Abstract
Eating problems are common among children with Autism Spectrum Disorder (ASD), but it is unknown to what extent infant eating behavior is associated with later autistic traits. As eating behavior is currently not included in ASD screening instruments, it is important to evaluate whether infant eating behavior predicts later autistic traits and might therefore be used to enhance the early detection of ASD. We investigated the association of breastfeeding and eating behavior during infancy with later autistic traits in the population-based Generation R cohort. We included 3546 mother-child dyads with maternal reports on feeding and eating at age two months and autistic traits at six years. Eating behavior was assessed with seven items on specific eating habits and the Social Responsiveness Scale was used to evaluate autistic traits. Covariates included child sex, and maternal psychopathology and autistic traits. Linear regression analyses showed that being formula fed at two months was associated with a higher autistic trait score at six years (adjusted B = 0.07; 95% CI: 0.00–0.14). Children who were drinking only small quantities (adjusted B = 0.17, 95% CI: 0.04–0.30) and were hungry/not satisfied (adjusted B = 0.23, 95% CI: 0.08–0.39) at age two months also had a higher autistic traits score at age six years. We found no interactions with sex or breastfeeding. This study shows that eating behavior during infancy is related with autistic traits in childhood. Although the associations were fairly small, these findings suggest that early-life eating problems might be relevant for early detection of ASD and a potential addition to ASD-specific screening instruments.
Highlights
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that is present from early life onwards
We investigated the association between eating behavior in infancy, differentiated into breastfeeding and feeding habits, with later autistic traits in a prospective, population-based cohort
Our study shows that infant eating problems and the absence of breastfeeding at two months of age are associated with a higher autistic traits score in later childhood
Summary
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that is present from early life onwards. It is characterized by persistent deficiencies in communication and social interaction, and restricted, repetitive patterns of behaviors, interests and activities. There is an urgency to identifying children with ASD, as partic ularly early interventions can improve language and cognitive abilities (Dawson & Burner, 2011) and result in better long-term outcomes across the school age years (Clark et al, 2018) compared to interventions at a later stage. Detection of the earliest signs of ASD can enhance timely identification and diagnosis, which permits early treatment to achieve the most optimal long-term outcomes for children with ASD
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