To investigate the relationship between infant feeding practices and autism spectrum disorder (ASD) among children aged 2–5 years in the United States (US). Data from the 2016–2020 National Survey of Children’s Health, a nationally representative cross-sectional survey, were utilized for this study. Questionnaires were administered to parents of children aged 2–5 years to gather information on ASD diagnosis, infant feeding practices, and demographic factors (e.g., child sex, ethnic group, and maternal age at birth). Logistic regression with sample weights was employed to assess the association between infant feeding practices and ASD, while controlling for demographic variables. Polynomial regression models were used to examine trends in exclusive breastfeeding and ever breastfeeding rates among children with and without ASD. A total of 35,050 children aged 2–5 years were analyzed, including 616 diagnosed with ASD, after excluding participants with missing information on breastfeeding and ASD diagnosis. Of these children with ASD, 76.6% (n = 472) had a breastfeeding history, with 67.5% (n = 416) engaged in partial breastfeeding and 9.1% (n = 56) exclusively breastfed. Adjusted odds ratios for each additional month of breastfeeding compared to never being breastfed were 0.98 (95% CI, 0.96–1.01). The adjusted odds ratios for breastfeeding durations of > 0–6 months, > 6–12 months, > 12–24 months, and > 24 months were 0.81 (95% CI, 0.50–1.31), 0.65 (95% CI, 0.36–1.18), 0.81 (95% CI, 0.44–1.49), and 0.48 (95% CI, 0.23–1.01), respectively. Compared to children who were never breastfed, the adjusted odds ratio for children who were ever breastfed was 0.74 (95% CI, 0.47–1.18). Among children with ASD, the proportion of ever breastfeeding declined from 82.0% in 2017 to 64.3% in 2020, while exclusive breastfeeding decreased from 12.0% in 2016 to 4.2% in 2020. Although no significant association was found between infant feeding practices and ASD among US children aged 2–5 years, the rates of breastfeeding, particularly exclusive breastfeeding, were suboptimal among children with ASD. This highlights the need for specific policies and practices to promote and support breastfeeding among parents of children with ASD or those at high risk of having a child with ASD.

中文翻译：

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美国 2-5 岁儿童的婴儿喂养方式和自闭症谱系障碍：2016-2020 年全国儿童健康调查 (NSCH)

旨在调查美国 (US) 2-5 岁儿童的婴儿喂养方式与自闭症谱系障碍 (ASD) 之间的关系。本研究使用了 2016-2020 年全国儿童健康调查（一项具有全国代表性的横断面调查）的数据。对 2-5 岁儿童的父母进行了问卷调查，以收集有关 ASD 诊断、婴儿喂养方法和人口因素（例如儿童性别、种族和母亲出生年龄）的信息。采用样本权重的逻辑回归来评估婴儿喂养方式与 ASD 之间的关联，同时控制人口变量。使用多项式回归模型来检查患有和不患有自闭症谱系障碍的儿童纯母乳喂养和曾经母乳喂养率的趋势。排除了缺少母乳喂养和 ASD 诊断信息的参与者后，总共分析了 35,050 名 2-5 岁儿童，其中 616 名被诊断患有 ASD。在这些患有 ASD 的儿童中，76.6% (n = 472) 有母乳喂养史，其中 67.5% (n = 416) 进行过部分母乳喂养，9.1% (n = 56) 进行纯母乳喂养。母乳喂养每增加一个月与从未母乳喂养相比，调整后的比值比为 0.98（95% CI，0.96-1.01）。母乳喂养时间 > 0-6 个月、> 6-12 个月、> 12-24 个月和 > 24 个月的调整后比值比分别为 0.81 (95% CI, 0.50-1.31)、0.65 (95% CI, 0.36-分别为 1.18)、0.81 (95% CI, 0.44–1.49) 和 0.48 (95% CI, 0.23–1.01)。与从未母乳喂养的儿童相比，曾经母乳喂养的儿童的调整优势比为 0.74（95% CI，0.47-1.18）。在自闭症谱系障碍儿童中，曾经母乳喂养的比例从 2017 年的 82.0% 下降到 2020 年的 64.3%，而纯母乳喂养的比例从 2016 年的 12.0% 下降到 2020 年的 4.2%。美国 2-5 岁儿童中，自闭症谱系障碍 (ASD) 儿童的母乳喂养率，尤其是纯母乳喂养率并不理想。这凸显了需要制定具体政策和做法来促进和支持自闭症谱系障碍儿童的父母或自闭症谱系障碍儿童高风险人群的母乳喂养。