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SCIENTIFIC
JUSTIFICATION
For decades, pre-mastication has been used by mothers and caregivers during the weaning period, from
milk to table foods; however unbeknown to a majority of people, this practice carries several health risks, mainly 1) Increase
risk for childhood caries and 2) possible transmission of viruses such as HIV or Syphillis (Guar et al, 2009; Pingyu,
2009) or Streptococcus Mutans, the bacteria identified as the culprit in dental caries (Berkowitz, 2003).
Early childhood caries are the
single most common, preventable childhood disease in the United States. More than half of the children will have dental caries by the second grade. Moreover, the disease is endemic
in specific sectors of the population, specifically the economically disadvantaged. There is a well established health
risk associated with feeding babies or toddlers with pre-masticated food and increased incidence of dental decay. Streptococcus
Mutans, the bacteria identified as the culprit in dental caries can easily be transmitted by caregivers in pre-masticated
foods.
The extent of food pre-mastication in the United States is not known, however it has
been reported in literature since 1988. A survey of black patients in a pediatric clinic at the University of Nebraska
reported 65% of the adult caregivers acknowledged prechewing foods for the infants (Walburn, 1988) and more recently a study
of oral health in a random sample of Alaska Native children and their caregivers documented that 86% of caregivers are currently
prechewing or have prechewed foods for their infants (Lewis, 2002). Unpublished data from a survey (Infant Feeding Practices
Study II) conducted in 2007 (Fein, 2008) by the US Food and Drug Administration (FDA) in conjunction with the Centers for
Disease Control (CDC) and other federal agencies suggest a much higher prevalence of premastication thanexpected (Pingyu, 2009).
HIV rates within the United States are still high; the Centers for Disease Control
and Prevention now estimate that more than one million Americans are living with HIV and up to one-third of them do not know
they are HIV-positive. Two local cities make up a large portion off the HIV prevalence in the country: The District
of Columbia and Baltimore, Maryland. D.C. has one of the highest rates in the country, where it is estimated
that one in every 20 adults in the District of Columbia is infected with HIV. DC also tops the list with the highest rate of new AIDS cases per 100,000 population in
the United States -- a rate that is 10 times the
national average. References: Berkowitz, R.J. (2003). Causes, Treatment and Prevention
of Early Childhood Caries: A Microbiologic Perspective. Journal of the Canadian Dental Association, Vol. 69, No.
5, 304-308). Gaur, A.H., Dominguez, K.L., Kalish, M. L., Rivera-Hernandez, D., Donohoe,
M., Brooks, J.T., Mitchell, C.D., (2009). Practice of Feeding Premasticated Food to Infants: A Potential
Risk Factor for HIV transmission. Pediatrics, Volume 124, 2, 658-666. Fein SB, Grummer-Strawn LM, Raju TN. Infant
feeding and care practices in the United States: results from the Infant Feeding Practices Study II. Pediatrics. 2008;122(suppl
2):S25-S27. Lewis CW, Riedy CA, Grossman DC, Domoto PK, Roberts MC. Oral health of young Alaska Native children and their caregivers
in Southwestern Alaska. Alaska Med. 2002;44(4):83- 87. Pingyu, Z., Yihong, Q., Haikong, L., Zhifang, G.
(2009). Nonvenereal Transmission of Syphilis in Infancy by Mouth-to-Mouth Transfer of Prechewed Food. Sexually
Transmitted Diseases, Vol36, Issue 4, 216-217. Walburn JN, Pergam JM, Perry SH, Jensen J. Black child care practices in the Midwest.
Pediatrics. 1988;82(5):789 -790.
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