Nursing Bottle Syndrome


Nursing Bottle Syndrome (NBS) also known as baby bottle syndrome affects children less than 5 years of age. NBS causes extensive decay of baby teeth, as a result children as young as two year old end up needing fillings, crowns or extraction.

It is hard for me to comprehend the pain patients suffering with Nursing Bottle Syndrome (NBS) must be dealing with. For last ten years, I have seen these children suffer and their parents cry when I was treating them.  Most of my patients are children who are less than five years old.  Over the years, I have noticed how under addressed the issue of Nursing Bottle Syndrome is.  As serious as it is, NBS can be prevented very easily, with just basic education of parents. Some diseases just happen, nobody knows the cause or the cure and then there are others we know the cause and the preventive measures. The first kind, till the mystery is solved is out of our hands, but if the second one happens then we as doctors have failed. In this day and age nobody should be uninformed. Patient education should be the most important part of medical field and it should be facilitated by the media.

Some things in life leave a definite impression on our mind and motivate you to do things that we never thought of doing. Nursing Bottle Syndrome made me write the book, it gave me the drive to write for Greater Kashmir.

Picture of  a 5 year old child . No child should have to go through such extensive dental treatment.

NBS is caused by contact of liquids containing sugars, such as milk, formula or juice for an extended period of time. At night, when the child falls asleep while having the bottle or breast feeding, the child does not swallow the milk, and it remains in their mouth all night long. Bacteria which are present in the mouth will break down the sugar into acid, which will eventually lead to tooth decay. Some mothers also use a bottle filled with milk or juice as a pacifier. As a result, the liquid is left in contact with the teeth for an extended period of time, giving bacteria lots of time to cause cavities. NBS can also be caused by frequent snacking with sticky food.

  • Wean children from the bottle as early as 12 – 14 months.
  • Always follow feeding from the bottle with water, to rinse out any residue left from the milk or juice. If your baby wakes up at night to drink milk keep another bottle filled with water by your bedside .When you are done feeding the baby give him or her few sips of water to wash the milk away. Same is true for breast feeding.
  • Bottle should only be used for feeding purpose not as a habit to make baby sleep. Never let your child walk around with bottle filled with milk for more than 20 minutes.
  • Begin brushing your child’s teeth as soon as teeth appear in the mouth, or clean them using a wet cloth.
  • Dental examination should begin at 12 months, or earlier if a problem is noted.
  • Juices and sodas cause erosion of teeth they should be avoided in children. Water and fresh fruits are excellent alternatives. 4 oz is the maximum amount of juice a child should consume in a day.
  • Children should be fed every 2-3 hours breakfast at 8.00 AM, snack at 10.30AM, lunch at 1.00 PM and so forth. This will also increase their appetite.

Dr. Shah is a dentist and an author of a book, “Sam and the Sugar Bug.”  The book teaches kids importance of brushing their teeth.  The book is free.  Download the book here.


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