Betsy should be advised that she may want to reconsider her decision to solely bottle feed her baby. Research has shown that non-breast fed babies have higher decay rates.

Additionally, the American Academy of Pediatric Dentisry endorses the American Academy of Pediatrics' (AAP) policy statement on "Breastfeeding and the Use of Human Milk." The AAP statement concludes that "breastfeeding ensures the best possible health as well as the best development and psychosocial outcomes for the infant."

However, the risk of potentially devastating dental caries exists for the breast-fed child as it does for the bottle-fed child, and is related to extended and repetitive feeding times with prolonged exposure of erupted teeth to fermentable carbohydrates without appropriate oral hygiene measures.

Recommendations from the American Academy of Pediatric Dentisry include:

Infants should not be put to sleep with a bottle. At-will, nocturnal breastfeeding should be avoided after the first primary tooth begins to erupt.

Parents should be encouraged to have infants drink from a cup as they approach their first birthday. Infants should be weaned from the bottle at 12-14 months of age.

Consumption of juices from a bottle should be avoided. When juices are offered, it should be from a cup.

Oral hygiene measures should be implemented by the time of eruption of the first primary tooth.

As stated earlier in this online course, an oral health consultation visit within six months of the eruption of the first tooth is recommended to educate parents and provide anticipatory guidance for prevention of dental disease.