By Ellen Rubin, IBCLC

When baby’s first teeth appear, it’s not unusual for parents to be uncertain about how to handle this new development.  But at least you knew that this day was coming!  Imagine what a surprise it must be for your baby to suddenly have something sharp emerge in his mouth.  For the breastfeeding mother, the good news is that the first teeth usually erupt on the lower gum and are covered by baby’s tongue while breastfeeding.  If anybody is at risk for getting bitten, it is the baby himself.

With the appearance of the first teeth comes a great opportunity for you to teach baby what teeth are for.  Encourage him to practice using his new chompers on a teething toy or a large wooden spoon.  For babies who have been introduced to solids, something firm and cold to gnaw on, such as a frozen bagel, can be perfect.  Just watch out for any choking hazards by avoiding anything that baby could take a chunk out of and swallow.  While some babies are not bothered by these new found teeth, others may find themselves irritated by increased saliva and tender gums.  They may respond well to a cold teether or a gentle massage with a parent’s clean finger.  Offering these chewing opportunities and comfort measures before putting baby to the breast helps ensure that baby will learn when and what to bite.

Even with plenty of practice, some slip ups can occur.  Babies are most likely to nip a breast when they are not actively feeding.  Frequently, this is experienced at the end of the feed, when baby is falling asleep, during distracted periods, or if baby is offered the breast at a time when he is not interested in feeding.  In this case, forewarned is forearmed.  If baby is at the breast and you sense his attention is elsewhere, be ready with a finger near the corner of his mouth.  In order to bite down, he must first withdraw his tongue (or he’ll bite the bottom of it before biting you) and this is your cue to gently insert a finger between his gums.  Being vigilant from the start encourages baby to be involved in the process as well and he will likely begin to unlatch on his own when he moves his tongue away from the breast.

Sometimes you will both be caught unaware and a bite can happen.  If this occurs, there is no need to worry. Stay calm and gently take baby off the breast.  No matter the age, share with baby that breasts are not for biting and offer something appropriate for exercising teeth such as a teething toy.  Should baby desire to return to the breast, be mindful of avoiding future mishaps by having a finger handy to prevent a bite and unlatch baby quickly.  Maintaining this pattern of taking baby off the breast without any fanfare will decrease the chance of clamping down in order to trigger a response in mom.  Sometimes however, it is difficult to suppress a yelp and older babies may enjoy their newfound ability to cause mother to react.  If this occurs repeatedly, ending that feeding entirely may be a firmer response that helps baby learn that this is not a game.  Considering other triggers may be helpful in avoiding biting in the future.  As babies get older, they may be prone to biting to get your attention or to signal that they feel they are slipping off the breast.  Finding a more supportive position and using your nursing time to connect (put down the smartphone!) can greatly decrease the incidents of a bite.

If a wound occurs, wash your nipple with a mild, non-drying soap and gently pat dry. Apply an over-the-counter nipple balm or coconut oil to the affected area and cover with a non-stick pad. Be aware that some may have a sensitivity or an allergy to coconut oil or lanolin. See here for sore nipple care Treatment for Sore Nipples To avoid pressure as it heals, try placing baby in a different position and make sure that your breast has plenty of support so that it does not drag down on his mouth.  Watch out for signs of infection such as redness, discharge, or warmth to the touch and contact your physician if this should occur.

As both you and baby learn to manage breastfeeding with a mouthful of pearly whites, you may find it odd to notice teeth marks on your areola when baby is done feeding. This is nothing to worry about. Keep in mind that breastfeeding a baby with teeth is the biological norm for all mammals and likely part of the reason that the first set of teeth is often referred to as “milk teeth”.  Knowing that this is an expected, albeit temporary stage in your breastfeeding relationship, can be reassuring and keep both of you smiling a toothy grin!