Breastfeeding Beyond Infancy is the Norm…in Much of the World

breastfeedingBy Rivkah Estrin, The Attached Family, reprinted with permission by Attachment Parenting International.

As an expectant or new mom we very likely heard that “breast is best.” And here is what many of us imagined next: a sweet, precious newborn positioned lovingly at the breast. Beautiful.

But what happens next? What are moms supposed to do after that initial newborn stage? For for how long is breast the best? What happens when baby’s first tooth appears? How about when baby starts walking or talking? Is it a good idea to breastfeed past the first year?

Across the globe, breastfeeding past 12 months is more than just possible, it’s the norm. UNICEF’s report entitled “The State of the World’s Children 2012” collects data about breastfeeding across the globe.

Included in this report are the following statistics on the number of children breastfeeding at age 20-23 months.

  • 91% in Bangladesh
  • 43% in Cambodia
  • 49% in Costa Rica
  • 88% in Ethiopia
  • 46% in Guatemala
  • 77% in India
  • 50% in Indonesia
  • 77% in Malawi
  • 95% in Nepal
  • 72% in Papua New Guinea
  • 84% in Rwanda
  • 84% in Sri Lanka

Impressive figures. Let’s compare this to the other side of the spectrum—countries with little or no data to suggest breastfeeding at the same age:

  • United States
  • United Kingdom
  • Canada
  • France
  • Germany
  • Mexico

Why the discrepancy? Why does the data from some countries point to a majority of nursing toddlers, while ‘modernized’ nations don’t have any data to report? One word: Support. There just isn’t a lot of support for the nursing mother-toddler relationship in many of these cultures.

But there are clear benefits of nursing past infancy.

The American Academy of Pediatrics recommends “exclusive breastfeeding for about the first six months of a baby’s life, followed by breastfeeding in combination with the introduction of complementary foods until at least 12 months of age and continuation of breastfeeding for as long as mutually desired by mother and baby.”

The World Health Organization (WHO) suggests exclusive breastfeeding for six months and continued breastfeeding for two years. As mothers, as caregivers, we understand breast is best for young babies, but why keep nursing—what are the benefits of extended breastfeeding?

According to Kelly Bonyata, IBCLC, better known as Kellymom, of St. Petersburg, Florida, USA, in the second year (12-23 months), 448 milliliters of breast milk provides:

  • 29% of energy requirements
  • 43% of protein requirements
  • 36% of calcium requirements
  • 75% of vitamin A requirements
  • 76% of folate requirements
  • 94% of vitamin B12 requirements
  • 60% of vitamin C requirements

Bonyata also states that breastfeeding toddlers between the ages of one and three have been found to have fewer illnesses, illnesses of shorter duration and lower mortality rates. According to the WHO, “a modest increase in breastfeeding rates could prevent up to 10% of all deaths of children under five: Breastfeeding plays an essential and sometimes underestimated role in the treatment and prevention of childhood illness.”

And the American Academy of Family Physicians states:

As recommended by the WHO, breastfeeding should ideally continue beyond infancy, but this is not the cultural norm in the United States and requires ongoing support and encouragement. It has been estimated that a natural weaning age for humans is between two and seven years. Family physicians should be knowledgeable regarding the ongoing benefits to the child of extended breastfeeding, including continued immune protection, better social adjustment and having a sustainable food source in times of emergency.

Furthermore, “If the child is younger than two years of age, the child is at increased risk of illness if weaned.”

The benefits of breastfeeding past baby’s first year are numerous and include benefits for mom as well. The New York Times reported in 2009 on a study by Stuebe et al that stated “of women with an immediate relative, like a mother or a sister, who had breast cancer, those who breastfed had a 59% lower risk of premenopausal breast cancer.” The article goes on to discuss additional health benefits to mom, including a reduced risk of osteoporosis, ovarian cancer, high blood pressure and heart disease.

Separately, there is a huge emotional angle to the comfort and closeness that extended breastfeeding offers an adventurous, curious, fall-prone toddler. Holding a child close, loving away the pain and enjoying some quiet snuggle time with a toddler who is often too busy to sit on mom’s lap are some benefits to breastfeeding that can’t be quantified.

