Role of Exclusive Breastfeeding in Conferring Protection in Children At-Risk for Autism Spectrum Disorder: Results from a Sibling Case–control Study

Abstract

Background:Gut microflora influences neural development through complex mechanisms. Feeding practices, especially breastfeeding influence gut microbiome and thereby play a pivotal role in immune and neural development. Current understandings of the role of healthy distal gut microflora in the development of immune and neural systems provide insights into immunological mechanisms as one of the possible etiologies in autism spectrum disorder (ASD). Studies have shown that optimal breastfeeding is associated with lower odds of being at-risk for ASD and children with ASD are suboptimally breastfed.Methods:The feeding practices of children with ASD (n = 30) was compared to their typically developing siblings as matched controls (n = 30). Information regarding feeding practices was collected from mothers through a semi-structured questionnaire.Results:About 43.3% of children with ASD received exclusive breastfeeding, whereas 76.7% of their typically developing siblings were exclusively breastfed. Exclusive breastfeeding was associated with lower odds for ASD (odds ratio [OR] = 0.166; 95% confidence interval [CI] = 0.025–0.65), while early introduction of top feeds was associated with higher odds (OR = 6; 95% CI = 1.33–55.19). Difficulties in breastfeeding were attributed to child-related factors in 13.2% of the children.Conclusion:Children with ASD are suboptimally breastfed compared to their typically developing siblings. Exclusive breastfeeding may confer protection in vulnerable children. Further studies on larger prospective sample are required to establish the association.

<p>Eating and Mealtime Behaviors in Patients with Autism Spectrum Disorder: Current Perspectives</p>

“…Correlation with age (most common at ages 1–3) ( p =0.001), increasing autism severity ( p <0.0001), poor appetite ( p <0.0001), and constipation ( p =0.0003) Dovey 2019 37 Higher eating difficulties, behavioral problems and sensory hypersensitivity ( p <0.002) than in TD Huxham 2019 20 76% initially exclusive breastfeeding, of which 19.1% > 6 months; 60.9%: early weaning; approxim. 50%: problems with weaning and transition to textured foods Food acceptance influenced by food features (51% color, 64.7% food presentation); 75.6% limited variety (sensory aspects and mealtime behavioral features also described) Manohar 2019 19 43.3% exclusive breastfeeding; association with suboptimal breastfeeding (<6 months) ( p =0.0162) Mayes 2019 36 Higher frequency of atypical eating behaviors in autism (70.4%) than in children with other disorders (13.1%) and typical children (4.8%) 41.6% only one atypical eating behavior; 58.9% two or more; 26.3% three or more; 88% FS; 46% hypersensitivity to food textures; 27% eating only one brand of food; 19% pocketing food without swallowing; 12% pica. Peverill 2019 62 Four eating behavior trajectories: less severe and stable, moderate and declining, severe and declining, very severe and stable Soke 2019 21 Lower breastfeeding rate (85.7%, p =0.003).…”

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“…8,26,30 The factors commonly associated with ADHD in the children were joint families and lower middle-class families, having 2 or more siblings, and parental stress. 25,31 Intellectual disability…”

Pre-emptive Intervention for Autism Spectrum Disorder: Theoretical Foundations and Clinical Translation

“…Breastfeeding, either exclusively or with some formula supplementation, is associated with decreased risk of ASD (Schultz et al, 2006; Boucher et al, 2017; Tseng et al, 2017; Bittker and Bell, 2018; Manohar et al, 2018). A Spanish multicenter birth-cohort study of 1,346 children showed that longer duration of breastfeeding protected against autistic traits (Boucher et al, 2017).…”