Non-Cochrane · aetiology · PM40254914
Risk of Early Childhood Dental Caries Associated With Prolonged Breastfeeding: A Systematic Review and Meta-Analysis.
Lustosa Karina, Rodrigues Larissa Rosa Santana, Rocha Reuber Mendes, et al. · International journal of paediatric dentistry · 2025 · PubMed · doi:10.1111/ipd.13313
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
6
current version
GRADE rated
5
No studies
0
Included studies
41
linked below
No studies 0 · 0%Ungraded 1 · 16.7%Very low 0 · 0%Low 5 · 83.3%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children up to 71 months | Children up to 71 months across 25 cohort studies; 19,681 pooled participants (n=25) |
| Intervention | Prolonged breastfeeding > 12 months (exposure) | Prolonged breastfeeding (>12 months overall; categories 12-24 months and >24 months) (n=25) |
| Comparison | No comparison group or children not breastfed at the same age | Children not breastfed / breastfed a shorter duration at the same age |
| Outcomes | Risk/prevalence of dental caries (early childhood caries, ECC) | ECC incidence (RR) and ECC prevalence (OR/PR) |
| Study designs | Observational studies published as full articles; no date or language restriction. Excluded: cross-sectional, case-control, randomized trials, reviews, in vitro/animal studies, case reports, conference abstracts | Cohort studies (1 doctoral thesis; 1 retrospective cohort) published 1999-2024; sample sizes 132-4146; follow-up 1-9 years (n=25; 20 meta-analyzed, 5 excluded from pooling) |
| Timing | Children up to 71 months of age | Follow-up 1-9 years; children up to 71 months |
Search date: Up to May 17, 2024. Databases: PubMed (MEDLINE); Scopus; EMBASE; LILACS (via BVS); Web of Science; Livivo; CINAHL (EBSCO); Cochrane Library; gray literature: Google Scholar, ProQuest, Bibliografia Brasileira de Odontologia (BBO)
Questions and results
Prolonged breastfeeding for more than 24 months vs Not breastfed at the same age or breastfed for a shorter duration
Population: Children up to 71 months (early childhood; primary dentition)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Early childhood caries (ECC) - incidence/risk Up to 71 months of age (study follow-up 1-9 years) · More than 24 months Breastfeeding beyond 24 months is associated with an increased risk (incidence) of early childhood caries versus not breastfeeding at the same age (RR 2.44, 95% CI 1.97 to 3.02; low certainty). Source: Results, 'Synthesis of Results' para (Figure 4A); Abstract; 'Certainty of Evidence' section (GRADE = low; primary outcome); SoF table… · same question in other reviews | RR 2.44 [1.97, 3.02] | 2 studies | Low Downgraded: inconsistency |
Prevalence of early childhood caries 12-24 months Population: Children up to 71 months Breastfeeding for 12-24 months is associated with higher ECC prevalence (low certainty). Source: Results, Synthesis of Results; Figure 5B; Certainty of Evidence · same question in other reviews | PR 3.32 [1.57, 5.07] | 2 studies | Low Downgraded: inconsistency |
Risk of early childhood caries 12-24 months Population: Children up to 71 months Breastfeeding for 12-24 months may not increase ECC risk (low certainty). Source: Results, Synthesis of Results; Figure 4A; Certainty of Evidence · same question in other reviews | RR 1.21 [0.82, 1.78] | 5 studies | Low Downgraded: inconsistency |
Breastfeeding for more than 24 months vs Not breastfed at the same age
Population: Children up to 71 months
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prevalence of early childhood caries More than 24 months Breastfeeding for more than 24 months is associated with higher ECC prevalence (low certainty). Source: Results, Synthesis of Results; Figure 5A; Certainty of Evidence · same question in other reviews | OR 2.99 [1.03, 8.67] | 4 studies | Low Downgraded: inconsistency |
Breastfeeding for more than 12 months vs Not breastfed at the same age
Population: Children up to 71 months
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Prevalence of early childhood caries More than 12 months Breastfeeding for more than 12 months is associated with higher ECC prevalence (low certainty). Source: Results, Synthesis of Results; Figure 5A; Certainty of Evidence · same question in other reviews | OR 1.86 [1.48, 2.35] | 13 studies | Low Downgraded: inconsistency |
