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Breastfeeding and Autism

Breastfeeding for autistic women & parents

Breastfeeding an autistic child

Autism is a neurodevelopmental difference which may cause differences in how an autistic person will experience the world and communicate. An autistic person may be described as neurodivergent.

Autism presents differently across the spectrum and many autistic people’s abilities and challenges will change depending on the situation they are in. Many autistic women will choose to have children and breastfeed, and some breastfed children are autistic.

Many autistic women and parents will choose to breastfeed. There may be additional challenges and strengths for both the autistic parent, and for the parent breastfeeding an autistic child.

Breastfeeding for autistic women & parents

An estimated 0.82% of the population of England are diagnosed autistic, but up to 72% of the autistic population of England are estimated to be undiagnosed[1], and this is something to consider when supporting parents. Autistic women and people may have different needs when accessing maternity care and breastfeeding support, and these needs may be different for each autistic person[2].

Autistic women may all present differently, with a wide range of different experiences across the spectrum. Individualised support can be very helpful for autistic people, and some autistic people may struggle to access support in standard ways[3]. Autistic women may mask, which means they may suppress their behaviors in lots of situations, even when they need support.

 

The Positives

Many autistic women say they find the act of breastfeeding provides calm, quiet time that they enjoy. Breastfeeding offers protected time to sit and rest, and many find breastfeeding empowering.

Autistic women often excel at researching and finding out information independently. This means those who plan to breastfeed may already know a lot about breastfeeding and, if they decide to breastfeed, are likely to be very determined[4].

 

Communication differences

 Some autistic people have communication differences. This may be situational, for example, an autistic person may be unable to verbally communicate in certain situations, but able to speak the rest of the time. It can be useful to have a range of communication methods, including the option to write or type on a phone, use picture cards or sign language.

baby sleeping in a sling on mum's front

Support for breastfeeding women & parents

Some people feel more comfortable attending local breastfeeding groups where there are pictures available to show exactly where to go and what happens at the groups, or when they can attend the group with a support person. Many autistic women find it difficult – or do not feel comfortable – asking for additional support.

Some autistic women already feel that they haven’t had control over their own bodies and experiences after giving birth. Post traumatic stress disorder (PTSD) rates are higher in the autistic community compared with neurotypical people[5]. 

Many autistic mothers experience a lack of social support and may find it challenging to seek support from maternity services[6]. This can be due to anxiety about attending groups or differences in communication. This may include struggling with phone calls, which prevents access to national helplines or reaching out to local breastfeeding support.

LLLGB offers the option to seek breastfeeding support via a written Help Form.

 

Sensory differences

Many autistic people experience senses differently. Sensory differences can cause a heightened or reduced experience of smell, taste, touch, sight and sound. This may affect breastfeeding in a number of ways:

  • The milk ejection reflex (MER), commonly called the ‘let down’, is a neurohormonal reflex that releases milk from the breast. This can be experienced as a tingly feeling, or in someone with sensory differences it may feel uncomfortable, or even be experienced as pain. Some do not feel the let down at all. Very rarely, some people experience Dysphoric Milk Ejection Reflex (D-MER).
  • Some people experience an aversion to nursing. This is often temporary and dependent on the situation. Some people with sensory differences may have an aversion to feeding in a noisy area, or a very bright or busy area. Some people experience this more strongly when dehydrated, very tired or having their period.
  • Noise can be particularly difficult for some autistic people. Increased noise can cause so much sensory input that other input – such as touch or experiencing a let down – cannot be tolerated. Many mothers find that it can be helpful to use ear plugs or avoid loud areas. Often, this doesn’t apply to noise created by the person themselves, or their baby. Maternity care providers should be reminded of this when on postnatal wards.

