Feeding behaviours in infancy of children later diagnosed with autism spectrum disorder

Authors

  • Chaitanya Varma Sethu Centre for Child Development and Family Guidance, Goa, India
  • Nandita de Souza Sethu Centre for Child Development and Family Guidance, Goa, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20232249

Keywords:

Autism spectrum disorder, Breastfeeding, Dysregulated sucking, Early identification, Weaning, India

Abstract

Background: Autism spectrum disorder, the fastest growing childhood neurodevelopmental diagnosis, shows good outcomes with early intervention. The search for behavioral early markers is an important area of research. Studies of breastfeeding and weaning behaviours in autism have reported characteristic patterns which could be early indicators of this condition.

Methods: The study was a cross sectional survey of breastfeeding and weaning patterns during the first year of life in 50 children aged 15 months to 5 years, including 25 with ASD and 25 Neurotypical children. A semi-structured interview schedule and the brief assessment of mealtime behavior in children scale was used to elicit feeding history from their mothers. Data was analysed using descriptive statistics and tests of significance.

Results: There were significant differences in the patterns of early feeding of children with ASD, compared to the NT children. 64% ASD children showed dysregulated vigorous sucking during breastfeeding, without knowing when to stop. 52% of them breast fed for more than 40 minutes per feed. 68% continued to breastfeed beyond the age of 2 years. A significant proportion of ASD children also showed weaning difficulties such as limited variety (40%), food refusal (36%) and disruptive mealtime behaviour (32%).

Conclusions: Children with ASD show significantly more challenging breastfeeding and weaning behaviours in infancy, compared to NT children. These patterns could be identified by parents and health workers in early child development as possible early signs of ASD and prompt referral for further diagnostic evaluation.

References

Battle DE. Diagnostic and statistical manual of mental disorders (DSM). Codas. 2013;25(2):191-2.

Ardhanareeswaran K, Volkmar F. Focus: Autism Spectrum Disorders. Yale J Biol Med. 2015;88(1):3-4.

Makrygianni M, Reed P. A meta-analytic review of the effectiveness of behavioural early intervention programs for children with autistic spectrum disorders. Res Autism Spect Disord. 2010;4(4):577-93.

Lyall K, Croen L, Daniels J, Fallin MD, Ladd-Acosta C, Lee BK, et al. The changing epidemiology of Autism Spectrum Disorders. Annu Rev Public Health. 2017;20(38):81-102.

Bandini LG, Anderson SE, Curtin C, Cermak S, Evans EW, Scampini R, et al. Food selectivity in children with autism spectrum disorders and typically developing children. J Pediatr. 2010;157(2):259-64.

Ranjan S, Nasser JA. Nutritional status of individuals with autism spectrum disorders: do we know enough? Adv Nutr. 2015;6(4):397-407.

Crasta J, Benjamin T, Suresh A, Alwinish M, Kaniappan K, Padankatti M. Feeding problems among children with autism in a clinical population in India. Indian J Pediatr. 2014;81(2):169-72.

Vissoker RE, Latzer Y, Gal E. Eating and feeding problems and gastrointestinal dysfunction in Autism Spectrum Disorders. Res Autism Spectr Disord. 2015; 12:10-21.

Gomez CR, Baird S. Identifying Early Indicators for Autism in Self-Regulation Difficulties. Focus Autism Other Develop Disab. 2005;20(2):106-16.

Jahromi LB, Bryce CI, Swanson J. The importance of self-regulation for the school and peer engagement of children with high-functioning autism. Res Autisn Spect Disord. 2013;7(2):234-42.

Nadon G, Feldman DE, Dunn W, Gisel E. Mealtime problems in children with autism spectrum disorder and their typically developing siblings: a comparison study. Autism. 2011;15(1):98-113.

Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. J Am Diet Assoc. 2010;110(2): 238-46.

Postorino V, Sanges V, Giovagnoli G, Fatta LM, De Peppo L, Armando M, et al. Clinical differences in children with autism spectrum disorder with and without food selectivity. Appetite. 2015;92:126-32.

Margari L, Marzulli L, Gabellone A, de Giambattista C. Eating and mealtime behaviors in patients with autism spectrum disorder: current perspectives. Neuropsychiatr Dis Treat. 2020;16:2083-102.

Lucas RF, Cutler A. Dysregulated breastfeeding behaviors in children later diagnosed with autism. J Perinat Educ. 2015;24(3):171-80.

Al-Farsi Y, Al-Sharbati M, Waly M, Al-Farsi O, Al-Shafaee M, Al-Khaduri M, et al. Effect of suboptimal breast-feeding on occurrence of autism: A case-control study. Nutrition. 2012;28(7):27-32.

