Evaluation of Mother's Complementary Feeding Knowledge and Occlusion.

Aim: Mothers' understanding of feeding methods and how they affect deciduous dentition were the focus of this study. Materials and
Methods: This study looked at people from different parts of the population. In total, 230 moms of children aged 6 months to 5 years who completed an oral health questionnaire were included in the study. Mothers' awareness of feeding patterns and their impact on deciduous dentition were examined in the study.
Results: Illiterate moms' children showed a significant difference in the quality of their occlusion compared to similarly raised children of literate mothers. Children who began supplementary feeding before the age of 6 months were more likely to have occlusion changes.
Conclusion: Malocclusion prevalence was shown to be unrelated to meal behaviors. However, further research is required as there are just a few studies currently available. Copyright:

INTRODUCTION

Complementary feeding can be defined as the process of introducing food and other liquids to the young ones when breastfeeding single-handedly is no longer adequate to meet up their dietary needs.[1] These foods are often prepared or bought from the market for the young ones to suit their ingestion and satisfy their desires.[2]

The World Health Organization encourages breastfeeding for the first 6 months of life. There is a great deal of importance placed on oral and perioral muscles, which are responsible for both the development of the occlusal structure and the growth of jaws.[3] A child's stomatognathic system is composed of static and dynamic structures and the balanced relationship between them.[1] A literature review has shown breastfeeding/bottle feeding affects developing jaws and occlusion of young ones. Breastfeeding and its effects on developing occlusion have been a divisive topic.[45]

Malocclusion in deciduous dentition is the combination of genetic and environmental factors such as feeding practices.[678] Physiological growth of deciduous dental arches lays the groundwork for the developing dental arches. Studies show a positive correlation between non-nutritive sucking habits such as the use of pacifiers, digit, or dummy sucking, and the development of various types of malocclusion.[9] Malocclusions have a lasting detrimental result on oral health-related quality of life.[10]

Because of the lack of information, this research was conducted to examine the mother's awareness of complementary feeding habits and their impact on deciduous dentition.

MATERIALS AND METHODS

The study comprised 230 participants (mothers) of children aged 6 months to 5 years who completed the given questionnaire. The sample was determined based on the g power of the patient population in the particular area. The moms were given a questionnaire to fill out. This study looked at mothers' awareness of feeding habits and how they affected their children's deciduous dentition.

The research was carried out at the college's Department of Pediatric and Preventive Dentistry.

Structured questionnaires were used to gather the information, including information on sociodemographic characteristics, knowledge and attitude, and supplemental nutrition.

Procedures for research

The questionnaire was provided to mothers to collect all of the information listed below.

Part 1 included information about the child's age, parents' education and occupation, and the child's gender and place of residence. The mother's primary source of complementary feeding information was also questioned (dentist, media, or friends). Part 2 consisted of a nine-item quiz about pediatric KOH. Mothers' complementary feeding habits were discussed in part 3. In this study, the occlusion of teeth in children was investigated. The examiners were blinded from the method to reduce the bias and they were just recording the values after the questionnaire was answered.

Criteria for acceptance

Children ranging in age from 6 months to 5 years.

To guarantee a healthy sample, only full-term children were chosen.

Teeth with a typical number, size, and form.

There are no local or systemic conditions.

Criteria for exclusion

The refusal of the mother to give informed consent

Children who have missing, deformed, or extra teeth

Children with significant carious lesions and massive repairs.

RESULTS

The study enlisted the participation of 230 mothers. The youngsters were 3.1 (1.2) years old on average. Male children made up 51.7% of the total, while female youngsters made up 48.3%. Further, 51.7% of the 230 moms were literate, 50% of the mothers worked, and 52.6% lived in the city [See Table 1].

Table 1

Sociodemographic characteristics of the mothers and children included in the study

Sociodemographic Characteristics (n=230)	n (%)
Mean age of the children	3.1 years (±1.2)
Sex of the children
Male	119 (51.7%)
Female	111 (48.3%)
Literacy status of the mothers
Illiterate	119 (51.7%)
Literate	111 (48.3%)
Occupation of the mothers
Housewives	115 (50.0%)
Working	115 (50.0%)
Residence of the mothers
Urban	121 (52.6%)
Rural	109 (47.4%)
Income groups of the family (based on monthly income)
I	67 (29.1%)
II	47 (20.4%)
III	33 (14.4%)
IV	43 (18.7%)
V	40 (17.4%)

Table 2 shows that 40% of women relied on previous experiences for knowledge on complementary feeding, whereas 30% depended on health professionals and 29% on relatives and friends. Of 230 moms, 42.2% started supplemental feeding at 6 months, 32.1% at 7 months–1 year, and 21.8% at 1–2 years. Among 127 moms who postponed supplemental feeding, 28.4% said their milk was sufficient, 22.8% said they did not know when to start, 17.3% said they did not try because their child did not have teeth yet, and 14.2% said their child vomited after eating (13.4%). Moreover, 43.5% of mothers fed their kids commercially available infant food, 51.3% fed twice daily, and 30.9% fed three times daily. Further, 46.5% of mothers fed their children thin supplemental food, 30.9% thick, and 22.6% acceptable.

