Feeding Practices and Their Association with Nursing Bottle Caries in Infants Across Southern African Nations

Abstract

Nursing bottle caries (NBC), also known as early childhood caries (ECC), represents a significant public health challenge across Southern African nations, where socioeconomic disparities, cultural feeding practices, and limited access to preventive dental care converge to create conditions favorable for dental disease in infants and young children. This research paper examines the multifaceted relationship between various feeding practices and the prevalence of nursing bottle caries among infants in Southern African countries, including South Africa, Botswana, Zimbabwe, Namibia, and Mozambique. Through a comprehensive analysis of existing literature and epidemiological data, this study explores how infant feeding modalities—including prolonged bottle feeding, nocturnal feeding patterns, the introduction of sweetened beverages, and the timing of complementary food introduction—contribute to the development and progression of dental caries in the primary dentition. The findings reveal that nursing bottle caries affects between 30% and 70% of children under five years of age in various Southern African regions, with particularly high prevalence rates observed in rural communities where traditional feeding practices intersect with the increasing availability of processed, sugar-containing foods and beverages. The research highlights critical risk factors including the use of sweetened pacifiers, extended breastfeeding beyond recommended durations without proper oral hygiene, and the common practice of adding sugar or honey to infant bottles. Furthermore, this paper examines the socioeconomic determinants that influence feeding practices, such as maternal education levels, household income, access to clean water, and the availability of dental health services. The study emphasizes the urgent need for culturally sensitive, evidence-based interventions that address both the proximal causes of nursing bottle caries and the underlying social determinants of health. Recommendations include strengthening maternal and child health programs to incorporate oral health education, improving access to fluoridated water and dental care services, and developing community-based prevention strategies that respect traditional practices while promoting optimal infant feeding behaviors.