Association of Breastfeeding Duration with Neurodevelopmental Outcomes in an Enriched Familial Likelihood Cohort for Autism Spectrum Disorder

Abstract

This study aimed to compare the breastfeeding (BF) duration of the younger siblings of children with ASD in an enriched-likelihood cohort for autism spectrum disorder (ASD), and to determine whether longer BF duration was associated with differences in neurodevelopmental outcomes in this cohort. Information on BF practices was collected via surveys in the MARBLES (Markers of Autism Risk in Babies-Learning Early Signs) study. Developmental evaluations, including the Mullen Scales of Early Learning and the Autism Diagnostic Observation Schedule, were conducted by expert clinicians. Participants’ neurodevelopmental outcome was classified by an algorithm into three groups: typical development, ASD, and non-typical development. The median duration of BF was 10.70 months (interquartile range of 12.07 months). There were no significant differences in the distribution of duration of BF among the three neurodevelopmental outcome categories. Children in this enriched-likelihood cohort who were breastfed for > 12 months had significantly higher scores on cognitive testing compared to those who were breastfed for 0–3 months. There was no significant difference in ASD symptomatology or ASD risk based on BF duration.

Role of breastfeeding in disease prevention

“…Results from a trial in Belarus further support this positive association, where clinics randomised to promote breastfeeding showed longer durations of both total and exclusive breastfeeding, and the children belonging to this group exhibited better performance in intelligence tests at 6.5 years of age (Kramer et al., 2008 ). More recent studies on the association between breastfeeding and increased IQ in children further support the positive impact this practice has on neurodevelopment in the case of both term (Plunkett et al., 2021 ; Strøm et al., 2019 ) and preterm births (Belfort et al., 2022 ; Rodrigues et al., 2022 ), and in children at higher risk of developing autism spectrum disorders (Punatar et al., 2024 ).…”