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Many moms wonder, "How long should I breastfeed for?" And the answer is, as long as you and your baby desire. It is not up to anyone other than the breastfeeding pair how long they choose to breastfeed. It is the ultimate in personal decisions within mothering.

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Breastfeeding for the last time on her 5th birthday.

Breastfeed a Toddler—Why on Earth?

Because more and more women are now breastfeeding their babies, more and more are also finding that they enjoy breastfeeding enough to want to continue longer than the usual few months they initially thought they would. UNICEF has long encouraged breastfeeding for two years and longer, and the American Academy of Pediatrics is now on record as encouraging mothers to nurse at least one year and as long after as both mother and baby desire. Even the Canadian Paediatric Society, in its latest feeding statement acknowledges that women may want to breastfeed for two years or longer and Health Canada has put out a statement similar to UNICEF’s. Breastfeeding to 3 and 4 years of age has been common in much of the world until recently in human history, and it is still common in many societies for toddlers to breastfeed.

Why should breastfeeding continue past six months?

Because mothers and babies often enjoy breastfeeding a lot. Why stop an enjoyable relationship?   And continued breastfeeding is even good for the health and welfare of both the mother and child.

But it is said that breastmilk has no value after six months.

Perhaps this is said, but it is patently wrong. That anyone (including paediatricians) can say such a thing only shows how ignorant so many people in our society are about breastfeeding. Breastmilk is, after all, milk. Even after six months, it still contains protein, fat, and other nutritionally important and appropriate elements which babies and children need. Breastmilk still contains immunologic factors that help protect the baby. In fact, some immune factors in breastmilk that protect the baby against infection are present in greater amounts in the second year of life than in the first. This is, of course as it should be, since children older than a year are generally exposed to more sources of infection. Breastmilk still contains special growth factors that help the immune system to mature, and which help the brain, gut, and other organs to develop and mature.

It has been well shown that children in daycare who are still breastfeeding have far fewer and less severe infections than the children who are not breastfeeding. The mother thus loses less work time if she continues nursing her baby once she is back at her paid work.

It is interesting that formula company marketing pushes the use of formula (a very poor copy of the real thing) for a year, yet implies that breastmilk (from which the poor copy is made) is only worthwhile for 6 months or even less (“the best nutrition for newborns”). Too many health professionals have taken up the refrain.

I have heard that the immunologic factors in breastmilk prevent the baby from developing his own immunity if I breastfeed past six months.

This is untrue; in fact, this is absurd. It is unbelievable how so many people in our society twist around the advantages of breastfeeding and turn them into disadvantages. We give babies immunizations so that they are able to defend themselves against the real infection. Breastmilk also helps the baby to fight off infections. When the baby fights off these infections, he becomes immune. Naturally.

But I want my baby to become independent.

And breastfeeding makes the toddler dependent? Don’t believe it. The child who breastfeeds until he weans himself (usually from 2 to 4 years), is generally more independent, and, perhaps, more importantly, more secure in his independence. He has received comfort and security from the breast, until he is ready to make the step himself to stop. And when he makes that step himself, he knows he has achieved something, he knows he has moved ahead. It is a milestone in his life.

Often we push children to become "independent" too quickly. To sleep alone too soon, to wean from the breast too soon, to do without their parents too soon, to do everything too soon. Don’t push and the child will become independent soon enough. What’s the rush? Soon they will be leaving home. You want them to leave home at 14?   If a need is met, it goes away. If a need is unmet (such as the need to breastfeed and be close to mom), it remains a need well into childhood and even the teenage years.

Of course, breastfeeding can, in some situations, be used to foster an over dependent relationship. But so can food and toilet training. The problem is not the breastfeeding. This is another issue.

What else?

Possibly the most important aspect of nursing a toddler is not the nutritional or immunologic benefits, important as they are. I believe the most important aspect of nursing a toddler is the special relationship between child and mother. Breastfeeding is a life-affirming act of love. This continues when the baby becomes a toddler. Anyone without prejudices, who has ever observed an older baby or toddler nursing can testify that there is something almost magical, something special, something far beyond food going on. A toddler will sometimes spontaneously, for no obvious reason, break into laughter while he is nursing. His delight in the breast goes far beyond a source of food. And if the mother allows herself, breastfeeding becomes a source of delight for her as well, far beyond the pleasure of providing food. Of course, it’s not always great, but what is? But when it is, it makes it all so worthwhile.

And if the child does become ill or does get hurt (and they do as they meet other children and become more daring), what easier way to comfort the child than breastfeeding? I remember nights in the emergency department when mothers would walk their ill, non-nursing babies or toddlers up and down the halls trying, often unsuccessfully, to console them, while the nursing mothers were sitting quietly with their comforted, if not necessarily happy, babies at the breast. The mother comforts the sick child with breastfeeding, and the child comforts the mother by breastfeeding.

