Table 4.
Site-Specific Associations between Measures of Breastfeeding and Dental Caries in Primary Dentition.
| Study | Exposure | Outcome/Age | Findings (95% CI) |
|---|---|---|---|
| SMILE study (Do et al. 2014) | BF >12 moa | ECC prevalence/2 to 3 y | PR: 1.42 (0.85 to 2.38) |
| 2004 Pelotas Birth Cohort Study (Peres et al. 2017) | BF ≥24 mo | 1. Caries prevalence 2. S-ECC/5 y |
1. RR: 1.9 (1.5 to 2.4) 2. RR: 2.4 (1.7 to 3.3) |
| Porto Alegre Early Life Nutrition and Health Study (Chaffee et al. 2014) | 1. BF 6 to 11 mob
2. BF 12 to 23 mob 3. BF ≥24 mob |
S-ECC/38 mo | 1. PR: 1.77 (1.12 to 2.85) 2. PR: 1.82 (0.85 to 3.20) 3. PR: 2.10 (1.50 to 3.25) |
| Sao Leopoldo Ten Steps Healthy Feeding and Nutrition Study (Feldens et al. 2010) | 1. BF 3 to 6/d 12 mo 2. BF ≥7/d 12 mo |
S-ECC/4 y | 1. RR: 2.04 (1.22 to 3.39) 2. RR: 1.97 (1.45 to 2.68) |
| Jena Birth Cohort Study (Wagner and Heinrich-Weltzien 2017) | BFc ≥12 mo | Caries prevalence/5 y | OR: 6.20 (3.25 to 11.75) |
| The Prospective Cohort Study of Thai Children–Khon Kaen Site (Nirunsittirat et al. 2016) | Full BFd 6 to 11 mo | 1. Caries prevalence/3 to 4 y 2. dmfs (count variable) |
1. RRe: 0.45 (0.22 to 0.90) 2. RR: 0.77 (0.63 to 0.93) |
| PROMISE-EBF study (Birungi et al. 2015) | Exclusive BF/6 mo | ECC prevalence/5 y | IRR: 0.62 (0.43 to 0.91) / 0.60 (0.41 to 0.88)f |
| Caries Risk Study–US (Fontana et al. 2019) | BFg 12 mo | Decay = ICDAS ≥3/1 to 4 y | OR: 2.04 (1.22 to 3.41) |
| IFS: The Iowa Fluoride Study (Hong et al. 2014) | 1. BF <6 vs ≥6 mo | 2. Primary second molar (cavitated enamel/dentin and/or filled)/5 y | OR: 15.58 (P < 0.05) |
For the findings, the measure of association was controlled for confounders.
BF, breastfeeding; ECC, early childhood caries; ICDAS, International Caries Detection and Assessment System; IRR, incidence relative ratio; OR, odds ratio; PR, prevalence ratio; RR, risk ratio; S-ECC, severe early childhood caries.
a
Reference category: BF, 6 to 12 mo.
b
Reference category: BF, <6 mo.
c
BF in combination with bottle-feeding.
d
Feeding breast milk but not formula, regardless of other liquids and foods. Reference category: BF <6 mo.
e
Two regression models.
f
Child goes to sleep daily while breastfeeding or drinking something other than water from bottle/sippy cup.