Association of feeding patterns in infancy with later autism symptoms and neurodevelopment: a national multicentre
Xueli Xiang1, Ting Yang1, Jie Chen1
1Chongqing Key Laboratory of Childhood Nutrition and Health, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Nutrition Research Center, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Insights
Children with autism spectrum disorder (ASD) show different infant feeding patterns than typically developing children. Longer breastfeeding may reduce ASD symptoms, and feeding difficulties warrant neurodevelopmental follow-up.
Area of Science:
- Neurodevelopmental Pediatrics
- Child Psychology
- Nutritional Science
Background:
- Infant feeding patterns, including breastfeeding and complementary feeding, are crucial for child development.
- Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition with potential links to early life factors.
- Understanding feeding differences in ASD may offer insights into symptom management and developmental trajectories.
Purpose of the Study:
- To compare infant feeding patterns between children with ASD and typically developing (TD) children.
- To investigate the relationship between feeding patterns and core ASD symptoms and neurodevelopment.
Main Methods:
- A multicentre study analyzed breastfeeding and complementary feeding in 1389 children with ASD and 1190 TD children.
- Neurodevelopmental levels were assessed using the Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016).
- ASD symptoms were evaluated using the Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Childhood Autism Rating Scale (CARS), and ASD Warning Behavior Subscale of the CNBS-R2016.
Main Results:
- Children with ASD exhibited shorter breastfeeding duration, later introduction of complementary foods, and poorer acceptance compared to TD children.
- Extended breastfeeding (≥12 months) was associated with lower total ABC and CARS scores in children with ASD.
- Delayed complementary feeding (>6 months) correlated with lower general quotient, adaptive ability, fine motor, and language scores in children with ASD.
Conclusions:
- Infant feeding patterns differ significantly between children with ASD and TD children.
- Breastfeeding duration and complementary feeding introduction/acceptance appear related to ASD symptoms and neurodevelopmental outcomes.
- Extended breastfeeding and monitoring infants with feeding difficulties are recommended for potential benefits in ASD management.
Background:
We aimed to compare differences in infant feeding patterns (breastfeeding and complementary food supplementation) between children with the autism spectrum disorder (ASD) and typically developing (TD) children through a multicentre study. The relationship between these patterns and later core symptoms and neurodevelopment in children with ASD was also investigated.
Methods:
We analysed breastfeeding and complementary feeding patterns in 1389 children with ASD and 1190 TD children. The Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) was used to assess neurodevelopmental levels. The Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Childhood Autism Rating Scale (CARS), and ASD Warning Behavior Subscale of the CNBS-R2016 were used to assess ASD symptoms.
Results:
Children with ASD had a shorter breastfeeding duration in infancy (8 (3-12) months vs. 10 (6-14) months, P < 0.001), later introduction of complementary foods (P < 0.001), and poorer acceptance of complementary foods (P < 0.001) than TD children. Total ABC and CARS scores were lower in the group of children with ASD who had been breastfed for 12 months or more than in the group who had been breastfed for less than 6 months. Children with ASD who were given complementary food after 6 months had lower general quotient (GQ), adaptive ability, fine motor and language scores than those who were given complementary food within 4-6 months. Children with ASD with poor acceptance of complementary foods had higher ABC and SRS scores and lower gross motor scores than those who had good acceptance.
Conclusions:
Children with ASD have a shorter duration of breastfeeding, a later introduction of complementary foods, and poorer acceptance of complementary foods than TD children. These feeding patterns may be related to the symptoms and growth of children with ASD. The research suggests that continued breastfeeding for longer than 12 months may be beneficial in reducing ASD symptoms and that infants who have difficulty introducing complementary foods should be followed up for neurodevelopment.
Trial Registration:
The ethics committee of the Children's Hospital of Chongqing Medical University approved the study. Approval Number: (2018) IRB (STUDY) NO. 121, and registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000031194, registered on 23/03/2020).
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