Bottle feeding to sleep beyond 12 months is associated with higher risk of tooth decay and overweight in Australian children: Findings from the Healthy Smiles Healthy Kids cohort study

Objective: Bottle feeding to sleep may increase early childhood caries (ECC) and overweight risk through sugar exposure and overfeeding. This study examined the association between feeding to sleep at 24 and 36 months on both ECC and overweight at 3-4 years. Methods: Participants were children in the Healthy Smiles Healthy Kids longitudinal birth cohort. Exposure was bottle feeding to sleep at 24 and 36 months. Outcomes were ECC (prevalence; number of caries-affected tooth surfaces, dmfs) and overweight at 3-4 years. Results: 718 and 729 children had dental examinations and anthropometric measurements, respectively. 30.3% and 21.7% of children were bottle-fed to sleep at 24 and 36 months, respectively. Feeding to sleep at 24 months was associated with higher odds of overweight (OR 1.90, 95%CI 1.06-3.38) and moderately associated with higher caries (dmfs 1.48, 95%CI 1.00-2.20). Feeding to sleep at 36 months was associated with higher caries (dmfs 1.88, 95%CI 1.22-2.91). Conclusions: Feeding to sleep was associated with higher odds of overweight and higher numbers of caries-affected tooth surfaces. Communicating appropriate sleep, settling and bottle cessation methods throughout early childhood may prevent ECC and overweight. Implications for Public Health: Early interventions addressing bottle feeding could reduce the dual burden of ECC and obesity.