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