Eating and drinking supply the bacteria in the mouth with the carbohydrates they need to grow and produce acid that can destroy tooth enamel. (Refer to Chapter 4: Caries for more information.) The types of food chosen and especially the pattern of ingestion can significantly alter a child’s risk for the development of caries. The basic goal is to decrease the overall number of hours per day that the teeth are exposed to sugars by decreasing the frequency and duration of sugar intake, promptly removing carbohydrates from the teeth, and choosing less cariogenic foods.

The following recommendations should be included in your anticipatory guidance:

		Stop night feedings once the teeth erupt. The majority of children are physiologically able to tolerate a prolonged fast around 6 months of age, which is when the teeth typically begin to erupt.
		Parents should try to use methods other than feeding to calm a crying child, including providing a transitional object such as a small blanket or stuffed toy, offering a pacifier, rocking, or singing.
		If a child needs a bottle to fall asleep, it should contain only plain water.
		Parents who elect to continue to feed on demand at night should be instructed to wipe the infant’s teeth clean after feedings.
		Never prop a bottle and always remove it promptly once the infant is done feeding.
		Discourage prolonged and frequent use (especially ad lib) of a bottle or sippy cup during the day, unless the cup contains plain water.
		Parents should be encouraged to limit the drinking of sugary fluids to meals and snack times.
		Introduce a cup as soon as the child can sit unsupported (around 6 months of age) and try to eliminate the bottle by 1 year of age.