Abstract
A
In the present study, we compared breastfeeding durations of ASD and ADHD groups with each other and with healthy controls. The study included 98 children 3–18 years of age with ASD, 96 age- and gender-matched children with ADHD, and 79 age- and gender-matched healthy controls. Subjects with ASD or ADHD were recruited from among outpatients of the Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Medical Hospital, Samsun, Turkey. The diagnoses of ASD and ADHD were established by interviews with patients and parents based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria. Demographic features and duration of breastfeeding were evaluated by a questionnaire that was prepared by the authors and completed by the mothers of participants.
The mean age of the ASD group was 8.73±3.86 years (77% boys, 23% girls), that of the ADHD subjects was 8.80±1.98 years (71% boys, 21% girls), and that of the healthy control group was 8.45±4.61 years (78% boys, 22% girls). There were no significant differences among groups regarding age/gender of children, maternal age at birth, and education of parents.
The mean duration of breastfeeding was significantly shorter in the ADHD group (9.10±7.847 months) compared with the ASD (12.18±10.480 months) and healthy control (12.99±8.658 months) groups (p=0.005). We also evaluated the rates of children who were never breastfed and those who continued breastfeeding at 1 month, 3 months, 6 months, 12 months, and 24 months of age. The rate of children who were never breastfed was significantly higher in the ADHD group (9.6%) compared with the healthy control group (1.3%) (p=0.034). The ADHD group showed significantly lower rates of exclusive breastfeeding at 1, 3, and 6 months of age than the other groups. At 1 month of age, 84% of children with ADHD were still breastfed, whereas 93% of the ASD group were breastfed, and 98% of the healthy controls were breastfed (p=0.001). At 3 months of age, 71% of the ADHD group were still breastfeeding compared with 78% in the ASD group and 88% in the healthy control group (p=0.025). By 6 months of age, breastfeeding rates were as follows: 50% in the ADHD group, 58% in the ASD group, and 72% in the healthy control group (p=0.012). The ASD group did not show any significant differences regarding mean duration and rates of breastfeeding compared with either the ADHD or healthy control group. The rates of breastfeeding were similar in all groups at 1 and 2 years of age. The results are summarized in Table 1.
Data are mean±standard deviation values or number (%), as indicated.
Statistically significant difference.
ADHD, attention deficit /hyperactivity disorder; ASD, autistic spectrum disorder.
Breastfeeding has promoting effects on mental and motor development of the newborn. 4 This preliminary study noted that children with ADHD were more likely to be less breastfed, especially during the first 6 months after birth, compared with children with ASD or healthy controls. In the ASD group, the rates of breastfeeding during the first 6 months after birth were also lower than those in the healthy controls, but the difference did not reach statistical significance. We think that possible explanations for this observation are as follows: mothers of children with ADHD may also have ADHD, leading to inadequate nursing skills; children with ADHD may have an inability to maintain breastfeeding; or the neurotrophic benefits of breastmilk itself may reduce the risk. However, as no proof of causation exists, the lower breastfeeding rate may just be a marker for neurobehavior of the infant. Either way, a possible association of ADHD with inadequate breastfeeding should be added to the list of reasons for supporting breastfeeding in the mother–infant dyad.