Dentistry For Young People

Breastfeeding and Early Childhood Caries

The American Academy of Pediatrics views human milk as the ideal nutrient for infants.  Pediatricians recommend breastfeeding until at least one (1) year of age, continuing as long as the mother and child both desire.  However, prolonged breastfeeding in children older than one year old has been suggested as a risk factor for early childhood caries.  Iida et al from the University of Rochester, New York, aimed to assess the association between breastfeeding duration and early childhood caries.  Data from the 1999-2002 National Health and Nutrition Examination Survey were used to analyze feeding habits and oral health in 1576 children aged 2-5 years old.  Between 3-6 months of age, the majority of breastfed children were introduced to something other than breast milk, making it difficult to accurately assess the impact of breast feeding alone on early childhood caries.  However, the data contains information on the extent and duration of breastfeeding.  The study found that 60% of all children surveyed had been breastfed.  These children were found to actually have a lower rate of early childhood caries than those who had never been breastfed.  Even children who had been partially breastfed for more than a year did not show an increased risk for early childhood caries.  Although these children would be expected to have more at-will feedings, they were still not exposed to a higher risk.

Overall, after adjusting for other potentially confounding factors such as family income, race and maternal smoking, breastfeeding and its duration were not associated with statistically significant increase in risk for early childhood caries.  The study also found that low income and prenatal smoking, linked to decreased breastfeeding in other studies, showed an independent association to increased early childhood caries in these children. 

Breastfeeding and its duration, whether or not it was exclusive, were not associated with an increase in early childhood caries.  These findings support recommendations that encourage breastfeeding as part of a healthy diet and address increased caries risk posed by such factors as low income and maternal smoking.

Source:  Iida H, Auinger P, Billings RJ, Weitzman M. Association between infant breastfeeding and early childhood caries in the United States.  Pediatrics 2007; 120:e944-e952