655 - Infants at increased likelihood of childhood ADHD have behaviors that may reduce breastfeeding duration

Publication Number: 655.5292

Heather M. Joseph, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Elyse Mark, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Michelle Wilson, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States

Background: Prior research has suggested that breastfeeding may be neuroprotective due to decreased likelihood and reduced length of breastfeeding amongst children with ADHD as compared to children without ADHD. However, ADHD is highly heritable and parental ADHD may interfere with the planning and organization required to sustain breastfeeding. Additionally, parental ADHD has been associated with lower mother-to-baby attachment and children with ADHD have been found to differ in temperament in infancy both of which may contribute to length of breastfeeding.

Objective: We aimed to (1) compare families with and without parental ADHD on breastfeeding length and satisfaction, and (2) examine mother-to-baby attachment and infant temperament traits associated with childhood ADHD in relation to breastfeeding duration.

Design/Methods: Two longitudinal cohorts of mother-father-infant triads (N=151) enrolled in pregnancy or infancy. Nearly half the infants were at elevated likelihood for ADHD due to parental ADHD (n=71). Mothers reported on breastfeeding (length and satisfaction), mother-to-baby attachment, and infant temperament when their offspring were 9 months of age. Chi-squared and linear regression analyses were used to test the aims of this project.

Results: Across the sample, 140 (93%) mothers initiated breastfeeding and 52 (39%) breastfed for 1 year or greater. Rates of initiation and duration of breastfeeding did not differ significantly by parent ADHD status. However, mothers in families with parental ADHD reported less satisfaction with their breastfeeding duration (X2=7.63, p< 0.01) and more frequently cited “my baby lost interest/began to self-wean” as a reason for discontinuing breastfeeding (X2=5.17, p=0.02). Controlling for parent ADHD, mother age, and highest parent education, primigravida (β=0.37, p< 0.01) and infant surgency (β=-0.31, p=0.02), but not maternal attachment (β=0.11, p=0.38) were associated with breastfeeding length.

Conclusion(s): Infants at increased likelihood of childhood ADHD due to parent ADHD and/or greater surgency (positive affect and activity level) appear to have behaviors that contribute to reduced duration of breastfeeding. These findings suggest an alternative explanation to the prior research findings on breastfeeding length and later development of childhood ADHD.