# A Study of the Relationship Between Breastfeeding, Attachment Style and Oral Health in Pubertal Children: A Network Analysis

## TL;DR

Exclusively breastfed children show better oral health and secure attachment styles, suggesting a link between early feeding and later development.

## Contribution

This study explores the novel relationship between breastfeeding, attachment style, and oral health in pubertal children using a network analysis approach.

## Key findings

- Exclusively breastfed children had fewer cavities, better oral hygiene, better occlusion, and higher secure attachment scores.
- Breastfeeding is associated with better health and development in children from Azueta, Veracruz.
- Secure attachment may act as a psychosocial pathway linking breastfeeding to oral health outcomes.

## Abstract

What are the main findings?
•Exclusively breastfed children had less history of cavities, better oral hygiene, better occlusion, and had higher scores on the secure attachment style scale compared to those who were not exclusively breastfed.•Breastfeeding may be associated with better health and development in the children sampled in the municipality of Azueta, Veracruz.

Exclusively breastfed children had less history of cavities, better oral hygiene, better occlusion, and had higher scores on the secure attachment style scale compared to those who were not exclusively breastfed.

Breastfeeding may be associated with better health and development in the children sampled in the municipality of Azueta, Veracruz.

What are the implications of the main findings?
•Secure and closeness attachment can be considered a potential psychosocial pathway, linking early breastfeeding experiences with subsequent oral health patterns in middle childhood. That is, attachment styles seem to be multidimensionally integrated by biological-evolutionary, cognitive, behavioral, affective, and social aspects.•It is important to study these phenomena from a comprehensive perspective, as this can guide public policies and the development of comprehensive health promotion programs.

Secure and closeness attachment can be considered a potential psychosocial pathway, linking early breastfeeding experiences with subsequent oral health patterns in middle childhood. That is, attachment styles seem to be multidimensionally integrated by biological-evolutionary, cognitive, behavioral, affective, and social aspects.

It is important to study these phenomena from a comprehensive perspective, as this can guide public policies and the development of comprehensive health promotion programs.

Background/Objectives: Although the benefits of breastfeeding on the development and health of the infant are well known, the relationship between breastfeeding, oral health and attachment style or emotional bonding is not fully known. This research sought to explore, from a comprehensive perspective, the associations between breastfeeding history and children’s attachment styles, as well as the relationships between breastfeeding history and oral health indicators within conceptual psychophysiological frameworks discussed in the literature. Methods: This was a cross-sectional (descriptive and analytical) and correlational study. In this work, the associations of breastfeeding with attachment and oral health were analyzed in 100 children between 9 and 11 years old at a primary school in the municipality of José Azueta, Veracruz, Mexico, from December 2023 to September 2024 by a clinical history, dental examinations (Oral Hygiene Index-Simulated (OHI-S), Dental Caries History (DEOPT) and Detection of Malocclusions (DAI)) and the Attachment and Interaction Styles Instrument. Results: Significant differences were found in the security and closeness attachment style, the oral-hygiene index, the caries index, and occlusion by type of breastfeeding, showing better values in boys and girls who were exclusively breastfed. Likewise, both in the correlation analysis and in the multiple regression model, associations were observed between having been exclusively breastfed and the attachment style and oral indices. Conclusions: Our data show the importance of breastfeeding in pubertal children, since it was associated with better attachment and oral health; however, these findings reflect patterns of co-occurrence and should not be interpreted as causal relationships.