Breastfeeding Not Linked to Childhood Caries
Breastfeeding Not Linked to Childhood Caries
Iida H, Auinger P, Billings RJ, Weitzman M
Pediatrics. 2007;120:e944-952
Previous studies have suggested that unrestricted breastfeeding might be associated with early childhood dental caries. Iida and colleagues sought to evaluate whether such an association exists by using the 1999-2002 National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of children and adults.
Data were collected from household interviews on diet history. Dental examinations were also included in the survey evaluation. Data on breastfeeding were categorized according to such factors as duration of all breastfeeding and duration of exclusive breastfeeding. The outcomes of most interest were the number of early childhood caries (1 or more decayed, missing, or filled tooth surface) in children younger than 72 months of age and severe childhood caries (defined as any filling or cavity on a primary maxillary incisor).
The analyses accounted for many factors that might be associated with childhood caries, including age, sex, race/ethnicity, and dental care, among other variables. Several factors were associated with breastfeeding in the sample, including nonblack infants, more affluent parents, and older mothers. Early childhood caries (ECC) were present in 27.5% of the subjects, with 10% having severe ECC.
Multiple factors were associated with greater odds of ECC in bivariate analyses. In multivariate analyses, a history of ever being breastfed was not associated with ECC (adjusted odds ratio [OR], 0.97; 95% confidence interval, 0.63-1.49). Age was associated with higher rates in each year of age. Mexican American children (aOR 1.85), children living at less than 100% of the poverty level (aOR 3.45), and children exposed to maternal smoking in utero (aOR 1.68) were all more likely to experience ECC. Mexican American children and children living at less than 200% of the poverty level also experienced higher rates of severe ECC.
The authors also conducted multivariable analyses with different definitions of breastfeeding (duration total, duration of exclusive breastfeeding) and found that breastfeeding was not associated with either ECC or severe ECC in any of those models.
In separate models looking at total number of caries or fillings, breastfeeding status was not associated with total number of lesions or fillings.
The authors concluded that infant breastfeeding is not associated with ECC.
Iida and coworkers note that this study raises many questions, especially because the data do not have a level of detail to answer many "follow-up" questions one may ask after their findings. For example, what is different about the feeding practices (breastfeeding or otherwise) of Mexican American and other children? Is it really the prenatal or subsequent postnatal smoke exposure that raises the risk for caries? Much more detailed feeding data would be needed to determine the causes of the associations they found, but the data, at least, do not suggest that breastfeeding is bad for young teeth.
Abstract
Iida H, Auinger P, Billings RJ, Weitzman M
Pediatrics. 2007;120:e944-952
Previous studies have suggested that unrestricted breastfeeding might be associated with early childhood dental caries. Iida and colleagues sought to evaluate whether such an association exists by using the 1999-2002 National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of children and adults.
Data were collected from household interviews on diet history. Dental examinations were also included in the survey evaluation. Data on breastfeeding were categorized according to such factors as duration of all breastfeeding and duration of exclusive breastfeeding. The outcomes of most interest were the number of early childhood caries (1 or more decayed, missing, or filled tooth surface) in children younger than 72 months of age and severe childhood caries (defined as any filling or cavity on a primary maxillary incisor).
The analyses accounted for many factors that might be associated with childhood caries, including age, sex, race/ethnicity, and dental care, among other variables. Several factors were associated with breastfeeding in the sample, including nonblack infants, more affluent parents, and older mothers. Early childhood caries (ECC) were present in 27.5% of the subjects, with 10% having severe ECC.
Multiple factors were associated with greater odds of ECC in bivariate analyses. In multivariate analyses, a history of ever being breastfed was not associated with ECC (adjusted odds ratio [OR], 0.97; 95% confidence interval, 0.63-1.49). Age was associated with higher rates in each year of age. Mexican American children (aOR 1.85), children living at less than 100% of the poverty level (aOR 3.45), and children exposed to maternal smoking in utero (aOR 1.68) were all more likely to experience ECC. Mexican American children and children living at less than 200% of the poverty level also experienced higher rates of severe ECC.
The authors also conducted multivariable analyses with different definitions of breastfeeding (duration total, duration of exclusive breastfeeding) and found that breastfeeding was not associated with either ECC or severe ECC in any of those models.
In separate models looking at total number of caries or fillings, breastfeeding status was not associated with total number of lesions or fillings.
The authors concluded that infant breastfeeding is not associated with ECC.
Iida and coworkers note that this study raises many questions, especially because the data do not have a level of detail to answer many "follow-up" questions one may ask after their findings. For example, what is different about the feeding practices (breastfeeding or otherwise) of Mexican American and other children? Is it really the prenatal or subsequent postnatal smoke exposure that raises the risk for caries? Much more detailed feeding data would be needed to determine the causes of the associations they found, but the data, at least, do not suggest that breastfeeding is bad for young teeth.
Abstract
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