Breastfeeding and autism spectrum disorder: a cross-sectional study from Egypt

Background Breastfeeding (BF) was suggested as an environmental factor that may confer a protective role against autism.Aim The primary aim was to compare the patterns of BF in children with autism spectrum disorder (ASD) with their typically developing siblings. The secondary objective was to conduct a pilot study to investigate the effect of BF on the severity of the core ASD symptoms and the intellectual functions among children with ASD.Patients and methods A comparative cross-sectional study was conducted at the Outpatient Clinic of Alexandria University Children’s Hospital on 100 children; 50 children with ASD (group A, n=50) and 50 typically developing children; siblings of children of group A (group B, n=50) using a designed semistructured questionnaire.Results The comparison between both groups revealed that neither BF ever, early initiation, prolonged duration, nor exclusive BF were statistically different in children with autism and their siblings. Among children with ASD, there was a significant positive relationship between early BF initiation and less severe core symptoms of autism on Childhood Autism Rating Scale scores (U=405, P=0.017) and better intellectual functions on intelligence quotient score (U=18, P=0.03). Exclusive BF had a weak significant positive correlation (r=0.31, P=0.03) with higher intellectual functions on the intelligence quotient score.Conclusion In conclusion, BF practices are not linked to autism in children at risk. However, because early BF initiation is connected to less severe ASD core symptoms, our study implies that BF can be regarded a predictive factor of optimal outcomes for children with ASD. Future research with a prospective design and a large sample size could aid in establishing a cause-and-effect relationship.