Does infant sensory responsiveness explain exclusive breastfeeding 6 months after birth? A cohort prospective study

Abstract Background Although exclusive breastfeeding is recommended for the first 6 months of life, breastfeeding rates in most developed countries are low. Sensory responsiveness has been found to interfere with infant and childcare, development, and routines, but have not yet been examined as breastfeeding barrier. The aim of this study was to explore the association between infant sensory responsiveness and exclusive breastfeeding and whether it can predict exclusive breastfeeding cessation prior to 6 months of age. Methods In this cohort prospective study participants were 164 mothers and their infants recruited 2 days after birth in a maternity ward between June 2019 and January 2021. At this time, participating mothers completed a demographic and delivery information questionnaire. At 6 weeks after birth, the mothers completed the Infant Sensory Profile2 (ISP2), reporting their infants’ sensory responsiveness in daily activities. At 6 months, infants' sensory responsiveness was assessed using the Test-of Sensory-Functions-in-Infants (TSFI) and the Bayley-Scales-of-Infant-and-Toddler-Development-3rd -Edition was administered. Additionally, mothers provided information about their breastfeeding status and were divided into two groups accordingly: Exclusive breastfeeding (EBF) and non-exclusive breastfeeding (NEBF). Results The incidence of atypical sensory responsiveness (mostly of the sensory over-responsivity type) at 6 weeks was twice as high among NEBF infants than EBF infants (36.2% vs. 17%, χ2 = 7.41, p = .006). Significant group differences were found in the ISP2-touch section (F = 10.22, p = .002). In addition, NEBF infants displayed more sensory over-responsivity behaviors than EBF infants in the TSFI-deep touch (F = 2.916, p = .001) and tactile integration subtests (F = 3.095, p < .001), and had lower scores in the adaptive motor functions subtest (F = 2.443, p = .013). Logistic regression modeling revealed that ISP2 at 6 weeks (typical vs. atypical) and TSFI-total score at 6 months predicted 28% of NEBF at 6 months (χ2 = 23.072, p = .010). Conclusions Infant atypical sensory responsiveness, predominantly of the sensory over-responsivity type, were found to predict NEBF at 6 months after birth. This study contributes to the understanding of exclusive breastfeeding barriers, highlighting the importance of early identification of sensory over-responsivity in infants. Findings may suggest developing early sensory interventions and providing individualized breastfeeding support tailored to the infant’s unique sensory profile.