Ghozy S, Tran L, Naveed S, Quynh T, Helmy A, Waqas A, et al. Association of breastfeeding status with risk of autism spectrum disorder: A systematic review, dose-response analysis and meta-analysis. Asian J Psychiatr. 2020;48(1):38-42.

Manohar H, Pravallika M, Kandasamy P, Chandrasekaran V, Rajkumar RP. Role of exclusive breastfeeding in conferring protection in children at-risk for Autism Spectrum Disorder: Results from a sibling case-control study. J Neurosci Rural Pract. 2018;9(1):132-6.

Husk JS, Keim SA. Breastfeeding and autism spectrum disorder in the national survey of children's health. Epidemiology. 2015;26(4):451-7.

Soke GN, Maenner M, Windham G. Association between breastfeeding initiation and duration and autism spectrum disorder in preschool children enrolled in the study to explore early development. Autism Res 2019;12:816-29.

Lázaro CP, Pondé MP. Narratives of mothers of children with autism spectrum disorders: focus on eating behavior. Trends Psychiatry Psychother. 2017; 39(3):180-7.

Hof M, Ester WA, van Berckelaer-Onnes I, Hillegers MHJ, Hoek HW, Jansen PW. Do early-life eating habits predict later autistic traits? Results from a population-based study. Appetite. 2021;3(1):156-60.

Seiverling LJ, Castro K, Perry IS, Ferreira GP, Marchezan J, Becker M, et al. Validation of the Brief Autism Mealtime Behavior Inventory (BAMBI) Questionnaire. J Autism Dev Disord. 2019;49(6): 2536-44.

Statistics for Windows. Available at: https://www.ibm. com/support/pages/how-cite-ibm-spss-statistics-or-earlier-versions-spss. Accessed on 20 February 2022.

Saki A, Eshraghian MR, Tabesh H. Patterns of daily duration and frequency of breastfeeding among exclusively breastfed infants in Shiraz, Iran, a 6-month follow-up study using Bayesian generalized linear mixed models. Glob J Health Sci. 2013;5(2):123-33.

Guiding principles for complementary feeding of the breastfed child. Available at: https://www.who.int. Accessed on 20 November 2022.

Huang S, Wang X, Sun T, Yu H, Liao Y, Cao M, et al. Association of Breastfeeding for the First Six Months of Life and Autism Spectrum Disorders: A National Multi-Center Study in China. Nutrients. 2022;14(1): 45.

George B, Padman RMS, Nair MKC, Leena ML, Russell PSSR. Early child care practices at home among children (2–6y) with autism. A case-control study. Indian J Pediatr. 2014;81(2):S138-41.

Huxham L, Marais M, van Niekerk E. Idiosyncratic food preferences of children with autism spectrum disorder in England. South African J Clin Nutr. 2019; 3(4):1-7.

Berding K, Donovan SM. Microbiome, and nutrition in autism spectrum disorder: Current knowledge and research needs. Nutr Rev. 2016;74:723-6.

Say GN, Karabekiroğlu K, Babadağı Z, Yüce M. Maternal stress and perinatal features in autism and attention deficit/hyperactivity disorder. Pediatr Int. 2016;58(4):265-9.

Emond A, Emmett P, Steer C, Golding J. Feeding symptoms, dietary patterns, and growth in young children with autism spectrum disorders. Pediatrics. 2010;126(2):337-42.

Seiverling L, Towle P, Hendy HM, Pantelides J. Prevalence of feeding problems in young children with and without Autism Spectrum Disorder: A chart review study. J Early Interv. 2018;40(4):335-46.

Wallace GL, Llewellyn C, Fildes A, Ronald A. Autism spectrum disorder and food neophobia: clinical and subclinical links. Amer J Clin Nutr. 2018;108(4):701-7.

Malhi P, Saini S, Bharti B, Attri S, Sankhyan N. Sensory processing dysfunction and mealtime behavior problems in children with autism. Indian Pediatr. 2021;58(9):842-5.

Provost B, Crowe TK, Osbourn PL, McClain C, Skipper BJ. Mealtime behaviors of preschool children: comparison of children with Autism Spectrum Disorder and children with typical development. Phys Occup Ther Pediatr. 2010;30(3):220-33.

Gray HL, Sinha S, Buro AW, Robinson C, Berkman K, Agazzi H, et al. Early history, mealtime environment, and parental views on mealtime and eating behaviors among children with ASD in Florida. Nutrients. 2018;10(12):1867-72.

Chellaiyan VG, Liaquathali F, Marudupandiyan J. Healthy nutrition for a healthy child: A review on infant feeding in India. J Family Community Med. 2020;27(1):1-7.

World Health Organization. National Implementation of the Baby-Friendly Hospital Initiative 2017. Available at: https://www.who.int. Accessed on 20 November 2022.

Downloads

Published

2023-07-27

Issue

Section

Original Research Articles