Does infant sensory responsiveness explain exclusive breastfeeding 6 months after birth?-a cohort prospective study

Although exclusive breastfeeding (EBF) is recommended for the first 6 months of life, breastfeeding rates in most developed countries are low. Sensory over-responsivity (SOR) has been found to interfere with infant and childcare, development, and routines, but has not yet been examined as a breastfeeding barrier. The aim of this study was to explore the association between infant sensory responsiveness and EBF and whether it can predict EBF cessation prior to 6 months of age.

In this cohort prospective study participants were 164 mothers and their infants recruited 2 days after birth in a maternity ward between June 2019 and August 2020. At this time, participating mothers completed a demographic and delivery information questionnaire. At 6 weeks after birth, the mothers completed the Infant Sensory Profile 2 (ISP2), reporting their infants' sensory responsiveness in daily activities. At 6 months, infants' sensory responsiveness was assessed using the Test of Sensory Functions in Infants (TSFI) and the Bayley Scales of Infant and Toddler Development-3^rd Edition (Bayley-III) was administered. Additionally, mothers provided information about their breastfeeding status and were divided into two groups accordingly: EBF and non-EBF (NEBF).

The incidence of atypical sensory responsiveness (mostly of the SOR type) at 6 weeks was twice as high among NEBF infants than EBF infants (36.2% vs. 17%, χ²=7.41, P=0.006). Significant group differences were found in the ISP2 touch section (F=10.22, P=0.002). In addition, NEBF infants displayed more SOR behaviors than EBF infants in the TSFI deep touch (F=2.916, P=0.001) and tactile integration subtests (F=3.095, P<0.001), and had lower scores in the adaptive motor functions subtest (F=2.443, P=0.013). Logistic regression modeling revealed that ISP2 at 6 weeks (typical vs. atypical) and TSFI total score at 6 months predicted 28% of NEBF at 6 months (χ²=23.072, P=0.010).

Infant atypical sensory responsiveness, predominantly of the SOR type, was found to predict NEBF at 6 months after birth. This study contributes to the understanding of EBF barriers, highlighting the importance of early identification of SOR in infants. Findings may suggest developing early sensory interventions and providing individualized breastfeeding support tailored to the infant's unique sensory profile.