| Summary: | The type and duration of breastfeeding can be key factors in the development of early childhood caries (ECC). The association between nighttime feeding and ECC was investigated. Specifically, whether cosleeping is a potential mediator of children’s oral health was investigated, considering many of the etiological factors of caries. In this cross-sectional study, 212 children (aged 2–4 years) from Madrid (Spain) who breastfed at night were examined to assess the mean decayed/filled primary teeth (dft) index, and a questionnaire was administered to the mothers to collect data on the practice of breastfeeding and cosleeping and its duration, the number of nighttime feeding sessions, sugar content in the diet, dental hygiene habits, and age at first dental visit. The dft index was lower in the group that breastfed for less than 18 months (<i>p</i> = 0.02). In addition, there were significant differences in the dft index in the group breastfeeding for more than 18 months between those who coslept for 18 months or more and those who coslept for less than 18 months (<i>p</i> < 0.05), as well as between those who coslept for 18 months or more and those who did not cosleep (<i>p</i> < 0.01). In conclusion, breastfeeding at night from 18 months onwards is considered a risk factor for ECC.
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