Abstract
This systematic review investigated the relationship between early childhood caries (ECC) and breastfeeding. The systematic review methodology used by the Cochrane Collaboration was modified and adopted for this review. 28 of 151 articles (18.5%) were relevant for the study and were rated as strong (0), moderate (3), weak (9) or very weak (16). Validity scores indicated whether a study met the reviewer’s criteria for research rigour. The percentage of studies that received a passing score for each criterion examined were: study design (3.6%), confounders (21%), data collection method (54%), definition of ECC (57%), dental health practices (28%) and infant feeding practices (4%). A lack of methodological consistency related to the study of the association of breastfeeding and ECC, and inconsistent definitions of ECC and breastfeeding, make it difficult to draw conclusions. Moderate articles indicate that breastfeeding for over one year and at night beyond eruption of teeth may be associated with ECC. Due to conflicting findings in less rigorous research studies, no definitive time at which an infant should be weaned was determined, and parents should begin an early and consistent mouth care regime.
Résumé
L’étude porte sur la relation entre les caries du jeune enfant (CJE) et l’allaitement. Elle se fonde sur une version modifiée de la méthode d’étude méthodique du Centre de collaboration Cochrane. Nous avons sélectionné en fonction de leur pertinence 28 articles sur 151 (18,5 %) et nous leur avons attribué un indice de validité–élevé (0), moyen (3), faible (9) ou très faible (16)–en fonction de critères de rigueur analytique établis au préalable. Les critères examinés (et le pourcentage d’articles ayant obtenu la note de passage à leur égard) étaient les suivants: conception de l’étude (3,6 %), facteurs confusionnels (21 %), méthode de collecte des données (54 %), définition des CJE (57 %), pratiques de santé dentaire (28 %) et pratiques d’alimentation du nourrisson (4 %). En raison du manque d’uniformité méthodologique dans l’étude de la relation entre l’allaitement et les CJE, ainsi que des variantes dans les définitions de ces deux concepts, il a été difficile de tirer des conclusions. Les articles pondérés semblent établir un lien entre les CJE et l’allaitement nocturne pendant plus d’un an, après la poussée des dents. Les constatations des études moins rigoureuses sont contradictoires. Vu cette ambiguïté, nous ne recommandons aucun moment précis où sevrer les nourrissons, mais nous encourageons les parents à entreprendre un régime précoce et régulier de soins de la bouche.
Footnotes
Funding support was received from Region of Hamilton-Wentworth Social and Public Health Services Division: a Teaching Health Unit Affiliated with McMaster University and the University of Guelph. (Public Health Research, Education and Development)
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