Malocclusions in young children: Does breast-feeding really reduce the risk? A systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 28754184 · doi:10.1016/j.adaj.2017.05.018
What was done
The authors conducted a systematic review and meta-analysis of observational studies (prospective, retrospective longitudinal, case-control, and analytical cross-sectional) evaluating the association between breastfeeding history and malocclusions in healthy children with primary dentition. Two authors independently extracted data and assessed study quality using standardized instruments. Meta-analyses used random-effects models, supplemented by fixed-effects models when heterogeneity was 50% or less as measured by the I-squared statistic.
What was found
Seven studies were included. Breastfeeding for less than 12 months was significantly associated with an increased risk of anterior open bite (n = 1,875; risk ratio 3.58, 95% CI 2.55 to 5.03, P < .00001) and class II canine relationship (n = 1,203; risk ratio 1.65, 95% CI 1.38 to 1.97, P < .00001). An increased risk was also reported for posterior crossbite, but no numerical effect size was provided in the abstract.
Why it matters
This review provides quantitative evidence that breastfeeding for at least 12 months is associated with lower risks of specific malocclusions in primary dentition. It supports breastfeeding promotion in pediatric oral health while recognizing that malocclusion etiology remains multifactorial.
Limits
The review included only 7 studies, all with observational designs subject to confounding and recall bias. The abstract does not report numerical risk ratios or sample sizes for posterior crossbite, exact heterogeneity values, or the total pooled sample size across all included studies.
Cited by
- context Breastfeeding expands and broadens the jaw and maxilla, preventing dental crowding.