Connection of Jaw Development With Breastfeeding

Connection of Jaw Development With Breastfeeding

October 1, 2024

Joy Stepinski, MSN, RN-BC

Oral health focuses on preventing diseases that affect our mouth (i.e., cavities, periodontal disease, oral cancer, and tooth loss [1]). The public is often encouraged to brush their teeth twice daily, floss regularly, avoid foods high in sugar, and have professional cleanings and annual dental appointments. Yet oral health encompasses much more than disease. The World Health Organization states, “Oral health is the state of the mouth, teeth and orofacial structures that enables individuals to perform essential functions such as eating, breathing and speaking, and encompasses psychosocial dimensions such as self-confidence, well-being and the ability to socialize and work without pain, discomfort and embarrassment” [2]. Intricately related to feeding at birth, oral health begins long before the arrival of teeth as the oral cavity grows and forms. 

The health literature reports many benefits of breastfeeding. One meta-analysis [3] reviewed over 40 studies on infant and maternal health outcomes and 29 other systematic reviews. The findings showed that the infant experienced advantages, including decreased risk of ear infections, lower respiratory tract infections, and less obesity. Breastfeeding also positively affects mental health [4] with less maternal postpartum depression, higher physical contact between mother and baby, and a more regulated sleep-wake cycle. However, one rarely discussed benefit is the baby's oral cavity development.

Several key components of breastfeeding and oral health are acknowledged in the health literature [5]. Studies show lactation results in proper swallowing ability, mandibular development, teeth alignment, and breathing efficiency. Scientists have studied the coordination of sucking, swallowing, and breathing for decades. When infants breastfeed, a series of actions occur [6]. The tongue compresses the nipple evenly, then a vacuum seal attracts the nipple into the mouth. The tongue pulls downward to create a stronger vacuum force, while an upward movement squeezes the nipple to cease milk flow.

The coordinated movement of sucking involves the jaw, hyoid bone, tongue, soft palate, and lips, directly impacting the growth and development of the jaw and facial structures. There are differences between breastfed and bottle-fed babies because distinct muscles are used for each method. One research finding showed that a breastfed baby may suck more than once before swallowing whereas bottle-fed infants have a more consistent suck-swallow ratio. Breastfed infants develop fewer oral health disorders, including mouth breathing and swallowing issues.

Malocclusion describes the misalignment of the upper and lower sets of teeth. A cross-sectional survey of 5,278 5-year-olds in Brazil showed that a higher number of breastfed infants between ages 9 and 12 months showed a lower prevalence of malocclusion [7]. The authors relate that because the breast anatomy provides suitable oral sealing and promotes nasal breathing, it allows for the proper adaptation of the oral cavity. Additionally, because craniofacial growth occurs beyond six months, the authors suggest breastfeeding for the first year of life.

A second cross-sectional study of 1,377 children in Brazil [8] aged 3 to 6 years observed the prevalence of crossbite. Crossbite occurs when the lower teeth fit in front of the upper teeth. The results concluded that children who breastfed for less than six months had a higher risk of crossbite than those who exclusively breastfed between 6 months and 1 year. A Spanish survey compared the oral cavity of children between 3 and 6 years with healthy oral structures. The authors reported that breastfed children demonstrated a favorable positioning between the upper and lower teeth [9] more than bottle-fed infants.

Finally, breastfeeding has a positive effect on breathing. Health literature discusses that nasal breathing is important because the nose can filter the air and control the temperature by warming or cooling [10]. Nitric oxide produced in nasal epithelial cells promotes vasodilation and regulates inflammation. On the other hand, mouth breathing negatively impacts cognition and mood by interrupting sleep and causing sleep apnea, ear infections, misaligned teeth, and speech disorders. An observational and cross-sectional study surveyed the parents of 254 children [11] and provided a health examination. The findings showed that exclusive breastfeeding increased the development of a normal breathing pattern. The authors noted that breastfeeding prevents air from entering the mouth and stimulates the orofacial muscles to develop properly.

Oral health starts at birth. The feeding method plays a role in mouth and jaw development. The mechanics of breastfeeding for up to one [7, 8, 10] or two [9] years may set the stage for future oral health into adulthood. When the mouth structures have proper alignment, treating malalignment using constant forces through orthodontics [10] may be prevented or lessened. Breastfeeding positively impacts an accurate swallowing technique, proper jaw and teeth development, and beneficial breathing patterns.

 References

1.      Centers for Disease Control and Prevention. (2024). About oral health. https://www.cdc.gov/oral-health/about/index.html

2.      World Health Organization. (2024). Oral health. https://www.who.int/health-topics/oral-health/#tab=tab_1

3.      Ip, S., Chung, M., Raman, G., Chew, P., Magula, N., DeVine, D., ... & Lau, J. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment, (153), 1-186.

4.      Tucker, Z., & O’Malley, C. (2022). Mental health benefits of breastfeeding: a literature review. Cureus 14 (9): e29199.

5.      Palmer, B. (1998). The influence of breastfeeding on the development of the oral cavity: A commentary. Journal of Human Lactation, 14(2), 93-98.

6.      Geddes, D. T., Gridneva, Z., Perrella, S. L., Mitoulas, L. R., Kent, J. C., Stinson, L. F., ... & Hartmann, P. E. (2021). 25 years of research in human lactation: From discovery to translation. Nutrients, 13(9), 3071.

7.      Corrêa‐Faria, P., de Abreu, M. H. N. G., Jordão, L. M. R., Freire, M. D. C. M., & Costa, L. R. (2018). Association of breastfeeding and malocclusion in 5‐year‐old children: Multilevel approach. International Journal of Paediatric Dentistry, 28(6), 602-607.

8.      Kobayashi, H. M., Scavone Jr, H., Ferreira, R. I., & Garib, D. G. (2010). Relationship between breastfeeding duration and prevalence of posterior crossbite in the deciduous dentition. American Journal of Orthodontics and Dentofacial Orthopedics, 137(1), 54-58.

9.      Boo Gordillo, P., Marqués Martínez, L., Borrell García, C., & García Miralles, E. (2024). Relationship between Nutrition and Development of the Jaws in Children: A Pilot Study. Children, 11(2), 201.

10.   Peper, E., Swatzyna, R., & Ong, K. (2023). WHAT ABOUT THIS?: Mouth Breathing and Tongue Position: A Risk Factor for Health. Biofeedback, 51(3), 74-78.

11.   Lopes, T. S., Moura, L. F., & Lima, M. C. (2014). Association between breastfeeding and breathing pattern in children: a sectional study. Jornal de Pediatría, 90(4), 396-402.