Peres · Acta paediatrica (Oslo, Norway : 1992) 2015 · systematic review and meta-analysis · n=48 studies (41 in meta-analysis, 27,023 participants)

Effect of breastfeeding on malocclusions: a systematic review and meta-analysis.

Cited 194 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of observational studies

PubMed 26140303 · doi:10.1111/apa.13103 · record verified 2026-08-26

What was done

Six databases were systematically searched through October 2014 for observational and interventional studies evaluating the relationship between breastfeeding and malocclusion. Breastfeeding was evaluated across three comparisons: ever versus never, exclusive versus non-exclusive, and longer versus shorter duration. All types of malocclusion were included as outcomes. Pooled adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed, with heterogeneity and publication bias formally assessed.

What was found

Forty-eight studies were included in the systematic review and 41 in the meta-analysis (n = 27,023 participants). Breastfeeding was associated with reduced risk of malocclusions across all comparisons: - Ever vs. never breastfed: OR 0.34 (95% CI 0.24–0.48) - Exclusive vs. non-exclusive breastfeeding: OR 0.54 (95% CI 0.38–0.77) - Longer vs. shorter duration of breastfeeding: OR 0.40 (95% CI 0.29–0.54)

Why it matters

This review synthesizes evidence from over 27,000 subjects to demonstrate that breastfeeding—particularly exclusive and longer-duration feeding—is associated with substantially lower odds of developing malocclusion.

Limits

The included evidence relies on observational studies subject to confounding (e.g., non-nutritive sucking habits, pacifier use, genetics) and potential recall bias for infant feeding patterns. Specific numerical heterogeneity metrics (I-squared, Q-test results) and specific thresholds defining 'longer' versus 'shorter' breastfeeding duration were not reported in the abstract.

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