The Interplay Between Breastfeeding and Autism Spectrum
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Background
Evidence supporting the association between breastfeeding patterns and ASD is inconsistent. This study examined sociodemographic and birth factors related to breastfeeding duration and ASD, compared to a typically developing (TD) cohort, using a data-driven approach based on electronic health and developmental records (EHR).
Methods
Demographics, feeding preferences (breastfeeding, bottle or both), breastfeeding duration as reported by parents during routine baby wellness visits, were analyzed for a cohort of 11,766 (1.9%) children with ASD and a random subsample of 12,000 (2.03%) TD children. The designation of ASD versus TD was based on a national ASD registry and assigned after EHR were completed. Pre-term, very low birth weight, multiple births, and infants with complex medical comorbidities were excluded.
Results
Infants with ASD were breastfed for an average of 5.0 months, 1.5 months shorter than TD. Fewer ASD infants were exclusively breastfed in the first year of life. Two-way ANOVAs indicated a significant effect of socioeconomic status (SES) and ASD on breastfeeding duration, and a significant interaction with ASD. Post-hoc comparisons showed that the Low SES ASD and TD groups were breastfed longer than all other groups (p<.001). For the Low-Medium, Medium-High and High SES groups, infants with ASD were breastfed less than TD.
Conclusions
Shorter breastfeeding duration among ASD was confirmed in this representative cohort, calling for closer monitoring for ASD in infants with breastfeeding difficulties. These challenges were independent of birth parameters; however, influenced by socioeconomic factors.