Table 2

Complementary feeding practices followed by mothers

Complementary Feeding Practices	n (%)
Source of information for complementary feeding
Self (Previous Experience)	92 (40.0%)
Health Personnel	71 (30.9%)
Family/Friends	67 (29.1%)
Introduction of complementary feeding
At<6 months	6 (2.6%)
At 6 months	97 (42.2%)
At 7 months to 1 year	74 (32.1%)
At 1–2 years	50 (21.8%)
Complementary feeding not started	3 (1.3%)
Reasons for delaying complementary feeding (n=127)
Mother felt that her milk was enough	36 (28.4%)
Don’t exactly know when to start	29 (22.8%)
Family elders told not to give before 1 year	22 (17.3%)
Mothers didn’t try as the child had no teeth	18 (14.2%)
Tried but failed, as child vomited	17 (13.4%)
Mothers felt that her child might not be able to digest it	5 (3.9%)
Giving marketed weaning food?
Yes	100 (43.5%)
No	130 (56.5%)
Number of complementary feedings per day?
One	41 (17.8%)
Two	118 (51.3%)
Three	56 (24.4%)
More than three	15 (6.5%)
Consistency of complementary feeding?
Thin	107 (46.5%)
Thick	71 (30.9%)
Appropriate	52 (22.6%)

As given in Table 3, 57.1% and 54.8% of mothers were aware of dental caries and malocclusion, respectively.

Table 3

Awareness of mothers on malocclusion and dental caries

Awareness on malocclusion and dental caries	n (%)
Awareness about malocclusion
Yes	126 (54.8%)
No	83 (36.1%)
Don’t Know	21 (9.1%)
Awareness about dental caries
Yes	131 (57.1%)
No	86 (37.3%)
Don’t Know	13 (5.6%)

As shown in Table 4, 61.2% had alteration of occlusion comprising 18.5% of overjet, 14.6% crowding, 16.4% open-bite, and 11.7% crossbite. Out of 230 children, 63.1% of children had dental caries.

Table 4

Prevalence of malocclusion and caries among children

Parameter	n (%)
Alteration of occlusion
Yes	141 (61.2%)
No	89 (38.8%)
Caries
Yes	145 (63.1%)
No	92 (36.9%)
Type of malocclusion
Overjet	42 (18.5%)
Crowding	34 (14.6%)
Open-bite	38 (16.4%)
Cross-bite	27 (11.7%)
No alteration	89 (38.8%)

As given in Table 5, literate mothers had more awareness on dental caries and malocclusion in comparison to illiterate mothers, but the result was statistically insignificant.

Table 5

Association between the educational qualification of mothers and awareness about caries and malocclusion

Awareness	Yes (%)	No* (%)	P
Awareness about caries
Illiterate mothers	57 (47.8%)	62 (52.2%)	0.114
Literate mothers	74 (66.6%)	37 (33.4%)
Awareness about malocclusion
Illiterate mothers	51 (42.8%)	68 (57.2%)	0.236
Literate mothers	75 (67.5%)	36 (32.5%)

As shown in Table 6, the alteration of occlusion was observed more in children of illiterate mothers in comparison to literate mothers.

Table 6

Factors influencing malocclusion

Explanatory parameter	Alteration of occlusion
	Yes (%)	No (%)	P
Literacy status of the mothers
Illiterate	84 (70.5%)	35 (29.4%)	0.566
Literate	57 (51.3%)	54 (48.7%)
Awareness about malocclusion
Yes	70 (55.5%)	56 (44.5%)	0.732
No*	71 (71.7%)	33 (28.3%)
Awareness about dental caries
Yes	85 (64.8%)	46 (35.2%)	0.348
No*	56 (56.5%)	43 (43.5%)
Initiation of complementary feeding
At <6 months	4 (66.7%)	2 (33.3%)	0.434
At 6 months	63 (64.9%)	34 (35.1%)
At 7 months to 1 year	48 (64.8%)	26 (35.2%)
At 1–2 years	23 (46.0%)	27 (54.0%)
Complementary feeding not started	3 (100%)	-

DISCUSSION

Breastfeeding practice is promoted and prevalent in India and worldwide for newborn babies and infants. When it comes to the first few months of life, it has been advised to avoid gastrointestinal infections and growth deficiency[511] Studies have shown prolonged breastfeeding and bottle feeding have an association with cross-bite development among preschool children.[1213]

In mixed and permanent dentitions, studies have demonstrated that non-nutritive sucking practices contribute to malocclusion.[1415]

Various authors have found the association between childhood morbidity and mortality related to nutrition. Nutrition provided to children from the time of inception till the child's second birthday render benefit to them throughout life. Malnutrition is one of the leading causes of illness and death in children; 45% of the fatalities of children under the age of 5 years were attributed to undernutrition, which resulted in 3.1 million deaths every year. Because of this, the first 1000 days of a child's life may have an influence on their health in adulthood.[16] A total of 230 mothers were included in the study. Out of 230 mothers, 51.7% were literate, 50% were working, and 52.6% belonged to urban areas [Table 1]. In contrast to the current study, Duriasamy, et al.[9] had 31.6% undergraduates and 42.8% postgraduates. Study results have demonstrated that mother education and family wealth are likely contributors to inadequate indicators of supplementary feeding. A mother's educational level and her family's wealth were both linked to lower use of supplemental feeding in all five Asian nations (Bangladesh, India, Nepal, Pakistan, and Sri Lanka).[17] Low family income or a lack of maternal education were shown to be connected with a lower minimal dietary variety in an Indonesian study.[18] In Ghana, poverty and lack of maternal education were also risk factors for the practice of breastfeeding.[19] Dietary variety was shown to be correlated with maternal education and family income in this research.

In the present study, 54.8% of mothers were aware of malocclusion. As shown in Table 4, 61.2% had alteration of occlusion comprising 18.5% of overjet, 14.6% crowding, 16.4% open-bite, and 11.7% crossbite. However, these findings were statistically insignificant. Furthermore, a questionnaire interview-based methodology should be used to determine the values that have great importance.

Therefore, our data emphasize the need for breastfeeding till 6 months of age and introducing complementary foods at the proper age. Further studies are required to improve upon what is already out there.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.