The Association Between Breastfeeding and a Diagnosis of Autism Spectrum Disorder
Abstract
Introduction and Objective. Autism Spectrum Disorder (ASD) is a neuro-developmental disorder with affecting 1 out of 36 children in the US. Complex interactions between environmental risk factors and genetics are proposed for the etiology of ASD. Breastfeeding has been proposed as a protective effect, yet results are inconsistent. We aim to investigate the association between breastfeeding and ASD in children aged 0-5 years old, and to assess if socioeconomic status modifies this association. Methods. Secondary analysis of data from children 0-5 years participating in the National Survey of Children’s Health years 2013 to 2019. Our independent variable was breastfeeding history categorized as never breastfed, breastfed exclusively for at least six months, and breastfed exclusive for less than six months. The outcome was ever having a diagnosis of ASD reported by a health care person. Logistic regression analysis (crude and adjusted) was used to estimate the association between breastfeeding categories and ASD. Effect modification by income was assessed by adding an interaction term (income category*breastfeeding categories) to the regression models. Stata v 16 was used for analyses. Results. 9% were breastfed exclusively for at least 6 months. Overall, 2% had ASD diagnosed. In the crude model, compared to those who breastfed exclusively for at least 6 month, those who breastfed not exclusively for less than or equal to 6 months had 39% less odds of having ASD (OR= 0.61, 95% CI= 0.39-0.96) and those who never breastfed had no difference in the odds of ASD (OR=0.86, 95% CI=0.43-1.71). After adjusting for potential confounders, breastfeeding was no longer associated with the odds of ASD. (OR= 0.58, 95% CI=0.28-1.18 and OR=0.72, 95% CI=0.45-1.13, for never breastfed and breastfed not exclusively for less than six months, respectively). We also found socioeconomic status not to be an effect modifier for the association between breastfeeding history and a diagnosis of ASD. Conclusions-Implications. We found no evidence that breastfeeding reduced the risk of ASD, but findings should be considered considering limitations. Exclusive breastfeeding is recommended considering its many other health benefits. Meta- analyses and studies including broader age range are warranted.
Abstract Category
26. Pediatrics
Secondary Abstract Category
11. Health Disparities
Keywords
Autism Spectrum Disorder, Breastfeeding, Children
Presentation Type
Poster Presentation
The Association Between Breastfeeding and a Diagnosis of Autism Spectrum Disorder
Introduction and Objective. Autism Spectrum Disorder (ASD) is a neuro-developmental disorder with affecting 1 out of 36 children in the US. Complex interactions between environmental risk factors and genetics are proposed for the etiology of ASD. Breastfeeding has been proposed as a protective effect, yet results are inconsistent. We aim to investigate the association between breastfeeding and ASD in children aged 0-5 years old, and to assess if socioeconomic status modifies this association. Methods. Secondary analysis of data from children 0-5 years participating in the National Survey of Children’s Health years 2013 to 2019. Our independent variable was breastfeeding history categorized as never breastfed, breastfed exclusively for at least six months, and breastfed exclusive for less than six months. The outcome was ever having a diagnosis of ASD reported by a health care person. Logistic regression analysis (crude and adjusted) was used to estimate the association between breastfeeding categories and ASD. Effect modification by income was assessed by adding an interaction term (income category*breastfeeding categories) to the regression models. Stata v 16 was used for analyses. Results. 9% were breastfed exclusively for at least 6 months. Overall, 2% had ASD diagnosed. In the crude model, compared to those who breastfed exclusively for at least 6 month, those who breastfed not exclusively for less than or equal to 6 months had 39% less odds of having ASD (OR= 0.61, 95% CI= 0.39-0.96) and those who never breastfed had no difference in the odds of ASD (OR=0.86, 95% CI=0.43-1.71). After adjusting for potential confounders, breastfeeding was no longer associated with the odds of ASD. (OR= 0.58, 95% CI=0.28-1.18 and OR=0.72, 95% CI=0.45-1.13, for never breastfed and breastfed not exclusively for less than six months, respectively). We also found socioeconomic status not to be an effect modifier for the association between breastfeeding history and a diagnosis of ASD. Conclusions-Implications. We found no evidence that breastfeeding reduced the risk of ASD, but findings should be considered considering limitations. Exclusive breastfeeding is recommended considering its many other health benefits. Meta- analyses and studies including broader age range are warranted.