Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies.
PubMed 28698555 · doi:10.1038/s41598-017-05393-y
What was done
A systematic review and meta-analysis assessed the association between breastfeeding duration and malocclusion traits in primary and mixed dentition. Three electronic databases were searched for relevant articles. Methodological quality of the included observational studies was evaluated using the Newcastle-Ottawa Scale. Thirty-one studies met qualitative inclusion criteria, with nine included in the quantitative meta-analysis.
What was found
The 31 included observational studies were of moderate to high quality. Meta-analysis findings reported: - Posterior crossbite odds ratio (OR) was 3.76 (95% CI 2.01-7.03) for non-breastfed children compared to those breastfed >6 months, and 8.78 (95% CI 1.67-46.1) for non-breastfed compared to those breastfed >12 months. - Class II malocclusion OR was 1.25 (95% CI 1.01-1.55) for children breastfed up to 6 months compared to those breastfed >6 months. - Non-spaced dentition OR was 1.73 (95% CI 1.35-2.22) for children breastfed up to 6 months compared to those breastfed >6 months.
Why it matters
This review provides quantitative synthesis showing that longer breastfeeding duration is consistently associated with lower odds of multiple childhood malocclusions. It supports pediatric oral health guidance recommending sustained breastfeeding.
Limits
All included studies were observational, which prevents drawing causal conclusions. Only 9 of 31 included studies contributed to the meta-analysis, and estimates for breastfeeding >12 months had very wide confidence intervals. The abstract does not indicate whether studies adjusted for non-nutritive sucking habits (e.g., pacifiers or thumb-sucking).
Cited by
- supports Breastfeeding expands and broadens the jaw and maxilla, preventing dental crowding.