Extended Breastfeeding

Breastfeeding beyond the first birthday is known as extended breastfeeding.

Breastfeeding itself is a very emotive issue; it leaves many mothers for whom breast feeding did not work feeling guilty while those that do breast feed often have to deal with issues like negative reactions when feeding in public and so on. However, in general society it is fairly tolerant of breastfeeding for the first year, but what about after this?
Breast feeding beyond the first birthday is known as extended breast feeding. While according to the world health organization (WHO) and UNICEF it is recommended that normal breast feeding continue until at least two years of age, the majority of babies are wean during the first year.

Historically — and in many non western countries today — it is normal to breast feed a child well past toddlerhood, and a nursing child of 3 or 4 would not be unusual. In fact it was not until 1800 that popular English writings on child care were recommending weaning as young as 12 months. In today’s society however the practice of extended breast feeding meets with much disapproval.

We are generally told that after a year a baby no longer needs the breast milk or formula and that they can be weaned straight onto cow’s milk or other non-dairy milk. While it is true that formula fed babies would receive no added benefit of receiving formula beyond the first year over other forms of milk , the same is not true for the breastfed child.

In more developed societies breast feeding a toddler may no longer be a life of death issue, we can not discount the benefit that the child gets from the breast milk that they do get during extended breast feeding period. A newborn baby has an underdeveloped immune system and human milk provides important protection against disease until their own immune systems begin to function fully. Babies’ immune systems begin to produce some of the substances need to protect it from about 3-7months. Solids are usually introduced at about 6 months which shows nature’s perfect timing, as the child starts solids, and is not exclusively breast feed, their own immune system is starting to function.

However, the child’s immune system is not fully operational at adult level until 5 to 6 years old. Until this time their immune systems can be enhanced and augmented by the maternal milk.
A mother’s milk is constantly changing to meet the needs of her child. Her milk carries disease fighting cells in response to both past and current infectious agents. When her child starts solids and is no longer breast feeding as often the concentration of antibodies and immune protection per volume of milk drastically increases so that they child receives the protection they need in a smaller amount of milk.

Breast feeding a child does not mean that they will never get sick, they just gets the advantages of being at the mother breast through the experience. It also removes the sense of helplessness that many mothers feel when watching a sick child, especially in hospital. Often a child who is refusing all food and fluids will still breast feed and so help avoid serious dehydration. Many a breast feeding mother will comment on how she is sure that it was only the ability to breast feed her toddler through a bout of gastro that kept them out of hospital.
Avoiding or delaying allergies is another reason that many mothers continue to breast feed beyond one year, especially those with a strong family history of allergies. Much research is continuing in this area.

To say that the child no longer needs the nutritional benefit of breastmilk and can therefore wean after one, is perhaps missing the whole point of breastfeeding. An infant child need the nutritional benefit of breast milk but as the child begins to eat solid food it could be argued that they no longer need breast milk and that they can get all their dietary needs from the food they eat, but we have all seen enough 3-4 year old still sucking a dummy, their thumb, a bottle etc to know that there is a need to suckle beyond just the getting a nutritional need met.
Research into personality development has found that sucking serves 2 purposes one is nutritional and the other is attachment- the complex process where a baby learns to trust and rely on other human being especially his/her mother. To suppose that the nutritional need is the primary one is a mistake and in fact far more time is spend in non-nutritional sucking that on nutritional sucking.

During the few short years from birth into childhood will require these little people to learn, grow and develop more than at any other stage in their entire lives. These tasks can be quite overwhelming and comfort sucking is a blessing given to them to help them cope and make sense of the world. What better place to do this than in the warm reassuring arms of a loving mother.

A commonly held misconception is that extended breast feeding will create an overly dependant child, in fact the opposite seems to be true. The need to suckle will cease all on its own once it has done its job and this time table is unique to each child. Children who achieve independence at their own pace are far more secure in their independence that those who were forced into it prematurely.

The American Academy of Paediatrics has recently revised its breast feeding policy and now recommends exclusive breastfeeding for the first 6 months and that breast feeding should ideally continue for a minimum of one year.

The AAP statement then goes on to say that “there is no upper limit to the duration of breast feeding and there is no evidence of psychological or developmental harm from breast feeding into the third year of life and longer. Indeed the scientific evidence shows that the benefit of breastfeeding (nutritional, immunological, cognitive and emotional) continue as long as breastfeeding itself does.”

Weaning a child before they are ready will not remove the need, they may just turn to less effective behaviours or objects as a substitute, the reliance on which may continue for life.
Other added bonuses of continued sucking at the breast are better developed dental arches and less need for orthodontic correction later in life. Less middle ear infections as the Eustachian tubes are massages during the unique sucking a swallowing motion of breast feeding. As well as decreasing the need for speech therapy for lisps and other speech problems.

There are benefits to the mother of extended breast feeding too. Breast feeding has been found to reduce a woman’s risk of breast cancer, the longer she breast feeding the lower her risk of breast cancer. Breast feeding has also been found to reduce the risk of ovarian, endometrial and uterine cancer.

While there is no reason to parent out of guilt and no one should continue to breast feed if it is unpleasant for them. Hopefully highlighting the benefits behind continuing to breast feed beyond what our society considers normal, will help more mother consider this option and will make other less critical when they hear of a older breast feeding child. ?