{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:03:36Z","timestamp":1781517816790,"version":"3.54.1"},"reference-count":40,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Early childhood caries (ECC) compromise the nutrition, growth, and quality of life in young children, and their relationship with breastfeeding practices remains disputed. Aim: To determine if prolonged breastfeeding increases the risk of dental caries in children aged under 71 months. Material and Methods: A systematic review of PubMed, Multidisciplinary Digital Publishing Institute, and Evidence-Based Dentistry, was conducted through August 2025, including observational studies, randomized trials, narrative reviews, and meta-analyses on breastfeeding and ECC. Results: Thirty-one studies involving 28,000 children were included. Exclusive breastfeeding for under six months halves ECC probability (OR 0.53\u20130.58), whereas breastfeeding beyond 12 months and nocturnal feeds increase probability by 60\u201386% (OR 2.35\u20137.14). Parental factors\u2014high plaque levels, feeding-to-sleep, and skipped post-feed cleaning\u2014strongly predict ECC (OR 8.51\u201375.6). Interventions combining feeding counseling with home visits or visual aids reduce ECC incidence by 22\u201332% (RR 0.68\u20130.78). Conclusions: Exclusive breastfeeding through six months is protective against ECC, but prolonged or nocturnal feeding heightens risk. Integrating structured oral health education into breastfeeding promotion is recommended.<\/jats:p>","DOI":"10.3390\/children13010102","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:30:34Z","timestamp":1768203034000},"page":"102","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Review Regarding the Impact of Breastfeeding on Early Childhood Caries"],"prefix":"10.3390","volume":"13","author":[{"given":"Mihaela","family":"T\u0103nase","sequence":"first","affiliation":[{"name":"Pedodontics Department, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 041292 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Maria","family":"Pistol","sequence":"additional","affiliation":[{"name":"Pedodontics Department, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 041292 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2742-7699","authenticated-orcid":false,"given":"Diana Daniela Daciana","family":"Zm\u0103r\u0103ndache","sequence":"additional","affiliation":[{"name":"Pedodontics Department, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 041292 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana-Andreea","family":"Stanciu","sequence":"additional","affiliation":[{"name":"Pedodontics Department, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 041292 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5288-9898","authenticated-orcid":false,"given":"Aneta","family":"Munteanu","sequence":"additional","affiliation":[{"name":"Pedodontics Department, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 041292 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1111\/ipd.12490","article-title":"Early Childhood Caries: IAPD Bangkok Declaration","volume":"29","author":"Pitts","year":"2019","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.17796\/1053-4625-46.2.1","article-title":"Breastfeeding and its Association with Early Childhood Caries\u2014An Umbrella Review","volume":"46","author":"Panchanadikar","year":"2022","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.4103\/0976-9668.107257","article-title":"Early childhood caries update: A review of causes, diagnoses, and treatments","volume":"4","author":"Colak","year":"2013","journal-title":"J. Nat. Sci. Biol. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/ipd.12484","article-title":"Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective","volume":"29","author":"Tinanoff","year":"2019","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e12376","DOI":"10.1111\/jicd.12376","article-title":"Prevalence of early childhood caries among 5-year-old children: A systematic review","volume":"10","author":"Chen","year":"2019","journal-title":"J. Investig. Clin. Dent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"732","DOI":"10.5005\/jp-journals-10024-2116","article-title":"Early childhood caries: A review","volume":"18","author":"Alazmah","year":"2017","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_7","first-page":"307","article-title":"Prevalence of early childhood caries in rural non-fluoridated areas of Chile","volume":"5","author":"Zaror","year":"2016","journal-title":"J. Oral Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3892\/mi.2024.138","article-title":"Clinical significance and main parameters promoting the breastfeeding strategy (Review)","volume":"4","author":"Nixarlidou","year":"2024","journal-title":"Med. Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e2022057988","DOI":"10.1542\/peds.2022-057988","article-title":"Section on Breastfeeding. Policy Statement: Breastfeeding and the Use of Human Milk","volume":"150","author":"Meek","year":"2022","journal-title":"Pediatrics"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.identj.2021.07.001","article-title":"Feeding Practices and Early Childhood Caries in Korean Preschool Children","volume":"72","author":"Park","year":"2022","journal-title":"Int. Dent. J."},{"key":"ref_11","first-page":"1573","article-title":"Associated Factors of Early Childhood Caries (ECC) Among 24\u201342-Month-Old-Children in Jakarta: A Cross-Sectional Study","volume":"14","author":"Setiawati","year":"2021","journal-title":"J. Int. Dent. Med. Res."},{"key":"ref_12","first-page":"15","article-title":"Breastfeeding duration and early childhood caries risk: A meta-analysis","volume":"32","author":"Lee","year":"2022","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Badrov, M., Matijevi\u0107, M., and Tadin, A. (2025). Parental Knowledge of Breastfeeding and Nutrition: Influence on Oral Health and Self-Reported Early Childhood Caries in Preschool Children in Croatia. Pediatr. Rep., 17.","DOI":"10.3390\/pediatric17020043"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Shrestha, S.K., Arora, A., Manohar, N., Ekanayake, K., and Foster, J. (2024). Association of Breastfeeding and Early Childhood Caries: A Systematic Review and Meta-Analysis. Nutrients, 16.","DOI":"10.3390\/nu16091355"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1111\/ipd.13313","article-title":"Risk of Early Childhood Dental Caries associated with prolonged breastfeeding: A systematic review and meta-analysis","volume":"35","author":"Lustosa","year":"2025","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_16","first-page":"1190","article-title":"Exclusive breastfeeding under six months and early childhood caries: A systematic review and meta-analysis","volume":"98","author":"Paiva","year":"2019","journal-title":"J. Dent. Res."},{"key":"ref_17","first-page":"447","article-title":"Nocturnal feeding frequency and early childhood caries: A meta-analysis","volume":"48","author":"Li","year":"2020","journal-title":"Community Dent. Oral. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Carrillo-D\u00edaz, M., Ortega-Mart\u00ednez, A.R., Ruiz-Guill\u00e9n, A., Romera-Maroto, M., and Gonzalez-Olmo, M.J. (2021). Impact of Breastfeeding and Co-sleeping on Early Childhood Caries: A Cross-Sectional Study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10081561"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/j.envint.2018.07.015","article-title":"Identifying the PECO: A Framework for Formulating Good Questions to Explore the Association of Environmental and Other Exposures With Health Outcomes","volume":"121","author":"Morgan","year":"2018","journal-title":"Environ. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/apa.13118","article-title":"Breastfeeding and the risk of dental caries: A systematic review and meta-analysis","volume":"104","author":"Tham","year":"2015","journal-title":"Acta Paediatr."},{"key":"ref_21","first-page":"745","article-title":"Ever-breastfed and risk of early childhood caries: Systematic review and meta-analysis","volume":"25","author":"Cui","year":"2016","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_22","first-page":"79","article-title":"Breastfeeding and early childhood caries: A systematic review and meta-analysis","volume":"32","author":"Nascimento","year":"2018","journal-title":"Braz. Oral Res."},{"key":"ref_23","first-page":"77","article-title":"Impact of breastfeeding practices on early childhood caries: Narrative review","volume":"8","author":"Garcia","year":"2020","journal-title":"Dent. J."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Holmes, L., Williams, J., Thompson, N., John, V., Depeika, K., Ogundele, B., and Enwere, M. (2024). Implication of Exclusive Breastfeeding in Early Childhood Dental Disorders: Large Cohort Evidence, US National Survey of Children Health. Children, 11.","DOI":"10.20944\/preprints202409.2263.v1"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1038\/s41432-024-01078-4","article-title":"Iranian early childhood dental caries: A comprehensive systematic review and meta-analysis of prevalence and associated risk factors","volume":"26","author":"Jabbarian","year":"2025","journal-title":"Evid. Based Dent."