The Impact of Exclusive Breastfeeding on Malocclusion: a Systematic Review

It has been suggested that exclusive breastfeeding of infants has a significant effect on the development of the child; however, previous findings on the impact of breastfeeding on jaw development are inconclusive. This study aims to search for evidence concerning the association between breastfeeding and malocclusion in children. Article search was done on CINAHL, PubMed/MEDLINE, EMBASE, and advanced Google Scholar. Observational studies that investigated the effect of exclusive breastfeeding on the occurrence of malocclusion were included in the study. Studies conducted within January 2004 and December 2020 were searched. The risk of bias was assessed using the JBI guidelines. Important characteristics and outcomes were extracted and summarized. Fourteen studies met (n = 12,641 participants) the inclusion criteria and were included in the review. Exclusive breastfeeding habits had a significantly lower chance of developing different types of malocclusion: overjet (OR of 0.65 to 16.4%), crossbite (OR of 1.2), and open bite. A prolonged exclusive breastfeeding (EBF) (≥ 6 months) had a significantly lower chance of developing overjet (AOR = 0.511 (0.290, 0.902), p = 0.021) and anterior open bite (OR = 3.7). Meanwhile, a child with EBF of < 6 months was 4 times at risk of developing posterior crossbite compared to those who had ≥ 6 months of EBF. The quality of the studies was 50% and above. Exclusive breastfeeding for a longer duration will have a lower risk of developing malocclusion.