How long to breastfeed
This is a question that many breastfeeding parents consider, and is obviously mainly down to personal choice - what feels comfortable for the family.
If babies are left to their own devices, many won’t naturally stop before a year old, and often later - after two years old.
The World Health Organisation (WHO) and United Nations Children’s Fund (UNICEF), recommends:
WHO and UNICEF recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life – meaning no other foods or liquids are provided, including water.
Infants should be breastfed on demand – that is as often as the child wants, day and night. No bottles, teats or pacifiers should be used.
From the age of 6 months, children should begin eating safe and adequate complementary foods while continuing to breastfeed for up to two years of age and beyond.
There are also cultural practises and beliefs that impact how long parents want to breastfeed. For example in the Quran, it states that babies should be breastfed for two years: https://llli.org/islamic-cultural-practices-breastfeeding-2/
Breastfeeding is known to support a child’s developing immune system, which does not complete full development until around 6 years of age. Anthropologist Katherine Dettwyler took note of this along with research into other primates to look at weaning ages and possible correlation with a natural weaning age for humans. Using the markers of tripling or quadrupling of birth weight, adult body size, gestation length and the age at which milk teeth start to fall out, she came up with the human equivalent natural length of breastfeeding to be a minimum of 2.3 years up to seven years old (K Dettwyler, A Time to Wean in Breastfeeding Biocultural Perspectives). There is also an article here: http://whale.to/a/dettwyler.html
So the “normal” age of weaning could be anywhere between 2 years and 7 years old. Many parents find their baby stops breastfeeding before a year old, often between 7 and 9 months old, so why does that happen? At this age many babies are going through lots of changes and development, and it’s quite easy for a baby to be too distracted to feed. Naturally parents worry when their baby doesn’t breastfeed when expected, especially when the baby makes it very clear they’re not interested. Often what happens during this time is that the parents stop offering feeds and wait for the baby to request feeding - “don’t offer, don’t refuse” - which is a method of gently weaning a baby from breastfeeding.
Babies of this age often need to be reminded to breastfeed, they are just too busy exposing the world and forget. Offering feeds often, especially when they seem tired or upset, encourages even short feeds, and the baby settles back into happily breastfeeding once this phase passes. The book The Womanly Art of Breastfeeding from La Leche League explains this well, and further information here: https://kellymom.com/ages/older-infant/babyselfwean/
This behaviour may also be referred to as a nursing strike, which could last from a few days to as long as a couple of weeks. You can find more about this here: https://www.laleche.org.uk/nursing-strikes/
Of course, if parents are happy to stop breastfeeding at this time, then absolutely they can do so, but it’s important to know that this is a natural phase that many babies go through, and doesn’t mean breastfeeding is over unless parents want it to be.
Breastfeeding a toddler is not without its challenges though - from the perspective of how toddlers feed, as well as other’s opinions on whether you should or shouldn’t.
Parents feeding toddlers and older children may be subject to unhelpful and critical comments that can be hurtful and really undermine their confidence in how they are caring for their child. Anything from “once they can ask for it you should stop”, or “once they have teeth it’s game over” to comments about breastfeeding an older child being sexual or only for the parent’s benefit. None of this is true. Unfortunately some of the beliefs that breastfeeding should stop at an arbitrary age can sometimes come from health professionals too.
Those of you who have breastfed will know it’s just about impossible to force a baby or child to breastfeed if they don’t want to.
Part of the reason for some of these comments is almost certainly to do with the Western attitude that breasts are sexual or erotic, rather than a secretory gland of the body designed to make and feed human milk to human babies. In Dr Jack Newman’s book Breastfeeding - Empowering Parents, he also refers to Sigmund Freud’s idea that breastfeeding a toddler is not “right”, that the oral stage of development is over at a year, and therefore a baby should not be breastfed after that age. Even though many have forgotten this idea came from Freud, the message has somehow become ingrained.
Another incorrect belief is that after six months or so, breastmilk no longer has any nutritional benefits for the baby, or health benefits for the mother.
Breastmilk contains fat, protein, carbohydrates, immune and growth factors and much more ever after three years or longer of breastfeeding. Some of the antibodies and other immune factors even increase after the first few months into the toddler years, and breastmilk ALWAYS contains stem cells, alpha lactalbumin which changes into HAMLET (human alpha lactalbumin made lethal to tumour cells) when exposed to stomach acid.
For the parent, breastfeeding may also help reduce the risk of heart disease and type 2 diabetes, and they have a reduced risk of some types of cancers. For example, for every 12 months a parent breastfeeds, the risk of breast cancer is reduced by 4.3 percent, and the risk of ovarian cancer is reduced by 28 percent for those who breastfeed for 6-12 months (Interdisciplinary Lactation Care, 2019 pp6-7).
How can Breastfeeding toddlers truly not be ok?
Comments such as “breastfeeding might be natural but so is urinating and I don’t do that in public” reduce confidence to breastfeed at the best of times, and especially when they are feeding an older child. Have a look at Amy Brown’s book Breastfeeding Uncovered - who really decides how we feed our babies? for more on why she thinks the situation hasn’t improved much over the last few years - she says “(this book) It’s a challenge, a stand, a call to action to society: let’s make the change we need.”
Breastfeeding isn’t just about food and hydration, as those of you breastfeeding will know. It is love, connection, security, comfort, pain relief… as one mother of children who breastfed for over 4 years says in Breastfeeding Older Children by Ann Sinnott:
The child learns that someone really cares and reacts accordingly when they have a need. In times of emotional upheaval it is the best place to return to for stability and comfort.
Ann Sinnott’s book is another good read, containing lots of quotes from parents as well as references to research to back up her claims that breastfeeding older children is natural and necessary.
Those of you that want to feed your child until they naturally wean, at whatever age that is, I hope this helps you feel secure in your decision to parent this way.
For those of you that don’t feel comfortable doing this, please know that the breastfeeding relationship needs to work for both parties - if you don’t feel comfortable feeding after a certain age, then it may be time to stop.
Feeding babies and older children is not “extended” breastfeeding, it’s “natural” breastfeeding.
If you would like support on your breastfeeding journey, whether it’s about continuing or stopping, please get in touch.
Denise.ives@thebreastroom.org
denise@deniseives.com