Association of Sleep-Time Feeding Practices with Early Childhood Caries: A Case-Control Study

Abstract

Early childhood caries(ECC) remains a public health challenge globally, more so in developing countries. The association between sleep-time feeding practices and ECC remains obscure. The study evaluated this association using Feeding At Sleep Time(FeAST) scale. A case-control study was planned among 627 toddlers, where cases included children with ECC while controls were children without ECC. Three patterns of feeding associated with sleep were recorded; beginning of sleep, during the course of sleep and early morning hours sleep. Dental caries was scored using International Caries Detection and Assessment System(ICDAS II). The study participants included 302(48%) cases and 325(52%) controls. Adjusted odds ratios(AORs) for breast-feeding at the beginning of sleep, during the course of sleep and early morning hours sleep were 6.7, 6.5, and 3.7, respectively(p =0.001) on comparing cases versus controls. Similarly, AORs for bottle-feeding at the beginning of sleep, course of sleep and early morning hours sleep were 5.1, 8.3, and 3.7, respectively(p =0.001). Addition of sweeteners yielded an AOR = 2.84, while the intake of solids during sleep yielded an AOR of 6.02(P =0.001). Other feeding modes like sippers, tumblers, etc., had a statistically significant association(p =0.001). Sleep time feeding practices increase the risk for ECC in 12- to 36-month-old children.

Association of Breastfeeding and Early Childhood Caries: A Systematic Review and Meta-Analysis

“…Out of the 31 studies, 22 were cohort studies , and 9 were case-control studies [57][58][59][60][61][62][63][64][65]. Among the cohort studies, six were nested studies, one was nested within a cross-sectional study [36], and the remaining five were nested in randomised controlled trials [38,[40][41][42]51].…”

“…Eleven studies carried out dental examinations in clinical settings of dental clinics, hospitals, or universities [35,36,[43][44][45][46][47]53,57,60,62]. Fourteen studies carried out dental examinations in field settings [37,38,40,42,[48][49][50][51]54,55,58,59,61,64]. Four studies were unclear about their setting for dental examinations [39,56,63,65].…”

“…Seventeen studies [35,36,38,40,41,43,[48][49][50][51]54,[58][59][60][61][62][63] were conducted in middle-income countries [66] whereas fourteen [37,39,42,[44][45][46][47]52,53,[55][56][57]64,65] were carried out in highincome countries.…”

“…Four studies were conducted in Australia [39,42,46,64]. Two studies were conducted in India [58,59], and two were conducted in Thailand [48,50]). Among the high-income countries, one study was conducted in the USA [44], one was conducted in Canada [65], one was undertaken in Italy [45], one in Scotland [37], and one in the Czech Republic [57].…”

“…One study [44] reported dfs ECC. One study [54] [36,45,59] were the only three studies reporting ECC based on the International Caries Detection Assessment System (ICDAS) criteria.…”