The Experiences of Mothers Feeding Their Autistic and Neurotypical Children During Infancy: A Qualitative Study

Abstract

Children diagnosed with Autism Spectrum Disorder (ASD) are five times more likely to experience feeding difficulty than their neurotypical peers although there is less evidence about how problematic feeding behaviors present during infancy. The purpose of this study was to identify specific feeding characteristics in all oral feeding modalities (breast, bottle, and complementary feeding) during the first year of life in infants later diagnosed with ASD as compared to their neurotypical sibling(s). Twenty-four mothers who have a child diagnosed with ASD who experienced feeding difficulty in the first year of life and also have a neurotypical child participated in semi-structured interviews. Thematic analysis revealed themes that encompassed breast, bottle, and complementary feeding: 1) the struggle with latch, including infant behavior that hindered latching; 2) breastfeeding challenges, including problematic breastfeeding behavior by the infant; 3) cessation of breastfeeding, including physical symptoms of the infant that lead to breastfeeding cessation; 4) breastfeeding the neurotypical sibling, including mother’s detection of different breastfeeding behaviors in the neurotypical and autistic child; 5) bottle feeding and cup behaviors, including problematic drinking characteristics; 6) challenges in complementary food introduction, including gagging and choking that hindered food introduction; 7) continuing difficulty with complementary feeding, such as oral motor challenges and food selectivity; and 8) bottle feeding and complementary feeding in neurotypical sibling, including marked differences in bottle feeding neurotypical siblings. Infant feeding behaviors described by mothers in all oral feeding modalities may indicate early signs of autism including early sensory sensitivity, lack of regulation, repetitive and restrictive behaviors, and impaired social behaviors associated with feeding. Further research is needed to discern if these problematic infant feeding behaviors can be used to help identify early signs of autism and employed as additional surveillance for neurodevelopmental concerns at a young age in the pediatric primary care setting.