Feeding Practices, "Severe Early Childhood Caries" and "General Health Status" in One to Two years Old Indian Urban Children: A Cross-Sectional Study

Background: Improper feeding practice is a common risk factor for not only Severe Early Childhood Caries (S-ECC) but also poor general health; furthermore, S-ECC can be considered as an earliest marker of many non-communicable diseases of adulthood. Few studies in Indian literature have assessed association of bottle-feeding with oral and general health, in the age-group of one-two years.

Aim: To assess S-ECC and General Health Status (GHS) in 1-2 year-old children in relation to feeding practices.

Objectives: To assess the prevalence of S-ECC and to evaluate the GHS w.r.t respiratory infections, gastrointestinal infections, constipation, developmental and nutritional parameters of children fed with or without bottle in the age group 1-2 years.

Methods: 824 one to two year-old children in General hospitals, well baby clinics and other private paediatric set-ups were selected. The study tool recorded information such as the child`s age, gender, feeding practice, mother’s age, education, socioeconomic status, dmft, anaemia, respiratory infections, GI infections, constipation, developmental milestones and BMI (height and weight) of the child, etc.

Results: Out of the total population, 9.64% exhibited S-ECC. The odds in "non-bottle-fed" children as compared to "bottle-fed" were: for S-ECC (OR=0.15; p<0.0001), gastrointestinal infections (OR=0.59; p=0.0128), constipation (OR=2.08; p=0.0004), low BMI (OR=0.1; p=0.0002) as well high BMI (OR=0.23; p<0.0001); all statistically significant. Bedtime bottle-feeding amplified the risk of S-ECC in a regression analysis (OR=2.38; p=0.0329). Also, children having caries reported higher risk of developing anaemia, gastrointestinal infections and constipation; the odds being statistically significant. Exclusive breast-feeding had protective benefits against all conditions. Association of bottle-feeding practice with anaemia, respiratory infections and milestone delays was not statistically significant.

Conclusions: "Bottle-fed" children exhibited higher S-ECC and poor GHS w.r.t. gastrointestinal infections, constipation and effects on BMI, than "non-bottle-fed" children.