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Feeding practices in infancy associated with caries incidence in early childhood
Benjamin W Chaffee1,2, Carlos Alberto Feldens3, Priscila Humbert Rodrigues3
1Department of Preventive and Restorative Dental Sciences, University of California San Francisco School of Dentistry, San Francisco, CA, USA.
Insights
Early introduction of sweet foods and drinks before 12 months is linked to severe early childhood caries (S-ECC). Limiting sugary items in infancy can help prevent cavities and promote better oral health outcomes.
Area of Science:
- Pediatric Dentistry
- Nutritional Science
- Public Health
Background:
- Early feeding behaviors influence long-term health and dietary habits.
- Prospective studies on infant diets and caries occurrence are limited.
Purpose of the Study:
- To investigate the association between infant food and drink consumption patterns before 12 months and caries incidence by preschool age.
- To determine if early exposure to sweet items predicts later dental caries.
Main Methods:
- A birth cohort of low-income families in Brazil provided early-life feeding data.
- Three dietary indexes were created: sweet items introduced <6 months, nonsweet items introduced <6 months, and sweet items at 12 months.
- Severe early childhood caries (S-ECC) incidence at 38 months was analyzed against these indexes using regression modeling.
Main Results:
- Higher intake of sweet items in infancy correlated positively with future caries.
- The highest S-ECC incidence was observed in the top tertile of the '6-month sweet index' and '12-month sweet index'.
- No significant association was found between the '6-month nonsweet index' and caries incidence, indicating specificity for sweet items.
Conclusions:
- Infant dietary patterns before 12 months are associated with severe early childhood caries (S-ECC) at preschool age.
- These findings underscore the importance of early dietary interventions to prevent childhood caries.
- Multilevel interventions targeting early feeding practices are recommended.
Background:
Early-life feeding behaviors foretell later dietary habits and health outcomes. Few studies have examined infant dietary patterns and caries occurrence prospectively.
Objective:
Assess whether patterns in food and drink consumption before age 12 months are associated with caries incidence by preschool age.
Methods:
We collected early-life feeding data within a birth cohort from low-income families in Porto Alegre, Brazil. Three dietary indexes were defined, based on refined sugar content and/or previously reported caries associations: a count of sweet foods or drinks introduced <6-months (e.g., candy, cookies, soft drinks), a count of other, nonsweet items introduced <6-months (e.g., beans, meat), and a count of sweet items consumed at 12 months. Incidence of severe early childhood caries (S-ECC) at age 38 months (N = 458) was compared by score tertile on each index, adjusted for family, maternal, and child characteristics using regression modeling.
Results:
Introduction to a greater number of presumably cariogenic items in infancy was positively associated with future caries. S-ECC incidence was highest in the uppermost tertile of the '6-month sweet index' (adjusted cumulative incidence ratio, RR, versus lowest tertile: 1.46; 95% CI: 0.97, 2.04) and the uppermost tertile of the '12-month sweet index' (RR: 1.55; 95% CI: 1.17, 2.23). The association was specific for sweet items: caries incidence did not differ by tertile of the '6-month nonsweet index' (RR: 1.00; 95% CI: 0.70, 1.40). Additionally, each one-unit increase on the 6-month and the 12-month sweet indexes, but not the 6-month nonsweet index, was statistically significantly associated with greater S-ECC incidence and associated with more decayed, missing, or restored teeth. Results were robust to minor changes in the items constituting each index and persisted if liquid items were excluded.
Conclusions:
Dietary factors observed before age 12-months were associated with S-ECC at preschool age, highlighting a need for timely, multilevel intervention.
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