Breastfeeding and early childhood caries: a meta-analysis of observational studies

Lingling Cui ； Xing Li ； Yalan Tian ； Juntao Bao ； Ling Wang ； Dongmei Xu ； Bing Zhao ； Wenjie Li

《Asia Pacific Journal of Clinical Nutrition》 26卷5期 (2017/08) Pp. 867-880

https://doi.org/10.6133/apjcn.082016.09

摘要

Background and Objectives: The associations of breastfeeding and early childhood caries (ECC) risk have been evaluated in several epidemiological studies with conflicting results. We performed an update meta-analysis to estimate the association of feeding patterns, breastfeeding durations and ECC risk. Methods and Study Design: Studies were identified through searching Pubmed, Web of Science, and Embase from January 1990 to December 2015. Results: Thirty-five studies involving 73,401 participants aged 0-71 months were included. The overall analysis showed children ever breastfed had a reduced risk of ECC compared with those never breastfed (OR=0.77, 95% CI: 0.61-0.97, p=0.026). Subgroup analysis revealed ever breastfeeding significantly reduced ECC risk for the studies with 3-6 years old children (OR=0.70, 95% CI: 0.54-0.90, p=0.005), with sample size ＞500 subjects (OR=0.63, 95% CI: 0.46-0.87, p=0.004), with Newcastle-Ottawa Scale (NOS) score ≥6 (OR=0.66, 95% CI: 0.46-0.94, p=0.023), published after 2010 (OR=0.50, 95% CI: 0.30-0.82, p=0.006), with adjusted OR (OR=0.40, 95% CI: 0.18-0.88, p=0.023). Exclusive breastfeeding did not significantly decrease ECC risk compared with bottle feeding (OR=0.68, 95% CI: 0.35-1.31, p=0.248). The children breastfed ≥12 months significantly increased ECC risk compared with those breastfed ＜12 months (OR=1.86, 95% CI: 1.37-2.52, p＜0.001). Whereas, children breastfed ≥6 months did not significantly increase ECC risk compared with those breastfed ＜6 months (OR=1.13, 95% CI: 0.83-1.53, p=0.428). Conclusions: Our analysis suggests ever breastfeeding may protect children from ECC, and breastfeeding duration ≥12 months is associated with higher ECC risk. Additional large cohort studies are required to illustrate the relationship in further study.

關鍵字

breastfeeding ； feeding pattern ； early childhood caries ； meta-analysis ； association