},{"key":"ref_26","first-page":"39","article-title":"Connaissances, attitudes et pratiques en sant\u00e9 orale des femmes allaitantes","volume":"45","author":"Beaugrand","year":"2024","journal-title":"Soins Pediatr. Pueric."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.arcped.2019.10.004","article-title":"Breastfeeding and early childhood caries: Review of the literature, recommendations, and prevention","volume":"26","author":"Branger","year":"2019","journal-title":"Arch. Pediatr."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Chanpum, P., Duangthip, D., Trairatvorakul, C., and Songsiripradubboon, S. (2020). Early Childhood Caries and Its Associated Factors among 9- to 18-Month-Old Exclusively Breastfed Children in Thailand: A Cross-Sectional Study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17093194"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Haag, D.G., Jamieson, L.M., Hedges, J., and Smithers, L.G. (2011). Is There an Association between Breastfeeding and Dental Caries among Three-Year-Old Australian Aboriginal Children?. Nutrients, 11.","DOI":"10.3390\/nu11112811"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1111\/j.1600-0528.2010.00540.x","article-title":"Long-term effectiveness of a nutritional program in reducing early childhood caries: A randomized trial","volume":"38","author":"Feldens","year":"2010","journal-title":"Community Dent. Oral. Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Birungi, N., Fadnes, L.T., Okullo, I., Kasangaki, A., Nankabirwa, V., Ndeezi, G., Tumwine, J.K., Tyllesk\u00e4r, T., Atle Lie, S., and Nordrehaug \u00c5str\u00f8m, A. (2015). Effect of Breastfeeding Promotion on Early Childhood Caries and Breastfeeding Duration among 5 Year Old Children in Eastern Uganda: A Cluster Randomized Trial. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0125352"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1159\/000108596","article-title":"The effect of prolonged and exclusive breast-feeding on dental caries in early school-age children","volume":"41","author":"Kramer","year":"2007","journal-title":"Caries Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/idh.12507","article-title":"Randomized trial of a photography-aided behavioural intervention to reduce risk factors for caries and malocclusion in high-risk infants","volume":"20","author":"Pereira","year":"2022","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"29S","DOI":"10.1177\/0022034513484331","article-title":"Cluster-randomized trial of infant nutrition training for caries prevention","volume":"92","author":"Chaffee","year":"2013","journal-title":"J. Dent. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1089\/bfm.2014.0153","article-title":"Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight","volume":"10","author":"Brown","year":"2015","journal-title":"Breastfeed. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1604062","DOI":"10.3389\/ijph.2021.1604062","article-title":"Urban-Rural Gaps in Breastfeeding Practices: Evidence From Lao People\u2019s Democratic Republic","volume":"66","author":"Jordyn","year":"2021","journal-title":"Int. J. Public Health"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2478\/amma-2021-0029","article-title":"Breastfeeding and diversification attitudes among Romanian mothers","volume":"67","author":"Simion","year":"2021","journal-title":"Acta Marisiensis\u2014Ser. Medica"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Petrut, A.C., Filip, L., Banc, R., M\u00eerza, O., Gavrila, L., Ciob\u00e2rca, D., Tisa, I.B., Heghes, S.C., Popa, C.O., and Miere, D. (2021). Breastfeeding Practices and Determinant Factors of Exclusive Breastfeeding among Mothers of Children Aged 0\u201323 Months in Northwestern Romania. Nutrients, 13.","DOI":"10.3390\/nu13113998"},{"key":"ref_39","unstructured":"American Academy of Pediatric Dentistry (2025). Policy on dietary recommendations for infants, children, and adolescents. The Reference Manual of Pediatric Dentistry, American Academy of Pediatric Dentistry."},{"key":"ref_40","unstructured":"European Academy of Paediatric Dentistry (2021). Guidelines on Early Childhood Caries Prevention. Eur. Arch. Paediatr. Dent., 22, 23\u201330."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/1\/102\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:52:33Z","timestamp":1768204353000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/1\/102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,10]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["children13010102"],"URL":"https:\/\/doi.org\/10.3390\/children13010102","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,10]]}}}