What are the benefits of breastfeeding more than a year?

Ask Anne…

I currently have a wonderful nursing relationship with my seven-month old son. People are starting to ask me how long I plan to breastfeed. To be honest, I don’t know how long I plan to nurse. My question is, what are the benefits of breastfeeding more than a year? I understand the benefits of nursing your baby until twelve  months, but am curious as to the reasons for nursing beyond that.

Answer: Many mothers who are very committed to breastfeeding start out with the plan to nurse their babies for six months or even (gasp!) a whole year or longer. Once they reach that milestone, they often find that they want to continue nursing for a variety of reasons. Sadly, many mothers never reach their target breastfeeding goal to begin with, primarily due to lack of information and support.

In the US, 78% of mothers initiate nursing at birth, but less than 47% are still nursing at six months, and fewer than 25% at one year. This is in spite of the fact that the AAP (American Academy of Pediatrics)  recommends nursing for at least the first year, and the WHO (World Health Organization) recommends nursing for at least two years.

The reason that new mothers think about nursing for a specific length of time is because of two misconceptions: the first is that once babies start solids, (around the middle of the first year), there is an assumption that the baby somehow doesn’t “need” breast milk any more. This could not be further from the truth. Most pediatricians recommend that babies not drink cow’s milk until they are a year old, so if you wean your baby at six months, then you still need to buy formula for the next six months. Nursing an older baby is very different from nursing a newborn.

Once you have made it to the six-month mark, you have gotten past the early, often problematic stage of nursing. Problems like sore nipples, engorgement, and marathon forty-five minute nursing sessions are (for the most part) a thing of the past. Once you reach the six -month mark, there is absolutely no reason to stop nursing.

The second misconception is that once the average baby’s digestive system is ready to handle cow’s milk without allergies or serious gastrointestinal problems (usually by twelve months of age) then there must be no reason to continue nursing past that point. However, just because most babies can ‘tolerate’ cow’s milk at around a year, that doesn’t mean that there is any advantage to giving it to your baby instead of breast milk.

Breast milk is a very complete food for at least the first six months of life. From 6-12 months, an “educational diet” is recommended. This means that other foods gradually begin to provide for nutritional needs that milk alone can no longer provide, and your baby gets used to different tastes and textures as well.

Breastmilk or formula should be the main source of calories up till the end of the first year, and should still constitute about 75% of his diet at 12 months (25% solids). The need for iron increases after the first 6-9 months, so it is good to include iron rich foods during the latter half of the first year.

There is no point at which the benefits of breastfeeding suddenly “run out”. Breast milk does not turn into water overnight on your baby’s first birthday. As long as you nurse, your baby gets valuable immunities, as well as the security and emotional advantages of nursing.

Breast milk also changes in composition to meet the needs of your growing baby. The milk of premature infants is different from the milk of full-term babies, and the milk made for toddlers changes as your baby grows. For example, levels of certain antibodies in human milk actually increase as your baby grows older and nurses less. The theory is that this is a protective mechanism to reduce the toddler’s risk of illness during the weaning stage, when he is gradually being introduced to more solids and less mother’s milk. Breast milk is the perfect food for your child, no matter how old he is. Formula is static – it doesn’t change to meet your baby’s needs as he grows.

When you wean your baby depends on how long you want to nurse. It’s a decision that only you can make, although everyone you meet will give you authoritative advice on the topic. Interestingly enough, you will find that the people who give you the most advice are often the very ones who know the least about breastfeeding. The same thing applies to pregnancy and parenting. Go figure.

There are many, many benefits to extended breastfeeding, and very few (if any) benefits to weaning early.

Breastfeeding for a year or longer offers the most advantages. Extended breastfeeding is definitely not the norm in this country – worldwide, most babies are weaned between two and four years – but in the US, fewer than 25% of babies are still nursing when they are six months old. While you may find it hard to imagine a mother in India nursing a three year old, that same mother would probably be baffled at the idea of intentionally taking a baby off the breast when he was just a few weeks or months old.

Here are just some of the benefits:

• Your baby continues to get the immunological advantages of human milk, during a time when he is increasingly exposed to infection. Breastfed toddlers are healthier overall.
• When he is upset, hurt, frightened, or sick, you have a built in way to comfort him. Often a sick child will accept breast milk when he refuses other foods.
• Many of the medical benefits of breastfeeding (lower cancer risk in mother and baby, for example) are dose related – in other words, the longer you breastfeed, the greater the protective effects.
• Human milk offers protection for the child who is allergic
• Mothering a toddler is challenging enough – nursing makes the job of caring for and comforting him easier. There is no better way to ease a temper tantrum, or put a cranky child to sleep than by nursing.
• Nursing provides closeness, security, and stability during a period of rapid growth and development.
• Letting your baby set the pace for weaning spares you the unpleasant task of weaning him before he is ready.

I hope that you decide to nurse your son for at least the first year. There are SO many reasons to continue breastfeeding.

The other thing that I have to mention is the real reason that most mothers continue nursing their babies into toddlerhood. It has nothing to do with the antibodies in human milk or the protection against breast cancer. It’s all about the indescribable feeling you get when your older baby pulls off the breast and grins up at you with milk running out the side of his mouth, and then happily returns to nursing.

You can’t really explain that feeling to friends who have never nursed their babies, but once you experience it, you will never be the same again.

You should nurse your baby as long as you both want to continue, without worrying about what anyone else thinks, including your in-laws, your friends, or your well meaning but misinformed neighbor down the street. Remember that you have initiated the weaning process the first time you put a little dab of solid food in your baby’s mouth, so if anyone asks you “When are you going to wean that baby?, you can honestly reply that you’ve already started. Maybe then they’ll stop hassling you about it.

Your baby will grow up before you know it, and if you look at the eighteen years he lives at home as a big pie chart, then the tiny little piece of the pie that he spends nursing is such a small amount of time, even if he doesn’t wean until he is several years old.

Go ahead and nurse your baby for as long as it feels right to you. It is the lucky baby in this country who gets to nurse past six months or a year.  Follow your heart, enjoy every minute of the time you spend as a nursing couple, and know that you are doing what is best for your baby as well as for yourself.

Anne Smith, IBCLC
Breastfeeding Basics