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Prospective Cohort studies were included in the review. The systematic review was conducted according to PRISMA statement guidelines.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 4894 papers identified, the data extraction protocol led to 8 studies for further review. Assessment of Risk of Bias was made using the ROBINS-E tool. Six studies were characterized as high risk of bias, one characterized with some concerns and one with low risk of bias. Breastfeeding for 6\u201312 months has a protective effect against ECC. There is no association between breastfeeding and ECC for the ages 12\u201324 months; however, depending on the frequency or when combined with increased sugar consumption, it can have an impact on dental caries prevalence. Beyond 24 months, breastfeeding was associated with increased ECC prevalence.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Based on the studies included in this review and within their limitations, breastfeeding up to 2 years of age does not increase ECC risk, but after 2 years of age breastfeeding is associated with increased risk of ECC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration number<\/jats:title>\n            <jats:p>The protocol for this systematic review was registered on PROSPERO (CRD42020179773).<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40368-025-01051-4","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T06:52:31Z","timestamp":1748587951000},"page":"645-656","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Does breastfeeding increase the risk of early childhood caries (ECC)? A systematic review"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6425-5735","authenticated-orcid":false,"given":"F.","family":"Alexaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kostopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Koleventi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2394-2143","authenticated-orcid":false,"given":"N. 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