Consumption of Breast Milk Is Associated with Decreased Prevalence of Autism in Fragile X Syndrome

Abstract

Breastfeeding is associated with numerous health benefits, but early life nutrition has not been specifically studied in the neurodevelopmental disorder fragile X syndrome (FXS). Herein, I evaluate associations between the consumption of breast milk during infancy and the prevalence of autism, allergies, diabetes, gastrointestinal (GI) problems and seizures in FXS. The study design was a retrospective survey of families enrolled in the Fragile X Online Registry and Accessible Research Database (FORWARD). There was a 1.7-fold reduction in the prevalence of autism in FXS participants who were fed breast milk for 12 months or longer. There were strong negative correlations between increased time the infant was fed breast milk and the prevalence of autism and seizures and moderate negative correlations with the prevalence of GI problems and allergies. However, participants reporting GI problems or allergies commenced these comorbidities significantly earlier than those not fed breast milk. Parsing the data by sex indicated that males exclusively fed breast milk exhibited decreased prevalence of GI problems and allergies. These data suggest that long-term or exclusive use of breast milk is associated with reduced prevalence of key comorbidities in FXS, although breast milk is associated with the earlier development of GI problems and allergies.

Parental Reports on Early Autism Behaviors in Their Children with Fragile X Syndrome as a Function of Infant Feeding

“…There is a paucity of studies examining the effects of diet in FXS [ 11 , 14 , 15 , 19 , 20 , 21 , 22 , 23 , 24 ]. Herein, diet-responsive autistic behaviors in FXS included three behaviors in girls within the Language category (talk, speak in 3-word sentences and use words to request things), one behavior in girls within the Parent Thought Problem category (learning problem), and one behavior in boys within the Autistic Behaviors category (injure self) in association with soy-based infant formula.…”

“…Study Design: The impact of early infant diet on the severity of common FXS phenotypes was assessed through a retrospective survey study utilizing the FORWARD as a sampling frame. The study design, Fragile X Syndrome Nutrition Study questionnaire, study population, recruitment success, and data collection have been previously described [ 14 , 15 ]. Data collection for the survey began in November of 2019 and lasted 3 months.…”

“…Single-source soy-based diets are associated with increased sensitivity to audiogenic-induced seizures in Fmr1 KO mice [ 11 ]; increased prevalence of febrile seizures, simple partial seizures and epilepsy comorbidity in autism [ 12 ]; deficits in language, communication, social overtures and hypersensitivity to environmental stimuli in autistic children [ 13 ]; and increased comorbidity of autism, gastrointestinal problems and allergies in FXS [ 14 ]. Conversely, long-term infant feeding with breast milk is associated with decreased prevalence of autism in FXS [ 15 ]. There are several potential bioactive components in soy that could reduce seizure threshold and exacerbate autistic behaviors, i.e., soy phytoestrogens and agrochemicals [ 16 , 17 ].…”

Phenotypic Trade-Offs: Deciphering the Impact of Neurodiversity on Drug Development in Fragile X Syndrome

“…ASD in FXS patients with soy-based formula consumption and the opposite with breastmilk (47,48). Other examples include high birth size (e.g., weight, length), which is associated with a higher risk of ASD but a lower risk of SCZ, and could be influenced by many prenatal factors.…”

“…The factors that affect trade-offs also extend beyond features explainable by biological variations within neuronal networks and usually involve perplexing epigenetic and environmental elements. For instance, there was increased ASD in FXS patients with soy-based formula consumption and the opposite with breastmilk ( 47 , 48 ). Other examples include high birth size (e.g., weight, length), which is associated with a higher risk of ASD but a lower risk of SCZ, and could be influenced by many prenatal factors.…”