Putting an infant to bed with a bottle can result in aspiration or decay of all the upper teeth and the lower posterior teeth (Nainar & Mohummed, 2004); (Fig. 28.21). Decay occurs because while an infant sleeps, liquid from the propped bottle continuously soaks the upper front teeth and lower back teeth (the lower front teeth are protected by the tongue). The problem, called baby-bottle syndrome, is most serious when the bottle is filled with sugar water, formula, milk, or fruit juice. The carbohydrate in these solutions ferments to organic acids that demineralize the tooth enamel until it decays.
To prevent this problem, advise parents never to put their baby to bed with a bottle. If parents insist a bottle is necessary to allow a baby to fall asleep, encourage them to fill it with water and use a nipple with a smaller hole to prevent the baby from receiving a large amount of fluid. If the baby refuses to drink anything but milk, the parents might dilute the milk with water more and more each night until the bottle is down to water only.
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|FIGURE 28.21 Baby-bottle syndrome. Notice the extensive decay in the upper teeth. (K. L. Boyd, DDS/Custom Medical Stock Photo.) |
Obesity in Infants
Obesity in infants is defined as a weight greater than the 90th to 95th percentile on a standardized height/weight chart. Obesity occurs when there is an increase in the number of fat cells due to excessive calorie intake. Preventing obesity in infants is important because the extra fat cells formed at this time are likely to remain throughout childhood and even into adulthood. If a child becomes obese because of overingesting milk, iron-deficiency anemia may also be present because of the low iron content of both breast and commercial milk. Once infant obesity begins, it is difficult to reverse, so