Association of Prolonged Breastfeeding With Early Childhood Caries Using Propensity Score Matching in the French Longitudinal Study of Children (ELFE Cohort)

Abstract

Objectives: The aim of this study was to investigate the link between prolonged breastfeeding (≥ 12 months) and early childhood caries (ECC) using propensity score matching (PSM) to account for observed confounders, reduce bias, and provide a more reliable estimate of this relationship.

Methods: This study utilised data from the French Longitudinal Study of Children (ELFE Cohort), comprising 11 718 participants. PSM was employed to pair children who were breastfed for 12 months or longer with those breastfed for less than 12 months or not at all, controlling for shared risk factors such as socioeconomic status and dietary habits. Logistic regression models were conducted to examine the association between ECC, reported by the parents at 3.5 years, and prolonged breastfeeding.

Results: Infants (7.6%) who were breastfed for 12 months or more exhibited twice the odds of developing ECC at 3.5 years compared to those breastfed for less than 12 months or not at all (OR = 2.20, 95% CI: 1.39, 3.47).

Conclusion: Children breastfed for 12 or more months are at increased risk of developing ECC. Further research is needed to investigate specific breastfeeding practices that may contribute to this increased risk, with the aim of promoting prolonged breastfeeding while ensuring optimal oral health.

Keywords: Early childhood caries; birth cohort; breastfeeding; propensity score matching.