Wednesday, 19 August 2015

Breast milk protects against GI symptoms in high risk autism?

Happy house @ Paul Whiteley
"Late weaning and EBM [exclusive breast milk] were associated with protection against GI [gastrointestinal] symptoms in High-risk infants."

That was one of the conclusions presented in the paper by Alexander Penn and colleagues [1] who asked some pretty important questions when it comes to the increasingly strong relationship between bowel issues and autism spectrum disorder (ASD) (see here).

"Using questionnaires, diet history and gastrointestinal problems were tracked prospectively and retrospectively in 57 High-risk infants, and for comparison, in 114 Low-risk infants (infants from families without ASD history)." The main aims of this study were to examine whether those at an enhanced risk for autism by virtue of having a sibling already diagnosed were at any greater risk of presenting with functional bowel symptoms, and whether such bowel issues were "associated with diet and age at weaning from breast milk."

Early weaning - the introduction of solid foods to an infant - seemed to be more frequently present in high-risk infants with bowel issues as did "a no breast milk (NBM) diet" compared with an exclusive breast milk diet. This was particularly true for the bowel symptom constipation and especially for those who were weaned earlier than 6 months of age.

The authors suggest that their data indicate that weaning and breast milk diet practices might have some bearing for the presentation of bowel symptoms in those at high-risk for autism. Further: "The greater prevalence of GI symptoms in High-risk infants suggests that GI dysfunction during early infant development may be a part of the ASD endophenotype." That all sounds rather important.

I'm drawing back from making too many sweeping statements about this research bearing in mind the participant number, the use of the term 'high-risk' and elements of the questionnaire design of the study. There is quite a bit more research required in this area.

That all being said, I do think there are more than a few future studies that might come from such findings. So, thinking back to the paper by Afzal and colleagues [2] and the idea that "consumption of milk to be the strongest predictor of constipation" among their cohort diagnosed with autism, is the suggestion that more attention might be needed for specific elements of the diet such as cows milk. Added to the findings from Kushak and colleagues [3] (see here for a past post on this work) regarding lactose intolerance as being pretty rife in their cohort with autism (importantly, "not identified by clinical history"), and clues start to emerge alongside possible alternative strategies (see here and see here)...

Music: Stevie Wonder - Superstition.

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[1] Penn AH. et al. Breast Milk Protects Against Gastrointestinal Symptoms in Infants at High Risk for Autism During Early Development. J Pediatr Gastroenterol Nutr. 2015 Jul 29.

[2] Afzal N. et al. Constipation with acquired megarectum in children with autism. Pediatrics. 2003 Oct;112(4):939-42.

[3] Kushak RI. et al. Intestinal disaccharidase activity in patients with autism: effect of age, gender, and intestinal inflammation. Autism. 2011 May;15(3):285-94.

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ResearchBlogging.org Penn AH, Carver LJ, Herbert CA, Lai TS, McIntire MJ, Howard JT, Taylor SF, Schmid-Schönbein GW, & Dobkins KR (2015). Breast Milk Protects Against Gastrointestinal Symptoms in Infants at High Risk for Autism During Early Development. Journal of pediatric gastroenterology and nutrition PMID: 26230900