Effect of Breastfeeding Promotion on Early Childhood Caries and Breastfeeding Duration among 5 Year Old Children in Eastern Uganda: A Cluster Randomized Trial
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Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
Although several studies have shown short term health benefits of exclusive breastfeeding
(EBF), its long term consequences have not been studied extensively in low-income contexts.
This study assessed the impact of an EBF promotion initiative for 6 months on early
childhood caries (ECC) and breastfeeding duration in children aged 5 years in Mbale, Eastern
Uganda.
Methods
Participants were recruited from the Ugandan site of the PROMISE- EBF cluster randomised
trial (ClinicalTrials.gov no: NCT00397150). A total of 765 pregnant women from 24
clusters were included in the ratio 1:1 to receive peer counselled promotion of EBF as the intervention
or standard of care. At the 5 year follow-up, ECC was recorded under field conditions
using the World Health Organization’s decayed missing filled tooth (dmft) index.
Adjusted negative binomial and linear regression were used in the analysis.
Results
Mean breastfeeding duration in the intervention and control groups (n=417) were 21.8 (CI
20.7–22.9) and 21.3(CI 20.7–21.9) months, respectively. The mean dmft was 1.5 (standard
deviation [SD] 2.9) and 1.7 (SD 2.9) in the intervention and control groups, respectively.
Corresponding prevalence estimates of ECC were 38% and 41%. Negative binomial regression
analysis adjusted for cluster effects and loss-to-follow-up by inverse probability weights (IPW) showed an incidence-rate ratio (IRR) of 0.91 (95% CI 0.65–1.2). Comparing
the effect of the trial arm on breastfeeding duration showed a difference in months of 0.48
(-0.72 to 1.7).
Conclusion
PROMISE EBF trial did not impact on early childhood caries or breastfeeding duration at 5
years of age. This study contributes to the body of evidence that promotion of exclusive
breastfeeding does not raise oral health concerns. However, the high burden of caries calls
for efforts to improve the oral health condition in this setting.
Description
Keywords
Breastfeeding Promotion, Childhood, Breastfeeding Duration, Children
Citation
Birungi N, Fadnes LT, Okullo I, Kasangaki A, Nankabirwa V, Ndeezi G, et al. (2015) Effect of Breastfeeding Promotion on Early Childhood Caries and Breastfeeding Duration among 5 Year Old Children in Eastern Uganda: A Cluster Randomized Trial. PLoS ONE 10(5): e0125352. doi:10.1371/ journal.pone.0125352