Alexaki F, Kostopoulou M, Koleventi K, Lygidakis N N
Aristotle University of Thessaloniki, Thessaloniki, Greece.
Private Paediatric Dental Clinic, Thessaloniki, Greece.
Eur Arch Paediatr Dent. 2025 May 30. doi: 10.1007/s40368-025-01051-4.
To review the current evidence on the association of breastfeeding during the first years of life with the development of Early Childhood Caries (ECC).
A systematic review of literature was conducted in June 2019 and again in March 2024 at the following Databases: Pub Med, Scopus, Cochrane Library, Science Direct, Google Scholar, for studies reporting on children aged up to 71 months investigating breastfeeding duration/cessation and presence of caries at the examination. Prospective Cohort studies were included in the review. The systematic review was conducted according to PRISMA statement guidelines.
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 6-12 months has a protective effect against ECC. There is no association between breastfeeding and ECC for the ages 12-24 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.
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.
The protocol for this systematic review was registered on PROSPERO (CRD42020179773).
回顾关于生命最初几年母乳喂养与幼儿龋齿（ECC）发展之间关联的现有证据。
2019年6月和2024年3月在以下数据库进行了文献系统综述：PubMed、Scopus、Cochrane图书馆、Science Direct、谷歌学术，以查找有关71个月以下儿童母乳喂养持续时间/停止情况以及检查时龋齿情况的研究报告。纳入综述的为前瞻性队列研究。系统综述按照PRISMA声明指南进行。
在识别出的4894篇论文中，数据提取方案筛选出8项研究进行进一步综述。使用ROBINS-E工具进行偏倚风险评估。6项研究被判定为高偏倚风险，1项存在一些问题，1项为低偏倚风险。母乳喂养6至12个月对ECC有保护作用。12至24个月时母乳喂养与ECC之间无关联；然而，根据喂养频率或与糖分摄入增加相结合的情况，它可能会对龋齿患病率产生影响。超过24个月后，母乳喂养与ECC患病率增加相关。
基于本综述纳入的研究及其局限性，2岁前母乳喂养不会增加ECC风险，但2岁后母乳喂养与ECC风险增加相关。
本系统综述方案已在PROSPERO（CRD#42020179773）注册。
