According to UNICEF data, most women around the world breastfeed children past the 12-month mark. In fact, it’s considered the norm.
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?
But here in the United States, many mothers don’t make it past the 6-month mark, and only about 50% of mothers make it to the 12-month mark when it comes to breastfeeding their infants. As their children grow older, the percentage of mothers that breastfeed beyond 12 months goes down rapidly and significantly.
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 2018” 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
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.
Women in the United States, in particular, have faced significant difficulties when it comes to breastfeeding both for their infants and, especially, their toddlers. Only recently did all 50 states pass laws to protect breastfeeding mothers. More and more nursing rooms are available at airports and stores. But this outward support by government and large organizations is not matched by societal views on breastfeeding mothers.
Facebook still shows viral posts of mothers sharing their story of being shamed for nursing in public. You can still see the arguments on social media about whether women should cover up or not when they are being their children. And, on the other hand, you see women being praised for nursing while making arguments at parliament or drawing support from others after being asked to leave a courtroom while nursing.
But many of those viral examples are of women nursing their infant. When it comes to nursing a toddler, even the avid breastfeeding supporters turn their nose at the idea that a child that can walk and talk should still be nursing. Case in point: recently model and actress Coco came under fire after posting a picture on Instagram of her nursing her three-year old daughter on a plane. Followers made comments about how that it was “disgusting” and that her daughter was “too old to be doing that.”
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.
Breastfeeding is also beneficial to the mother. Prolonged breastfeeding can provide both emotional and physical benefits to the mother including a lower of cancers like breast and ovarian cancer, lower risk of rheumatoid arthritis, lower rates of endometriosis, osteoporosis, diabetes, hypertension, and cardiovascular disease. In addition to the physical benefits for a mothers, there are also emotional benefits. Mothers who breastfeed create more oxytocin during nursing sessions thereby decreasing the risk of postpartum depression and anxiety. The longer a mother nurses the more physical and emotional benefits she will see for both herself and her baby.
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.”
Even the content of breastmilk changes as a child gets older, which speaks volumes about how a woman’s body naturally changes to the needs of her growing child. A study conducted by the National Institute of Health found that as a mother continues to nurse her child that the amount of fat and energy increases per ounce. After on year of lactating, a mother’s milk has increased fat and energy content, suitable for a toddler’s needs.
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?
In the end it is crucial that a nursing mother feel supported in whatever decision she choses. The time when nursing no longer becomes beneficial for the mother or the baby is when one of those parties decides they are done- no matter if that is the mother or the baby. Only a mother should be making the decision to stop nursing, and whether that is after 6 months or after several years is up to her and the ongoing relationship with her child. The best thing society can do for new (or new again) mothers is support them in their decisions with mothering and not to judge them for whatever those decisions might be.