Summary of findings 2. Summary of findings ‐ breastfeeding promotion and support versus standard care.
Breastfeeding promotion and support compared with standard care for preventing caries in young children | ||||||
Population: for interventions, pregnant and lactating women; for outcomes, young children up to 6 years of age Settings: Belarus (1 RCT), Uganda (1 RCT) Intervention: breastfeeding promotion and support (e.g. individual tailored home‐based peer counselling focused on providing information about the importance of breastfeeding and offering advice and support for healthy breastfeeding) Comparison: standard care | ||||||
Outcomes | Illustrative comparative risks (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
Assumed risk | Corresponding risk | |||||
Standard care | Breastfeeding promotion and support | |||||
Caries presence in primary teeth (children 0 to 6 yrs) |
689 per 1000 |
661 per 1000 (613 to 709) |
RR 0.96 (0.89 to 1.03) | 1148 (2 studies) | ⊕⊕⊝⊝ low1 | |
dmfs index score (range 0 to 80) (children 0 to 6 yrs) |
Not assessed | The dmfs index expresses the total number of decayed missing or filled surfaces in primary dentition (five per posterior tooth and four per anterior tooth) as a score (range 0 to 80 surfaces, lower is better) | ||||
dmft index score (range 0 to 20) (children 0 to 6 yrs) |
The mean dmft index score in the standard care group ranged from 1.7 to 4.2 | The mean dmft index score in the intervention group was 0.12 lower (0.59 lower to 0.36 higher) | 652 (2 studies) | ⊕⊕⊝⊝ low1 | The dmft index expresses the total number of teeth affected by tooth decay (missing or filled) in the primary dentition as a score (range 0 to 20, lower is better) | |
The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; dmfs: decayed, missing and filled surfaces of primary teeth; dmft: decayed, missing and filled primary teeth; RR: risk ratio;yrs: years | ||||||
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. |
1ROB (‐1): downgraded for one of the two included trials at unclear risk of selection and detection bias, and with some attrition (this trial with 21% weight only in meta‐analysis) (not downgraded for lack of blinding of participants and personnel due to objective outcome); imprecision (‐1): downgraded for wide confidence interval passing through line of no effect