Questions? (416) 813-5757 (option 3) or drjacknewman@sympatico.ca or my book Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA)

Handout #21. Breastfeed a Toddler—Why on Earth?. January 2005

Written by Jack Newman, MD, FRCPC. 2005

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10 Good Reasons to
Breastfeed Your Toddler

BY ELIZABETH BRUCE


The average American may not be ready to admit it, but myriad cultures past and present have accepted the fact that babies past infancy can benefit from nursing. The !Kung of Africa represent the natural state of human feeding. Mothers of this nomadic tribe breastfeed each child for up to six years. Sherman Silber, MD, points out that "the human species has spent more than 90 percent of its existence leading this type of nomadic hunter/ gatherer life, and 'civilization' with its pressures is too recent to have had any appreciable impact on their genetic makeup."'

In our culture, many men and women are uncomfortable with the functional role of breasts, probably because of our national obsession with breasts as sexual objects. Unfortunately, people's psychological discomfort seems to increase as the nursing baby grows. Most Americans choose to wean their babies at about six months.

Whatever the psychological complexities may be, we can no longer deny the health and social benefits of prolonged breastfeeding. Even the conservative American Academy of Pediatrics now officially recommends that breastfeeding continue for at least 12 months .2 But what about nursing through a baby's second or even third year? Is breast still best for toddlers? If we can get past our collective ambivalence, I think the answer is a resounding "yes."

While most of your neighbors probably aren't doing it, there are plenty of enlightened mothers out there who are. Alice Bailes, CNM, co owner of Birth Care and Women's Health in Alexandria, Virginia, says that the majority of her clients breastfeed well into their babies' second year. In fact, she has clients who tandem nurse they continue nursing their toddler through their next pregnancy and even after the new baby is born. Bailes, who has had personal experience tandem nursing, believes that it helps a toddler's transition into being a big brother or sister.

Of course, the decision to continue nursing is a personal one, and it often is not made until the time comes. Rest assured, according to most moms who have decided to keep going, once you've managed to breastfeed through the challenging first year the rest is a breeze. In case you're still not convinced, I am sharing my top ten reasons to breastfeed your toddler.

Convenience

I must confess that convenience was my number one reason for continuing to breastfeed my babies. OK, call it laziness. For one thing, weaning a baby before he's ready takes a lot of time and effort. You have to carry messy snacks around and deal with tantrums. Fortu

nately, by the time the baby turns one, most moms have mastered the art of discretion, so nursing is the easiest thing in the world to do with a minimum of privacy.

Even better, there is no easier way to get a toddler to sleep on your schedule than by nursing him. I always feel sorry for mothers of toddlers who aren't nursing, because their job is probably a lot harder than mine. If worse comes to worst, I know an induced nap is right around the corner.

Instant Tantrum tamer

As any parent of a toddler knows, they are naturally insecure creatures. One moment your one year old is happy, and the next she is dissolved in a puddle of tears seemingly over nothing. Well,

surprise! Often the best way to handle your volatile toddler is to briefly treat her like a baby. Take her in your arms nurse her for a few minutes, and voiW your little screamer is transformed into a confident child once again. If you're at a party when your child melts down, you can discreetly take him or her into another room or to the car. Friends will marvel at your great mothering abilities when you return with a magically transformed, happy toddler.

Less Reliance on "Mommy Substitutes"

The toddler years are peak years for attachment objects like blankets and dolls. The major problem with these objects is that they can be lost. Such an episode can take on tragic proportions. Believe me, I know because my first son never nursed. There's nothing quite like arriving at a Holiday Inn after a day of traveling with a cranky toddler only to discover you have left the critical object at a rest stop 300 miles back!

Life is too short for all that unnecessary drama. If you are nursing your toddler, you can forget the frantic search for an identical blanket and the Fed Exing of Barney. With Mommy as the primary security object, you can rest easy on those long family trips. It is basically impossible to lose a breast, no matter how distracted you are! Plus, you never have to steal the beloved object away for a round in the washing machine. Much trauma is spared for all.

Allergy Prevention

My second little boy was so attached to nursing that I became (reluctantly) a toddler nurser. He ate absolutely no solid food until he was 17 months old. Even La Leche League veterans suggested that the situation was, well, unusual. Looking back, I think my baby's wisdom was in avoiding possible allergens. Studies (as well as anecdotal evidence) indicate that breastfeeding reduces the incidence of allergies." My first child, who was solely formula fed, had all sorts of food allergies, including rice and dairy products. In hindsight, my second child's lengthy, exclusive breastfeeding makes sense. Most likely, it was nature's way of protecting him from foods his body just was not ready to process. Undoubtedly, some children need longer than others to "outgrow" their allergies, and breastmilk provides the ideal support for their developing immune systems.

