Feeding Practices and Their Impact on Early Childhood Caries: A Comparison Between Breastfeeding and Bottle-feeding

<i>Background: </i>Early Childhood Caries (ECC) remains a prevalent public health concern globally. Feeding practices, particularly breastfeeding and bottle-feeding, along with oral hygiene behaviors and caregiver knowledge, are critical factors influencing ECC risk. This study aimed to compare the impact of breastfeeding and bottle-feeding on the prevalence and severity of ECC among children under five years of age. <i>Methods: </i>This cross-sectional comparative study was conducted among 105 children aged under five years at City Dental College and General Hospital, Dhaka, Bangladesh, from March 2004 to June 2004. Participants were categorized into breastfed (n = 58) and bottle-fed (n = 47) groups. Data were collected on demographic characteristics, feeding and brushing practices. <i>Results: </i>The mean age of bottle-fed children was slightly higher than that of breastfed children, though not statistically significant. Night-time feeding and higher feeding frequency (≥5 times/day) were significantly more common in bottle-fed children (p < 0.001 and p = 0.005, respectively). Oral hygiene habits did not differ significantly between groups (p > 0.05). The prevalence of ECC was significantly higher among bottle-fed children (61.7%) compared to breastfed children (31.0%) (p < 0.001). Gingivitis was more prevalent among breastfed children (32.7%; p = 0.017). Maternal knowledge was generally poor to average, with only 33.3% correctly identifying factors responsible for dental caries. <i>Conclusion: </i>Bottle-feeding is significantly associated with a higher prevalence and severity of ECC, particularly in children with frequent and night-time feeding. Oral hygiene practices were similar between groups, but maternal knowledge on dental caries prevention remains inadequate.