The aim of this study was to study the characteristics and to explore
risk factors within a group of Dutch children breast-fed on demand ove
r a prolonged period, whose mothers attended the meetings of La Leche
League. Ninety-six children, 55 boys and 41 girls (mean age 28.8 month
s, SD 8.8), were examined. Most of the parents belong to a higher soci
o-economic working class. The examination included a questionnaire and
dietary sheet, combined with the caries status of the child, On avera
ge the children were breast-feed for 21.5 months (SD 9.8). The mean ag
e at which the parents started brushing the children's teeth was 11.7
months (SD 5.1). Fluoridated toothpaste (250 ppm fluoride) was used by
70% of the children. The children were divided into three groups acco
rding to their caries pattern: 1 caries-free; 2 caries, and 3 nursing
caries. Dentine caries was found in 14 (14.5%) of the children, of whi
ch 9 (9.3%) met the criteria of nursing caries. The mean dmfs of all c
hildren examined was 1.2 (SD 4.8). Up to IS months of age the breast w
as given significantly more frequently during the night and up to 24 m
onths during the day time, to the children of the nursing caries group
compared to the children in the other two groups. The children still
being breast-fed at the time of investigation more Frequently slept in
their parents' bed. The children of the nursing-caries group used flu
oridated dentifrices less often. The majority of children of the carie
s and nursing-caries groups did not receive fluoride from other source
s. The results of the present study demonstrate that prolonged demand
breast-feeding does not lead to a higher caries prevalence although co
mparison between the groups demonstrates that frequent breast-feeding
and low additional fluoride use should be considered as contributing f
actors in the process of nursing caries.