 

Key things to be mindful of when supporting an autistic person to breastfeed:

  • Many autistic people prefer information that is “straight to the point”.
  • Autistic women often want to be given all options to make an informed decision and have a practical plan going forward.
  • Many expressed a dislike for support that involved physical touch.

breastfeeding mother with her child in front of a waterfall

Breastfeeding an autistic child

While adults can often go undiagnosed, autism diagnosis rates in children are increasing[7].

The World Health Organisation recommends breastfeeding for two years and beyond, and the natural age of weaning is estimated at 2.5–7 years[8]. Breastfeeding may be very important to a child who is autistic, or suspected to be neurodivergent. There may also be additional support needs and considerations.

 

Sensory differences in children

Autistic or neurodivergent children may process things or experience sensory input differently. Some autistic children may be more sensitive to certain sensory experiences, and this may include avoiding or seeking sensory experiences.

Sometimes, a child with sensory differences may want to breastfeed very frequently in order to regulate themselves. Sometimes sensory differences may mean a child wants to breastfeed less often.

They may want to feed and be close to their mother or parent when feeling overwhelmed, for example when in a busy, loud, or unfamiliar place. Or they may find it difficult to feed when struggling with sensory input– this can be anything from the temperature of the room to their socks! If this happens, it can be helpful to change the situation in order to reduce or avoid the sensory input they are struggling with.

 

High needs baby & feeding patterns

Many babies and children may be described as being ‘high needs’. This typically refers to babies and young children who have an intense need to be close to their mother or primary caregiver which is normal and expected, but this can be particularly intense with neurodivergent children.

Parents should be mindful of self-care. Support from family and friends, and finding like-minded communities is essential, particularly during the intense early years.

Feeding patterns, boundaries and weaning

 Many breastfeeding parents of autistic children find frequent feeding in toddlerhood difficult, and have highlighted the need for increased information about weaning.

Weaning can be more challenging with autistic children because of sensory and communication issues, or because breastfeeding is an important way for the child to co-regulate.

An LLL Leader can offer support and information about boundaries and weaning from the breast at different ages and stages.

If a child is experiencing sensory differences, they may struggle to eat solid foods and want to breastfeed frequently rather than eat. Sometimes, a child may only start rejecting certain foods due to texture, taste, smell or sight as they get older, and this may result in an increase in breastfeeding.

Some autistic people have interoception difficulties. This means they may struggle to feel when they are hungry, thirsty or full.

Many mothers continue to breastfeed until their child outgrows the need (‘self-weaning’), and some will continue to breastfeed older children responsively (‘on demand’). Others may choose to set gentle boundaries, and limit the number or length of feeds, or when and where breastfeeding takes place. Some parents may choose to stop breastfeeding altogether.

Continuing to breastfeed into toddlerhood and beyond provides a range of benefits for both the child and mother, and provides nutrients that a child may be missing from their diet if it is limited.

A mother who is breastfeeding an autistic toddler or child may request support to place boundaries or limit breastfeeding, if they choose to. This can be challenging when communication issues are involved, but options are:

  • Distraction from breastfeeding
  • Delaying feeds
  • Limiting feeds to a certain time of day, or limiting the length of feeds
  • Offering food or drink instead of breastfeeding
  • Finding another activity which helps with sensory regulation

 

Written by Emily Lunny, November 2023. Review due November 2026.

Photos courtesy of Sophie Burrows and Emily Lunny.

 

Further Reading

Dysphoric Milk Ejection Reflex (D-MER)
Still Nursing after 1 year
Supporting a breastfeeding mother
Weaning from the breast

 

Online Information

Maternity Autism Research Group (MARG)

 

References

[1] O’Nions, E. et al., 2023
[2] Hampton, S. et al., 2021
[3] Hampton, S. et al., 2021
[4] Grant, A. et al. 2022
[5] ‌Rumball, F., Happé, F. and Grey, N., 2020
[6] Grant, A. et al., 2022
[7] Crane, L. et al., 2018
[8] Dettwyler, K.A., 1999

 

Copyright LLLGB 2023