This is not to say that a mother can’t calm or love her toddler without nursing. However, the hormonal and neurological comforts offered by mom’s milk work in a special way. Settling a cranky 14-month-old by putting her to the breast is a loving way to transition this almost-baby to an almost-kid. What a sweet, gentle way to bridge the gap between dependent infant to independent child.

In an article for Parenting magazine, William Sears, MD, a pediatrician in Capistrano Beach, California, USA, author of the Sears parenting library and member of API’s Advisory Board, wrote about how extended breastfeeding is “better for your toddler’s behavior. We have many extended breastfeeders in our pediatric practice, and I have noticed that breastfed toddlers are easier to discipline. Breastfeeding is also an exercise in baby reading, which enables a mother to more easily read her baby’s cues and intervene before a discipline situation gets out of hand. Nursing is a wonderful calming tool on days when Mom needs to relax and to stave off an impending toddler tantrum.”

Additionally, Jack Newman, MD, of the International Breastfeeding Centre in Toronto, Ontario, Canada, author of The Ultimate Breastfeeding Book of Answers, states that “the child who breastfeeds until he weans himself (usually from 2 to 4 years old) is generally more independent and, perhaps more importantly, more secure in his independence.”

All this being said, extended breastfeeding is more than a checklist of benefits versus risks. As with all parenting decisions, it comes down to how the family functions and what works best for everyone involved. So what do we need to do to afford the opportunity, should parent and baby desire, to nurse into toddlerhood?

Toddlers often nurse at bedtime or when they are hurt, upset or feeling unwell. It is common in these circumstances for nursing to take place in the privacy of the home. Not many opportunities present themselves for children of a certain age to nurse in anyone else’s company—not by design but by default. Perhaps this is what perpetuates current attitudes toward nursing past baby’s first year. On the go, at the park, in the shopping malls and libraries of our cities and towns, these little people are too busy exploring to nurse. When they return home and want to reconnect with mom in a comforting, routine fashion, settling in on the couch and nursing can help these little explorers feel safe again.

And American actress Mayim Bialik, PhD, author of Beyond the Sling, told Kveller.com in an interview on extended breastfeeding: “I believe that children outgrow the need to nurse just as they outgrow the need to crawl or poop in a diaper.”

In Western societies, many mothers assume that babies should be weaned once they reach their first birthday. But what if a mother isn’t ready to wean her walking, talking 13-month-old son? What if the messages this mother received were those of understanding and lacking judgment? What if we allowed families to find their own rhythm without casting our own aspersions on them? What if the only repercussion to supporting extended breastfeeding was to have healthier, more emotionally secure kids? 

Image: moppet65535


16 thoughts on “Breastfeeding Beyond Infancy is the Norm…in Much of the World”

  1. I am still happily nursing my 3.5 year old and he is weaning himself. I have no support except from my spouse. If anything I have noticed a scornful and judgemental attitude towards those who nurse past one. I have been told so many “tales” such as your breasts will droop or my favorite, his teeth will grow crooked. I plan to follow my heart and my knowledge and allow my son to wean naturally – but I still feel compelled to keep it a “secret” I can’t help but wonder how many other mothers feel this way. I also can’t help but feel angry that this is not encouraged or supported. My son is an independent smart outgoing boy and unless I told you – you would never know :)

    1. My just over 3 year old (40 month old) still nurses up to 3 times a day, I’m in the same boat as you Carol, except my partner is starting to get really nasty about it, says it has to stop, she’s too big and it’s disgusting. I keep it secret too, even telling her to wait until Daddy is out. He was supportive when she was younger, but says HE’S had enough of it now!! From one year old he’s been talking about stopping. Sad out society has conditioned formula feeding and breast weaning asap as ‘normal’ and that natural term breastfeeding of older children is weird

    2. I know what you mean! My son is 4 and a half and still nurses a little to get to sleep at night. My family are not supportive and the general public would be downright horrified! I thought he’d self wean by now, but time and time again I am glad to still have the resource- like when he gets sick- which he does more often since starting preschool. Plus, I think it probably is nice to still have that comfort at a time when he’s having to branch out into the world more.

