Malta’s Bedtime Bottle Crisis: How Traditional Milk Habits Are Rotting Babies’ Teeth

The Sweet Trap: How Maltese Babies Are Losing Their First Teeth to Night-Time Bottles
By Hot Malta Staff | 6 min read

Every evening, as the last ferry leaves Valletta’s Grand Harbour and the church bells of Mosta fall silent, thousands of Maltese parents settle their babies with what feels like an innocent comfort: a warm bottle of milk in the cot. Yet the very ritual that promises a quiet night is quietly eating away at the next generation’s teeth.

“We’re seeing a spike in ‘baby-bottle caries’—severe decay in children under four,” warns Dr. Maria Camilleri, consultant paediatric dentist at Mater Dei Hospital. “Last year alone we extracted 212 baby teeth under general anaesthetic, and 78 % of those cases were linked to prolonged, on-demand bottle feeding, especially at night.”

The culprits are deceptively simple:
• Falling asleep with a bottle of formula, breast-milk, or even “ġulepp tal-ħelu” (sweetened condensed milk diluted with water)
• Constant sipping from a bottle throughout the day, replacing water
• Adding honey or sugar to follow-on milks “so the child drinks more”

In Malta, where family-run corner shops still sell glass bottles of “lat ibjad” and grandmothers swear by a teaspoon of honey for every ailment, these habits feel harmless—even loving. But the sugar bath that coats tiny teeth for six, eight, sometimes ten hours at a stretch fuels aggressive bacteria that drill through enamel faster than parents realise.

Cultural echoes
The tradition of the “biberon tat-tuff” (bedtime bottle) is woven into Maltese lullabies and Facebook mum-groups alike. Scroll through Għaxaq or Żabbar community pages and you’ll spot photos of toddlers clutching bottles at village festa sleepovers. “It’s what my mother did, and hers before her,” says 29-year-old Martina Pace from Birkirkara, whose three-year-old son recently had four incisors capped under sedation. “I didn’t know milk could hurt him. It’s milk, not Coca-Cola.”

Community cost
Beyond the tears in the dental chair, the ripple effect is tangible. Each round of general anaesthesia costs the national health service roughly €1,300—money that could fund two weeks of community midwife visits. Meanwhile, parents lose wages travelling to hospital, and children enter primary school already self-conscious about brown stumps instead of pearly smiles. “A child in pain can’t concentrate,” notes Ms. Antoinette Borg, head teacher at San Ġorġ Preca College in Ħamrun. “We’ve had five cases this term where decay led to repeated absences and speech delays.”

Turning the tide
Change is brewing, quietly but steadily.
• The Oral Health Directorate has just translated its “Lift the Lip” campaign into Maltese and Arabic, distributing mirror-shaped flyers at every well-baby clinic.
• Midwives at Karen Grech Hospital now demonstrate “cup feeding” from six months, emphasising that sipping water from a lidless tazza is the Maltese way older generations used before bottles became fashionable.
• Local influencers such as @maltamumdiaries are sharing before-and-after photos donated by parents, proving that even severely decayed teeth can recover with early intervention.

What parents can do tonight
1. Finish the last bottle before brushing, then switch to a trainer cup of plain water if the child still needs comfort.
2. Wipe gums and first teeth with a clean muslin after every feed—especially those 3 a.m. feeds when it’s tempting to skip.
3. Book the first dental check-up at the eruption of the first tooth; Mater Dei offers free appointments until age 16.

As the sun rises over the honey-coloured bastions, Malta stands at a crossroads: cling to nostalgia or protect the smiles of tomorrow. The choice is as small as a bedtime bottle—and as big as the future health of an island nation that has always put family first.

Dr. Camilleri sums it up best: “Love doesn’t need sugar. A cuddle and a lullaby in Maltese will soothe a child without costing them their teeth.”