Association Between Infant Breastfeeding and Early Childhood Caries in the United States




Orimoloye, Helen
Tan, Zhengqi
Chaturvedula, Ayyappa
Aryal, Subhash


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Purpose Despite the limited epidemiologic evidence, there has been concern that breastfeeding and its duration may increase the risk of early childhood caries. The objective of the study is to determine if there is an association between breastfeeding and its duration and the risk of early childhood caries among young children in the United States. Methods Data from the 2011-2014 NHANES database, a cross-sectional survey conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention, were analyzed. Data consists of 1771 Children between age 2 and 5 years of age with information on both infant feeding and oral health. According to the guideline from American Academy of Pediatric Dentistry, early childhood caries (ECC) and severe early childhood caries (SECC) were defined as the presence of any decayed or filled surfaces (DFs) in primary tooth and the presence of DFs in any maxillary incisors in children, respectively. The association of breastfeeding and its duration, as well as other factors that previous research has found associated with early childhood caries, were examined in unconditional bivariate analyses and multivariable logistic regression analyses and presented with estimated odds ratios (ORs) and 95% confidence intervals (95% CI). Results The prevalence of ECC and SECC were 25% and 8% of the study population. After adjusting for potential confounders significant in bivariate analyses, breastfeeding and its duration was not significantly associated with the risk for early childhood caries (ever vs. never breastfed, OR:1.16, 95%CI: 0.65,2.05). Independent associations with increased risk for early childhood caries were older child age (age 4 vs. 2, OR: 4.62, 95%CI: 2.38, 8.97, p for trend200 vs. Conclusions Breastfeeding or its duration didn’t present an elevated risk of early childhood caries, severe early childhood caries on primary teeth among US children aged 2 to 5 years old. There was an association between family poverty status, race (Mexican American), birth weight, and early childhood caries. These findings can be used to design more robust early child dental health programs for Mexican Americans that live in poverty.