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Breastfeeding, formula and autism



The following article by Mertha Herbert, MD, was posted on the ABC News website on October 23, 2008:


“How does breastfeeding affect the risk of autism in a baby?

Breastfeeding is not in itself a risk for autism. It's what may be in the breast milk. As we're learning that there are many substances, toxins in the environment, that can be present in breast milk. And they may be a risk for things which could contribute to autism, such as altered brain development. At the same time, though, breast milk is very protective of infants and toddlers because of the immune chemicals, the immunoglobulins that protect the baby from infections and many other things.

So it's a challenge that we have unhealthy things in our breast milk from the environment. But since breast milk is so important, it gives us motivation to clean up what's in our foods and our environment so we can give healthy breast milk to children. “

Doctor Herbert is a Pediatric Neurologist at the Massachusetts General Hospital and Assistant  Professor of Neurology at  Harvard



From this article, it may seem that a mother might be increasing her child’s risk of autism by breastfeeding. They don’t actually say this but it’s implied: something in your milk might lead to autism. Since the only alternative is formula, some women might get the impression that these chemicals are not in formula so it might be safer than breastfeeding.

What is this based on? No references are given to any scientific studies. So, what are the facts on breastfeeding and autism? Does it increase the risk? Diminish it? Make no difference?


Breast Milk. Formula, Autism


One study done by Stephen T Schultz et al, published in the International Breastfeeding Journal, found that, overall, babies who were not breastfed had a 4 times higher risk of autism than babies who were. The ABC article implies a risk from toxins in breast milk, but actually this study found the risk was related to something entirely different: AHA and DHA, two essential fatty acids are necessary for the proper development of the brain and nervous system. They found that children who were breastfed or given AHA-and DHA fortified formula had only one quarter the risk of autism when compared with children who received formula that did not contain these fatty acids. Since autism is a neurological condition it would make sense that a diet low in fatty acids could contribute to the risk.

When it came to regressive autism, babies fed formula without AHA and DRA had nearly 13 times the risk of autism that breastfed babies had and even babies that received the DHA-ARA fortified formula had 2.75 times the risk.  Regressive autism was significantly associated with formula feeding, especially formula without AHA and DRA added.

Early Weaning and Autism

Another study, called Weaning time of children with infantile autism, by Tanoue et al compared weaning time of 145 children with autism and 224 normal children. They found that more of the autistic children were weaned in under 1 week, compared to the controls: 24.8% vs 7.5 %. They also found that more of the autistic children were weaned early because of the mother’s rather than the child’s condition: 17.9% of the cases vs 5.8% of the controls. They concluded that these results suggest that early weaning may contribute to the cause of infantile autism.

Source: Weaning time of children with infantile autism, Tanoue Y, Oda S., J Autism dev Disord.,1989 Sep;19(3):425-34.


The evidence that we do have from these two studies points to a lack of breastfeeding significantly increasing the risk of autism, even when compared with breastfeeding only for one week.

AHA and ARA in Formula

Before you conclude that giving AHA-ARA enriched formula is an adequate alternative, even if it does raise the risk of autism by close to 3x, you should know that the fatty acids added to these formulas are made from fermented algae and fungus and that hexane, which is a neurotoxin, is used in the manufacturing process and these amino acids are structurally different from the ones found in breast milk. Based on 98 adverse events reported to the FDA by parents and physicians, the potential side-effects from these formulas include diarrhea, vomiting, severe dehydration, and occasionally even seizures. The Cornucopia Institute and the National Alliance for Breastfeeding Action are trying to get the FDA to mandate a warning label on DHA/ARA formulas.

No formula is “close to breast milk”. Forget it.


Environmental Toxins in Breast Milk

So what, if anything, may be in breast milk that could theoretically contribute to autism? Possibly mercury, since the symptoms of mercury poisoning and autism are virtually identical. The source of this mercury is mainly Mom’s amalgam fillings and fish in her diet. To minimize your baby’s exposure to mercury through breast milk, don’t get any amalgam fillings, and if you already have them don’t get them removed while you are nursing because this will lead to more mercury being in your system at that time. You may also want to avoid types of fish that are known to contain higher amounts of mercury.

Before you panic about this, you should know that unless you are eating fish that is highly toxic with mercury, the levels in your breast milk will be extremely low. Methyl mercury does not enter breast milk at high rates, but what little does get into breast milk is easily absorbed. The second form, inorganic mercury, enters breast milk easily but is not well absorbed. Even though, in one study, breastfed infants had higher levels of mercury in their hair, they also had better neurological development, which was attributed to the breast milk and showed that the beneficial effects of breastfeeding overcome any possible adverse effects of mercury in breast milk.


In conclusion, from the available research it is apparent that breastfeeding significantly decreases your child’s risk of autism any way you look at it. So don’t worry about the ABC report and keep breastfeeding!



Breastfeeding, infant formula supplementation, and Autistic Disorder: the results of a parent survey. International Breastfeeding Journal 2006, Stephen T Schultz et al.

Table 3

Age-adjusted association of infant formula use with autistic disorder for children aged 2–4 years.


Odds Ratio

(95% Confidence Interval)

p value

Formula without DHA/ARA


(1.24 – 15.7)


Formula with DHA/ARA


(0.33 – 3.18)


Exclusive breastfeeding (no formula use)


Limited to cases with reported regression in development

Formula without DHA/ARA


(1.27 – 132)


Formula with DHA/ARA


(0.28 – 27.4)


Exclusive breastfeeding (no formula use)



Schultz et al, International Breastfeeding Journal 2006 1:16 doi:10.1186/1746-4358-1-16


Disclaimer: The material contained on this website is for information purposes only and is not to be construed as medical advice. Please consult your doctor before making any decisions regarding your or your child's health.

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