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Breastfeeding and early childhood caries: a meta-analysis of observational studies
Lingling Cui1, Xing Li1, Yalan Tian1
1Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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.
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