Comparison
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Early childhood caries (ECC) - incidence/risk Sensitivity analysis (Feldens 2010 excluded): breastfeeding >12 months | RR 1.37 [0.89, 2.12] | 6 studies | Ungraded |
Included primary studies 41
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Bernabe 2017 Birth Weight, Breastfeeding, Maternal Smoking and Caries Trajectories DOI:10.1177/0022034516678181 | 2 other reviews | not stated | not extracted yet | not extracted yet |
| Abanto 2023 Prolonged breastfeeding, sugar consumption and dental caries at 2 years of age: A birth cohort study DOI:10.1111/cdoe.12813 | 1 other review | not stated | not extracted yet | not extracted yet |
| Barroso 2021 Influence of breastfeeding duration on the incidence of dental caries in preschoolers: a cohort study DOI:10.1590/1806-93042021000100012 | 1 other review | not stated | not extracted yet | not extracted yet |
| Chaffee 2014 Association of long-duration breastfeeding and dental caries estimated with marginal structural models. PMID:24636616 | 1 other review | not stated | not extracted yet | not extracted yet |
| Devenish 2020 Early childhood feeding practices and dental caries among Australian preschoolers DOI:10.1093/ajcn/nqaa012 | 1 other review | not stated | not extracted yet | not extracted yet |
| Feldens 2010 Early Feeding Practices and Severe Early Childhood Caries in Four-Year-Old Children from Southern Brazil: A Birth Cohort Study DOI:10.1159/000319898 | 1 other review | not stated | not extracted yet | not extracted yet |
| Feldens 2010 Early feeding practices and severe early childhood caries in four-year-old children from southern Brazil: a birth cohort study. PMID:20838043 | 1 other review | not stated | not extracted yet | not extracted yet |
| Feldens 2018 Feeding frequency in infancy and dental caries in childhood: a prospective cohort study. PMID:28868798 | 1 other review | not stated | not extracted yet | not extracted yet |
| Hong 2014 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Hong 2014 Infant breast-feeding and childhood caries: a nine-year study. PMID:25198001 | 1 other review | not stated | not extracted yet | not extracted yet |
| Nunes 2012 Association between prolonged breast‐feeding and early childhood caries: a hierarchical approach DOI:10.1111/j.1600-0528.2012.00703.x | 1 other review | not stated | not extracted yet | not extracted yet |
| Peres 2017 Impact of Prolonged Breastfeeding on Dental Caries: A Population-Based Birth Cohort Study DOI:10.1542/peds.2016-2943 | 1 other review | not stated | not extracted yet | not extracted yet |
| Tashiro 2021 Caries and Its Association with Infant Feeding and Oral Health-related Behavior in 18-month and 3-year-old Japanese Children DOI:10.2209/tdcpublication.2020-0033 | 1 other review | not stated | not extracted yet | not extracted yet |
| Yokoi 2021 Association between the incidence of early childhood caries and attending childcare among toddlers in a rural area of Japan: a prospective… DOI:10.1080/00016357.2020.1795249 | 1 other review | not stated | not extracted yet | not extracted yet |
| Abanto 2022 Prolonged breastfeeding, sugar consumption and dental caries at 2 years of age: A birth cohort study. PMID:36380436 | this review only | not stated | not extracted yet | not extracted yet |
| Bernabé 2016 Birth Weight, Breastfeeding, Maternal Smoking and Caries Trajectories. PMID:27834298 | this review only | not stated | not extracted yet | not extracted yet |
| Birungi 2017 Assessing causal effects of early life‐course factors on early childhood caries in 5‐year‐old Ugandan children using directed acyclic… DOI:10.1111/cdoe.12314 | this review only | not stated | not extracted yet | not extracted yet |
| Birungi 2017 Assessing causal effects of early life-course factors on early childhood caries in 5-year-old Ugandan children using directed acyclic… PMID:28631283 | this review only | not stated | not extracted yet | not extracted yet |
