Association between breastfeeding and autism spectrum condition in Saudi Arabia: a case-control study.

This study looked at 283 mothers in Saudi Arabia to see if breastfeeding might be linked to autism. They found that children who were breastfed less were more likely to have autism. Children who weren't breastfed at all were nearly 3 times more likely to have autism compared to those exclusively breastfed. However, the researchers warn that this doesn't prove breastfeeding prevents autism - more research is needed to understand this relationship.

This Saudi Arabian case-control study examined the relationship between breastfeeding practices and autism spectrum condition (ASC) in 283 participants (126 cases, 157 controls). Researchers found a dose-response relationship where reduced breastfeeding exposure was associated with progressively higher odds of ASC. Compared to exclusive breastfeeding, partial breastfeeding showed 2.28 times higher odds of ASC, while no breastfeeding showed 2.86 times higher odds after adjusting for other factors. The study categorized breastfeeding according to WHO definitions and used logistic regression analysis.

Authors emphasize cautious interpretation due to study design limitations and potential reverse causality concerns.

Findings support promoting breastfeeding as potentially beneficial for neurodevelopment, but causality cannot be established. Healthcare providers should continue evidence-based breastfeeding counseling while awaiting confirmatory prospective studies. Results require replication in diverse populations before clinical practice changes.

Case-control study design limits causal inference. Potential for reverse causality and recall bias. Single-country study may limit generalizability. Authors specifically note inherent limitations of case-control methodology.

Autism spectrum condition (ASC) is a neurodevelopmental disorder characterized by persistent difficulties in social communication and repetitive behaviors. Emerging evidence suggests that early nutrition, particularly reduced breastfeeding exposure, may be associated with an increased risk of ASC. However, this evidence is limited, especially in non-Western populations. We conducted an unmatched case-control study in Saudi Arabia to investigate the association between breastfeeding practices and ASC.

Data were collected through an online questionnaire from mothers of children with and without ASC. Cases were children with a confirmed ASC diagnosis, and controls were neurotypical children without a diagnosis of ASC. Breastfeeding exposure was categorized according to the World Health Organization definitions (from highest to lowest exposure) as follows: exclusive, predominant, partial, or no breastfeeding. Logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (CI).

Between 1 October 2024 and 25 January 2025, a total of 283 participants (126 cases and 157 controls) were recruited. A dose-response relationship was observed, where decreased breastfeeding exposure was associated with progressively higher odds of ASC (OR for trend: 1.58; 95% CI 1.24, 2.01). In univariable analyses, using exclusive breastfeeding as the reference category, partial breastfeeding was associated with increased odds of ASC (OR: 2.49; 95% CI 1.40, 4.42). Similarly, children who were not breastfed had significantly higher chance of ASC than the reference category (OR: 3.46; 95% CI 1.47, 8.13).

The strength of these associations was attenuated after multivariable adjustment but remained statistically significant (OR: 2.28; 95% CI 1.22, 4.25 for partial versus exclusive breastfeeding and OR: 2.86; 95% CI 1.12, 7.26 for no breastfeeding versus exclusive breastfeeding). Our findings suggest that reduced breastfeeding exposure is associated with increased odds of ASC. However, these results should be interpreted cautiously, considering the inherent limitation of case-control studies and the potential of reverse causality.