Nutrition

Good nutrition is admittedly tricky with toddlers. On some days they cram every morsel offered into their mouths, and other days you can't coax them to take a bite of even their favorite food. In short, they're picky eaters, and their appetites are capricious and unpredictable.

One popular myth that even pediatricians promote is that breastfeeding somehow loses its nutritional quality after the first year. In reality, the benefits change, but they are still there. Does it really make sense that after 12 months of providing your baby with optimal nutrition the breasts suddenly get "stupid" and start making something "less than optimal"? Obviously, the addition of solid foods changes the balance, but breastmilk is still an important element in the diet while your baby is sampling what the world has to offer. Certainly, there can be no harm in continuing with nature's perfect food.

Speech Development

In general, it's believed that breastfeeding provides better development of the teeth and jaws than sucking a hard, unnaturally shaped nipple.' Margaret Connor, a 35 year old mother in Austin, Texas, has discussed the subject at length with her son's speech therapist. Both of them believe that Connor's five year old son's speech/motor apraxia would have been worse if his muscles had not been "worked out" through extended nursing. If nothing else, Connor is happy she made the decision she did. "At least I won't look back and wonder if his articulation would have been better if I had breastfed longer than a year," she says.

Fighting Dehydration during Illness

Unfortunately, toddlers, breastfed and otherwise, get sick. Some get sick a lot, especially those in child care and those with older siblings. When my 14 monthold son got bronchitis, he wouldn't eat or drink anything other than breastmilk. Had he not been breastfeeding, the situation could have turned into a nightmare. When a bottle fed baby gets dehydrated, the parents have to struggle to get oral rehydration products down the child. When this tactic doesn't work, pediatricians have no choice but to order an IV for the child at the hospital. This is not only traumatic for a toddler, but it also exposes him to other germs that could complicate the original infection. With breastfeeding, you can almost always get the child to nurse, which might even save his life! Further, it comforts the mother. It feels so much better to be able to help your child through illness in a uniquely positive way.

Weight Loss for Mom

It's accepted that a woman's body stores up enough fat during pregnancy to exclusively feed her infant for at least the first six months. While there are few studies on this topic, anecdotal evidence suggests that a mother's weight loss may continue during the second year of nursing a baby. The fact is, Mother Nature never intended for human babies to be weaned from their mothers in the early months, so our bodies make sure we have plenty of fat stored up for years.

For the first year, our bodies seem to like to stay soft, almost like a cushion for the infant. After that time, the weight is not quite so resistant to leaving. The increased calorie requirements of toddlers help the process of weight loss as well. For every day she nurses, a lactating woman uses an extra 500 calories. Personally, I found that stubborn fat stores that had lived on my thighs for years melted away during the second year of nursing.

Delayed Menstruation

For those women using Natural Family Planning or the Fertility Awareness Method for birth control, breastfeeding provides a bonus. Research done by the Kippleys in The Art of Natural Family Planning showed that a nursing mother who uses no supplements for the first four to six months gets her first postpartum period on average after 13 to 16 months.' Among the ! Kung tribe, babies are spaced about 4 8 months apart all due to exclusive breastfeeding.' Contrast this with the usual six to eight weeks for a bottle feeding mother. Naturally, PMS and the other related troubles usually disappear for as long as the periods stay away, and the return of fertility is also put off. In addition, delayed menstruation means decreased exposure to estrogen, which may protect against cancer of the breast and reproductive organs. Breast cancer risk is associated with earlier menarche and later menopause, which points to estrogen exposure as a risk factor for the disease."

It's Good for the Planet

Breastfeeding is the best ecological thing going. No cups to wash, no bottles to sterilize, and nothing for the landfill. Postponing the use of cows' milk helps our planet. Because of their methane gas emissions, cows are major destroyers of the atmosphere.'o Overgrazing of land is responsible for serious ecological troubles, as well. As a bonus, the baby is not exposed to the unhealthy hormones and antibiotics injected into dairy cows.

LIKE MOST OTHER MOTHERS OF toddlers, I originally continued nursing out of a desire for convenience. Frankly, it was just easier to keep going than to stop. Along the way, I discovered how much simpler continuing to breastfeed made our lives. If at all possible, the transition away from Mommy should be a gradual one, made at the baby's own pace. Toddler life is difficult enough. Why not make it a little more manageable for everyone?

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