A mixed methods exploration of practitioner knowledge of autism and lactation within the context of maternal experiences

Currently, one out of every 59 infants born in the United States will be diagnosed with an autism spectrum disorder (ASD) at some point in their future (Baio, 2018). Families may face unique challenges related to atypical infant behaviors and feeding patterns before diagnosis of ASD occurs. There is wide variation of symptoms among children with ASD, yet, children with ASD are five times more likely to have both behavioral and skill-based feeding issues. However, little is known about when feeding issues begin, how atypical behaviors impact infant caretaking needs, and whether practitioners have sufficient training to identify infants for further developmental assessment. As a result, despite identifiable early indicators of ASD during infancy, most children are not diagnosed with ASD until they begin preschool. When practitioner views of infant feeding focus exclusively on nutrition, atypical feeding behaviors may be overlooked as a way to identify atypical development. Infants who have behaviors associated with later diagnosis of ASD may face unique challenges breastfeeding. Practitioners need to have knowledge of development, early indicators of ASD, and infant feeding behaviors to provide support to parents and promote healthy development. The purpose of this study was to better understand practitioners’ knowledge of infant feeding behaviors and early indicators of ASD within the context of mother’s experiences raising infants later diagnosed with ASD. Quantitative measures of lactation consultants’ and pediatricians’ knowledge of early indicators of ASD and lactation were integrated with phenomenological analysis of maternal experiences seeking help managing breastfeeding and atypical behaviors in infants later diagnosed with ASD. Individual and professional level influences on maternal access to support and barriers to support were explored