<p>Associations between prolonged breastfeeding and a higher caries burden in young children have long been described. However, many older studies are methodologically flawed because they do not adjust the observed associations for other caries-related factors. This applies in particular to the consideration of a high-sugar diet and oral hygiene. A number of more recent studies and reviews address this criticism by adjusting the caries findings associated with different durations of breastfeeding to reflect diet and oral hygiene. In many of these studies, an independent influence of breastfeeding on the development of early childhood caries was found for breastfeeding durations of 12 months or more. All the studies considered demonstrate, after adjustment, a significant association between prolonged breastfeeding and caries when breastfeeding continues for 24 months or longer. Based on this knowledge, consistent and effective caries prevention measures must be implemented, particularly in cases of prolonged breastfeeding.</p>