Breastfeeding association with autism spectrum disorders: A case-control study from Lebanon

Abstract

BackgroundAutism spectrum disorders (ASD) in Lebanon are rising whereas breastfeeding is declining. This case-control study investigates the association between breastfeeding and ASD. MethodsChildren below 36 months recently diagnosed with ASD were matched to healthy controls by gender and gestational age. The association between ASD and breastfeeding was investigated in univariate and multivariate conditional logistic regression analyses, adjusting for the confounding effects of socio-demographic, pregnancy, and birth variables; parental characteristics, and family history. ResultsCases (n = 46) were older than controls (n = 184), mean (SD) 31.6 (4.9) versus 25.5 (5.6) months, (p < 0.001). ASD was associated with lack of exclusive breastfeeding in univariate (OR = 0.37, 95% CI: 0.19 to 0.72) and multivariate regression analyses (OR = 0.37, 95% CI: 0.16 to 0.88). There were no significant associations between ASD and the durations of exclusive breastfeeding or any breastfeeding. Other independent predictors of ASD in the adjusted analysis were the lack of intake of prenatal vitamins, advanced paternal age, lower paternal education, higher intake of drugs prenatally, and family history of ASD. ConclusionsThis study provides further evidence on the protective effect of exclusive breastfeeding against ASD. Future studies may help determine whether advising pregnant women to exclusively breastfeed their infants would reduce ASD, especially those at high risk for ASD such as those with a family history of ASD. Further research to understand the physiological basis of the protective effects of breastfeeding is essential, as well as studies that target the optimal duration of exclusive breastfeeding that can protect from ASD.