  2. When you keep calling it “extended” breastfeeding you are supporting that it is beyond normal. “Extended” meaning past the normal timeframe. Let’s encourage mothers who “full term” breastfeed and help make them feel normal instead of using a term that says they’re different.

  3. I breastfed until My son was 5. When he was 7 he asked if he could please have one more sip….because it was so nice….. When he tried and there was nothing there, he was sooo disappointed.

  4. 4yrs 2mo love reading about other mom’s bf even if for a few month’s to years. My soon to be ex-husband bullied me almost every mo for the pass two yrs to stop. Finally saying to me that I’m causing our son psychological damage.

  5. 4 yrs.7m. Feel so lucky. Having all support from dad and family…my son told me he will wean when he will be 5…lets see…no rush just as he feels

  6. I think it’s absolutely disgusting to be breastfeeding a child that’s school age. I’m beyond shocked that this is wanted to be seen as normal. My feelings are stop it when they can hold a cup and feed themselves. Bet your sons grow to be hate you. Flashback memories of being in kindergarten and still sucking on their moms boob. The horror, the child will grow up turn to drugs to get over the way way way extended breastfeeding. Gross, for shame ladies, for shame. I support bf babies until 2 years old, after that it isn’t necessary just mothers being clingy.

    1. What a load of ridiculous crass accusations! It IS normal, biologically, psychologically and physiologically. Letting a child self-wean is gentle and aids security. It’s the first comfort the infant has known and has always been constant. My Daughter could use a cup around a year old, should I have refused her breastmilk then by your reasoning? I NEVER offer my daughter to nurse, she asks me, it is her want not me being clingy, you cannot force a child to drink! Studies have shown that the few kids who do remember breastfeed recall it as a warm hug, certainly not traumatic flash backs. To say that natural term breastfeeding will lead to drug abuse is just laughable!!

      I do applaud you for recognising that breastfeeding until the age of two years old is a good thing though.

    2. Alani, did you actually read the article? As Zoe said, it is completely normal in a biological/physiological sense. It’s just not culturally normal in Western society. It seems like you have some major issues regarding full term breastfeeding, but unless you have been there and experienced what it’s like, it’s probably best to refrain from commenting on something you clearly don’t understand.

    3. I was breastfed until 3 years old and my memories are of feeling safe and loved while nursing. I don’t hate my mother, I have much respect for her for what she did for me. I’m not on drugs. I’m a proud mother of 4 of my own children that I breastfed as well. None of them have any problem with knowing the we’re breastfed. They, unlike you, understand basic biology and know that’s how a baby, toddler, small child is fed.

    4. 6 years each, not least because we had multiple food allergies to get past. Star students and varsity athletes, totally healthy with no remaining allergies, who feel sad for their peers who were weaned at arbitrary ages.

  7. I’m not a mother, but have to admit that I’ve wondered how breastfeeding a child (say 5) might affect them later in life. I know the benefits are numerous, but could it be harmful for a child to remember the act later in life? Has anyone read of any actual cases where things didn’t go as planned? I’ve discussed this with friends who had the same questions before, but once they become mothers their opinions always change. I think their motherly instincts take over.

  8. Alani Knowells, my heart is heavy with your comment. My daughter could hold a sippy cup at seven months… Breastfeeding is not in any way a gross act. The only way it could be perceived as disgusting is if it were a sexual act and it certainly is not that. Drugs!!!??? Children breastfed into school years will need drugs to forget the horrible feeling of being loved and nourished? I dearly hope that no ones feelings were hurt with your horrible disgusting comment. As a woman, you should be ashamed of yourself! For shame, for shame; keep your asinine opinions to yourself woman.

    And to those women who full term breastfeed, good for you!!! I stopped breastfeeding my first at 12 mths. and my second at 15 mths. due to being pressured by family and the societal norm and I feel horrible about it when I look back at my less experienced years of mothering. My daughter is 14 mths. now and I am going to let her nurse as long as she pleases with no regards to society.

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