daughter was 15 months at the time, with a broken leg! - yeah - we know how to have FUN in our family!) I saved some of the milk, so when she was recovering from Open Heart Surgery at 6 weeks old she could have that for the first few days. She still needed the increased calories until she was about 12 weeks old.
    For those that BF good for you - I am happy it works for YOU and YOUR family! But for those that don't, or ca'nt - then good for you,because that is what is best for YOU and YOUR family!

  3. It is good practice for HCPs of any kind of ask. It influence types of medicines prescribed in case you had an issue with your tooth.

  4. I agree that there are contexts where a dentist should to ask that question for medical reasons. This was not such a context. It was a routine cleaning involving no medications, and it was in the context of small talk, not him sitting there with a chart writing things down.

  5. Crap, this got on Reddit and now a bunch of people are seeing it. Which is good, but just in case my dentist ever stumbles on this article, I'm not mad at him and I don't consider his question to be anything more than a minor faux pas. I just used this anecdote for an eye-catching title and lead to get to what I really wanted to discuss, which is personal judgement of individual decisions about breastfeeding. My dentist is great at his job and I like him quite a bit! /paranoid apologies off

  6. Great post... Right up to when you reference Amy Tuteur. I encourage you to do some digging into her background and perspective.

    I'm sure you can find a more reputable source to back up your point.

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  8. If the dentist is checking out your child's teeth, I guess asking if the kid was breastfed would be a valid one, as long as he isn't being offensive about it. Breast milk does include calcium, which strengthens our teeth, so it could've strengthened your child's. Pregnancy may affect the gums, so there's that possibility.
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