Breast Feeding Position Paper of the AAPMD

Breast feeding goes back millions of years as in other mammalian species for good reason.  At birth the infant is nourished by breast feeding which coordinates the respiratory system , cardiovascular system and orofacial reflexes.  There is obligate nasal breathing  in the human infant during the first 6 months of breast suckling achieved through an epiglottic-palatal lock. The breast is milked against a flat hard palate while nasal breathing proceeds uninterrupted. 

 The tongue must contact the  hard palate during feeding and swallowing for proper oronasal and maxillary development.  Humans are preferentially encoded according to Singh to suckle from the mammary glands at birth. The posterior pharyngeal airway and nasal airway are enhanced with breast feeding.

According to Chele Marmet, a speech pathologist who is the women who conceptualized and pioneered lactation in the world, babies should be allowed to breast feed as long as they want to. She feels the age is somewhere between 9 months and 3 years of age, which is normal. She also feels if the baby wants to breast feed longer, it is usually because they have allergies and need the extra time in order to develop their immune system. A recent study found that 2-5 months of breast feeding led to significantly lower levels of sleep disordered breathing.

The breast feeding issue is a contentious topic around the world. Remembering

that in under developed nations, children are usually breast fed for upwards of

3-4 years simply because of the lack of other adequate nutrition. In western

cultures cessation of breast feeding as early as 3 months post partum is a

culturally driven modality. We live in a busy world and mothers return to the work force .  Look

at the maxillary and mandibular jaw patterns of the tribal cultures. They are

normal if not even larger than those of children in developed nations- These kids breast feed an average of three years.

Bottle feeding alters the environment for achieving an ideal oronasal complex and posterior pharyngeal airway. There is no need for suckling with an artificial nipple and the swallowing mechanism is altered as well as nasal breathing patterns. The bones “deforms” around the artificial nipple , the tongue is displaced and the teeth erupt abnormally.

A recent study showed that 90% of young children developed malocclusion before age 5 , correlated with 90% bottle feeding. The bottle feeders are more prone to oral respiration or mouth breathing and will develop class 2 or retrognathic profiles.

Without the tongue up to the palate , pressing on the palate during feeding, functional development does not take place, which leads to a  vaulted, narrow, constricted palate with increased nasal resistance. This leads to upper airway resistance syndrome and nasal obstruction.

The orthodontic literature is full of references on the altered growth patterns observed with mouth breathing with no lip seal. The dental profession should promote breast feeding practices and discourage pacifier use whenever possible to promote proper development of the airway and breathing.

Nasal breathing with proper tongue placement and lip seal are critically important to ideal growth and development of the nasal complex, cheekbones, jaws and airway . Sleep quality is improved dramatically particularly after palatal expansion and removal of tonsils and adenoids.

Abnormal gene- environmental interactions take place with bottle feeding . Environmental factors which alter ideal growth and development and narrow the airway are:

  1. Changes in feeding patterns
  2. Soft modern diet
  3. Trauma
  4. Pacifier use
  5. Digit sucking
  6. Mouth breathing
  7. Swallowing habits

What can a mother do to assess their childs breathing?

  1. Have an ENT or pediatric ENT check the nasal airway
  2. Check your childs breathing pattern. Mouth breather or nose breather with lip seal.
  3. Check the swallowing pattern. The tongue should be up on the palate.

Possible treatment

  1. Myofunctional therapy
  2. Early orthodontic  intervention such as BioBloc (Mew and Hang)
  3. Physiologic expansion therapy or induced maxillary morphogenesis(Singh)
  4. Adenotonsillectomy
  5. Allergy testing ( wheat, dairy, environmental)

To summarize, Breast feeding is programmed into the survival of our species with definite advantages in all stages of life.  It provides immunologic protection to early respiratory viral exposures and may reduce proliferation of airway lymphadenoid tissue.

Kevin Boyd , a Darwinian Dentist is conducting his PhD thesis on modes of infant and early childhood feeding. He sees a very high prevalence of Sleep Disordered breathing SDB and  Obstructive Sleep Apnea in kids associated with a very high prevalence of behavioral disorders and ADHD as well as a high prevalence of Narrow jaws and crooked teeth. He believes that our faces started to shrink after women returned to the textile mill workplace post industrial revolution and couldn’t breast feed for months or years as before. Of course our soft sugar fueled  diet doesn’t help.

For more information on how to find a myofunctional therapist , trained orthodontist , lactation consultant, breathing specialist , ENT , dentist etc see our website

Special thanks to Joy Moeller, Patricia McBride , Kevin Boyd and Dr David Singh – Epigenetic Orthodontics.

As presented by


Michael L. Gelb DDS

Dr. Michael Gelb, with world class offices in both NYC and White Plains, New York is an innovator in sleep apnea, painful TMJ disorders, and other head and neck pain disorders. Dr. Gelb has studied breathing related sleep disorders (BRSD), specializing in how they relate to fatigue, focus, pain, and the effects all of these can have on a person’s life. The Gelb Center is known as “The Sleep Apnea / Sleep Disorders Specialist in NYC“, “The TMJ Specialist” and “The New York Headache Center” because The Gelb Center is the premier destination for patients suffering with TMJ, headaches, or sleep disorders. Dr. Michael Gelb is the Co-inventor the critically acclaimed Airway Centric ™ medical device as well as the NORAD, or Nocturnal Oral Airway Dilator appliance that reduces snoring by positioning the patient’s tongue and jaw so that airways stay open. Dr. Gelb has also updated the Gelb or MORA™ appliance, named after his father, a pioneer in the industry, and has multiple patents pending for sleep disorder devices and pain management. Dr. Michael Gelb is a highly rated author and speaker on TMJ, sleep apnea, sleep disorders, and chronic headache treatments. With over 30 years of experience, the renowned specialist has written and co-authored numerous journal articles and book chapters to share his knowledge and best practices with other doctors, specialists, and dentists. He has presented at numerous international meetings. With significant involvement in TMJ research and chronic headache teaching, The Gelb Center is committed to early adoption of the latest research findings, medical technology, diagnostic techniques & treatments into clinical practice in order to give the highest quality care to our patients.

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