Table 3.

Differences mothers reported in breastfeeding their autistic vs. neurotypical child

Autistic Child	Neurotypical Child
Lack of hunger cues (e.g., crying when hungry, excitement when presented with breast)	Eagerly opening mouth to feed Crying when hungry
Loss of interest on the breast quickly (short lived latch, lack of effort to suck, did not make eye contact with mother while feeding)	Interested in breastfeeding (content on the breast, effective suck to transfer milk for full feeding, gazed at mother while feeding)
Very particular about positioning while breastfeeding (needed movement while feeding, pushed off the breast often, very irritable when breast position changed)	Able to breastfeed in several positions, did not push off the breast, was able to breastfeed in several distinct locations outside the home
Uncoordinated latch / suck and difficulty coordinating swallowing with milk letdown	Coordinated latch with strong suck and no issues swallowing with strong milk letdown
Lack of regulation with feeding (constantly wanting to eat despite adequate milk intake)	Satiated after feedings and breastfed in age-appropriate intervals
Difficulty latching despite tongue tie revision	Siblings also with tongue tie but did not require revision and did not have latching difficulty
Choking and gagging while breastfeeding	Lack of gagging, choking, or coughing while breastfeeding
Poor milk transfer with weak suck despite adequate milk supply	Efficient suck with appropriate milk transfer
Lack of effort to latch and suck and was most effective eating only when asleep and relaxed	Strong suck and same effort / strength with suck when awake and asleep
Would fatigue easily on the breast and would fall asleep leading to persistent incomplete feeds	Latching difficulty the first two weeks but then resolved and breastfed without difficulty
Persistent painful latch for entire year of breastfeeding with no evidence of anatomic abnormality	No pain with latching