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Feeding practice during infancy is associated with attention-deficit/hyperactivity disorder and autism spectrum

Jong Ho Cha1, Yongil Cho2, Jin-Hwa Moon3

  • 1Department of Pediatrics, Hanyang University Hospital, Seoul, South Korea.

European Journal of Pediatrics
|May 23, 2023
PubMed

Insights

Exclusive breastfeeding significantly lowers the risk of attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in children. Breastfeeding offers protective benefits for neurodevelopmental outcomes.

Area of Science:

  • Neurodevelopmental Disorders
  • Pediatric Health
  • Infant Nutrition

Background:

  • Attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are common neurodevelopmental disorders.
  • Infant feeding practices, including breastfeeding and timing of solid food introduction, are potential factors influencing neurodevelopment.
  • Previous research suggests breastfeeding benefits overall child health and cognitive function.

Purpose of the Study:

  • To investigate the impact of infant feeding practices on the development of ADHD and ASD.
  • To analyze the association between breastfeeding (exclusive, partial, formula) and supplementary food introduction timing with ADHD/ASD incidence.

Main Methods:

  • Utilized a large-scale nationwide database of 1,173,448 children aged 4-6 months from the National Screening Program for Infants and Children (NHSPIC) (2008-2014).
  • Followed children until 6-7 years of age, collecting feeding data (exclusive breastfeeding [EBF], partial breastfeeding [PBF], exclusive formula feeding [EFF]) and supplementary food introduction timing.
  • Employed generalized linear models for statistical analysis, with diagnoses based on the International Classification of Diseases, Tenth Revision.

Main Results:

  • Exclusive breastfeeding (EBF) was associated with significantly lower incidence of both ADHD (OR: 0.77) and ASD (OR: 0.64) compared to exclusive formula feeding (EFF).
  • Partial breastfeeding (PBF) also showed a protective effect against ADHD (OR: 0.91) and ASD (OR: 0.89) versus EFF.
  • The timing of supplementary food introduction (<6 or >6 months) was not significantly associated with ADHD or ASD risk, except for a slightly increased ASD risk in EFF infants with late introduction (>6 months).

Conclusions:

  • Breastfeeding, particularly exclusive breastfeeding, demonstrates a significant protective effect against the development of ADHD and ASD.
  • These findings support and strengthen recommendations for promoting breastfeeding to foster positive neurodevelopmental outcomes.
  • The timing of solid food introduction appears to have a limited impact on ADHD/ASD risk compared to breastfeeding status.

Keywords:
Attention-deficit hyperactivity disorderAutism spectrum disorderBreastfeedingNationwide studySupplementary food

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