Supplementary Material for: Association of sleep time feeding practices with Early Childhood Caries – A case control Study

Early childhood caries(ECC) remains a public health challenge globally, more so in developing countries. The association between sleep-time feeding practices and ECC remains obscure. The study evaluated this association using Feeding At Sleep Time(FeAST) scale. A case-control study was planned among 627 toddlers, where cases included children with ECC while controls were children without ECC. Three patterns of feeding associated with sleep were recorded; beginning of sleep, during the course of sleep and early morning hours sleep. Dental caries was scored using International Caries Detection and Assessment System(ICDAS II). The study participants included 302(48%) cases and 325(52%) controls. Adjusted odds ratios(AORs) for breast-feeding at the beginning of sleep, during the course of sleep and early morning hours sleep were 6.7, 6.5, and 3.7, respectively(p =0.001) on comparing cases versus controls. Similarly, AORs for bottle-feeding at the beginning of sleep, course of sleep and early morning hours sleep were 5.1, 8.3, and 3.7, respectively(p =0.001). Addition of sweeteners yielded an AOR = 2.84, while the intake of solids during sleep yielded an AOR of 6.02(P =0.001). Other feeding modes like sippers, tumblers, etc., had a statistically significant association(p =0.001). Sleep time feeding practices increase the risk for ECC in 12- to 36-month-old children.