Parental Feeding Styles, Sugary Drinks Intake, and Early Childhood Caries in Egyptian Children: A Mediation Analysis.

Background: Early childhood caries (ECC) is associated with unhealthy eating.

Objective: To assess the relationship of parental feeding styles (PFS) with ECC and the mediating effect of sugary drinks.

Methods: A cross-sectional study was conducted at a hospital in Egypt (2022-2023) including 2-6-year-old children. Clinical examination assessed ECC and plaque. Children's feeding habits were assessed by the PFS questionnaire. The World Health Organization Child Questionnaire assessed children's oral hygiene practices. A standardized questionnaire assessed the frequency and quantity of daily sugary drinks. Negative binomial regression assessed the relation between dmfs, PFS, and sugary drinks, controlling for confounders. PROCESS macro was used to assess mediation by sugary drinks.

Results: The study included 412 children. Most children (80.8%) had ECC and consumed sugary drinks daily (84.2%). There were significantly higher odds of dmfs with instrumental feeding (AOR = 2.35, 95% CI: 1.82, 3.03) and lower odds with encouragement-to-eat (AOR = 0.62, 95% CI: 0.50, 0.77). Sugary drinks significantly mediated the relationship of control-over-feeding and emotional feeding with ECC.

Conclusions: ECC was significantly associated with encouragement-to-eat and instrumental feeding. Sugary drinks significantly mediated the association with emotional feeding and control-over-feeding. Identifying PFS helps children at risk through preventive and health education programs.