| Blanco 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Devenish 2020 Early childhood feeding practices and dental caries among Australian preschoolers. PMID:32047898 | this review only | not stated | not extracted yet | not extracted yet |
| Helderman 2006 Risk Factors of Early Childhood Caries in a Southeast Asian Population DOI:10.1177/154405910608500115 | this review only | not stated | not extracted yet | not extracted yet |
| Helderman 2006 Risk factors of early childhood caries in a Southeast Asian population. PMID:16373687 | this review only | not stated | not extracted yet | not extracted yet |
| Ibrahim 2009 A longitudinal study of early childhood caries risk, dental caries, and life style DOI:10.1016/s0917-2394(09)70171-5 | this review only | not stated | not extracted yet | not extracted yet |
| Ji 2006 Risk behaviors and its association with caries activity and dental caries in Japanese children DOI:10.1016/s0917-2394(06)70070-2 | this review only | not stated | not extracted yet | not extracted yet |
| Lunteren 2021 Breastfeeding and Childhood Dental Caries: Results from a Socially Diverse Birth Cohort Study. PMID:33706311 | this review only | not stated | not extracted yet | not extracted yet |
| Mathias 2023 Breastfeeding, consumption of ultraprocessed foods, and dental caries at 4 years of age: A birth cohort study. PMID:37171456 | this review only | not stated | not extracted yet | not extracted yet |
| Mathias 2024 Breastfeeding, consumption of ultraprocessed foods, and dental caries at 4 years of age: A birth cohort study DOI:10.1111/ipd.13087 | this review only | not stated | not extracted yet | not extracted yet |
| Nakamura 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Nakamura 2009 [Chronic rejection of a transplanted heart]. PMID:2009191 | this review only | not stated | not extracted yet | not extracted yet |
| Nirunsittirat 2016 Breastfeeding Duration and Childhood Caries: A Cohort Study. PMID:27606624 | this review only | not stated | not extracted yet | not extracted yet |
| Nirunsittirat 2016 In vivo Confocal Microscopy in Differentiating Ipilimumab-Induced Anterior Uveitis from Metastatic Uveal Melanoma. PMID:27790127 | this review only | not stated | not extracted yet | not extracted yet |
| Nunes 2012 Association between prolonged breast-feeding and early childhood caries: a hierarchical approach. PMID:22725605 | this review only | not stated | not extracted yet | not extracted yet |
| Peres 2017 Impact of Prolonged Breastfeeding on Dental Caries: A Population-Based Birth Cohort Study. PMID:28759394 | this review only | not stated | not extracted yet | not extracted yet |
| Pires 2020 Can be Grandmother as Child’s Daytime Caregiver a Risk Factor for Higher Caries Experience in Early Childhood? A Retrospective Study DOI:10.1590/pboci.2020.150 | this review only | not stated | not extracted yet | not extracted yet |
| Saethre 2023 Prolonged breastfeeding and dental caries in preschool children DOI:10.1080/00016357.2023.2211154 | this review only | not stated | not extracted yet | not extracted yet |
| Sæthre 2023 Prolonged breastfeeding and dental caries in preschool children. PMID:37211628 | this review only | not stated | not extracted yet | not extracted yet |
| Sritangsirikul 2024 A longitudinal study on the impact of breastfeeding with or without formula milk on dental caries. PMID:38710791 | this review only | not stated | not extracted yet | not extracted yet |
| Tada 1999 Caries Risk Factors among Three-year Old Children in Chiba, Japan DOI:10.1177/101053959901100210 | this review only | not stated | not extracted yet | not extracted yet |
| Tada 1999 Caries risk factors among three-year old children in Chiba, Japan. PMID:11195157 | this review only | not stated | not extracted yet | not extracted yet |
| Tashiro 2021 Caries and Its Association with Infant Feeding and Oral Health-related Behavior in 18-month and 3-year-old Japanese Children. PMID:33994420 | this review only | not stated | not extracted yet | not extracted yet |
| Yokoi 2021 Association between the incidence of early childhood caries and attending childcare among toddlers in a rural area of Japan: a prospective… PMID:32692586 | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).