Sugar Intake and Breastfeeding Duration Lead to Dental Caries at an Early Age

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Highlights:

• Dietary habits and breastfeeding practices rooted in infancy influence lifelong preferences
• Hence, it is advised to avoid sugar consumption and encourage exclusive breastfeeding in the first 24 months of a baby's life
• Now, it is shown that high sugar intake and early interruption of breastfeeding might also contribute to dental caries

The inclusion of sugar in the diet and an early interruption of breastfeeding are the main factors that contribute to the appearance of dental caries by age 2, according to a study published in the journal Community Dentistry and Oral Epidemiology involving 800 children.

The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life, followed by solid food together with continued on-demand breastfeeding up to 2 years of age or beyond. It also advises against giving infants added sugar before age 2.

‘Breastfeeding for 24 months reduced consumption of ultra-processed foods or foods with added sugar, acting as a preventive factor for dental caries.’

Some previous studies pointed to an association between extended breastfeeding [for 12 months or more] and the occurrence of dental caries, but without properly accounting for the role of early added sugar consumption by these children.

The new study found the increased risk of caries in the context of extended breastfeeding to correlate with sugar consumption. The results corroborate prior research findings on the role of free sugar in the development of dental caries (1^✔).

Breast milk lactose alone doesn't cause the problem. Practically all the children surveyed by our study were exposed to free sugar at an early age.

Impact of Timing of Sugar Introduction and Breastfeeding on Dental Caries in Infants

Dental caries was found in 22.8 percent of the 800 children tracked. In isolation, this proportion means children breastfed for more than 24 months ran a higher risk than those breastfed for 12 months or less. However, the incidence of dental caries declined in line with falling sugar consumption in the former.

Information about food consumption was obtained from interviews in which mothers or carers described what the babies had eaten in the previous 24 hours. The amount of sugar added to various kinds of food and drink was also recorded.

Only 2.8 percent never consumed sugar before their second birthday, and 66.7 percent consumed food with added sugar more than five times a day. Only 7.6 percent consumed no added sugar at all in the first year of their lives.

The frequency of dental caries varied with household income, educational attainment, and the mother's or carer's skin color. It was highest for children of black women in low-income families and with less schooling.

How does Dental Caries Occur due to Breastfeeding and Sugar Intake?

High sugar consumption results in the formation of a cariogenic dental biofilm, known as bacterial plaque. Breast milk is modified by plaque and contributes to the demineralization of tooth enamel, but sugar consumption triggers this process.

The frequency with which plaque is exposed to breast milk is probably the main factor in the heightened risk of dental caries observed in breastfed children over 12 months of age.

Even if the teeth affected are deciduous or milk teeth, dietary habits such as consuming large amounts of sugar in infancy tend to become permanent and pose the risk of dental caries developing later in life (2^✔).

Other studies have also shown that having dental caries in infancy usually means having them in adolescence, too. Even 100 percent fruit juice is currently discouraged in the first 12 months by the WHO.

It may not contain added sugar, but the natural sugar in fruit is separated from the fiber when it is crushed, and this free sugar has similar effects to sucrose from sugarcane. The WHO's guidelines do not discourage the consumption of whole fresh fruit and vegetables by infants, however.

Therefore, it is recommended that exclusive breastfeeding for the first six months and advocates continued on-demand breastfeeding until age 2, introducing fruit and other solid foods from the age of six months. It also advises against added sugar until age 2.

References:

1. Prolonged breastfeeding, sugar consumption and dental caries at 2 years of age: A birth cohort study - (https:onlinelibrary.wiley.com/doi/abs/10.1111/cdoe.12813)
2. Early childhood caries update: A review of causes, diagnoses, and treatments - (https:www.ncbi.nlm.nih.gov/pmc/articles/PMC3633299/)

Source: Medindia

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