Night-Time Breastfeeding and Feeding Practices in the First Years of Life and Their Association with Early Childhood Caries: A Cross-Sectional Study

Early childhood caries (ECC) is a major public health concern in young children. This study aimed to investigate the association between feeding practices, with particular emphasis on the frequency of night-time breastfeeding after 12 months of age, and parent-reported ECC among children aged 1–5 years. In this cross-sectional study, ECC was assessed as a binary outcome (presence vs. absence). Sociodemographic characteristics, perinatal and health-related factors, feeding practices, and oral health-related behaviors, were collected through an online questionnaire distributed to mothers via social media between June 2024 and January 2025. Associations between variables and parent-reported ECC were explored using chi-square tests.Multivariable logistic regression analyses were performed separately for children aged 12–17 months, 18–23 months, and ≥ 24 months to examine factors associated with parent-reported ECC, with adjustment for relevant sociodemographic, feeding, and oral health-related variables. Among 732 children, bivariate analysis showed that extended family structure, male sex, vitamin D supplementation, iron deficiency anemia(IDA), antibiotic use, adding sugar, prolonged breastfeeding beyond 24 months, and higher night-time breastfeeding frequency after 12 months were significantly associated with parent-reported ECC. The significant risk indicators for parent-reported ECC in multivariable regression were age, extended family, IDA, adding sugar, frequency of night-time breastfeeding. In this study of children aged 1–5 years, higher frequency of night-time breastfeeding after 12 months of age was independently associated with parent-reported ECC after adjustment for relevant sociodemographic, nutritional, feeding, and oral health-related factors. These findings highlight the importance of considering the frequency and timing of breastfeeding, rather than breastfeeding duration alone, when evaluating early-life feeding practices in relation to ECC.