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Breastfeeding Beyond a Year: Why Stop Now?

BabyC is fast approaching her first birthday, and I’ve been asked more than a few times, “How long do you plan to keep breastfeeding?”

When I first started thinking about this question, the scientist in me wondered about the health benefits of “extended” breastfeeding.  I wrote about some of my research on the (purported) health benefits of nursing beyond a year last week.  I plowed through hundreds of breastfeeding studies looking for some data on extended breastfeeding, but the truth is that very little research on this topic has been published, and almost nothing has been published on extended breastfeeding in the developed world.  Please let me know if I missed something – just don’t send me links to La Leche League and KellyMom.  I’ve seen their pages and tracked down all those citations, and I couldn’t find any convincing evidence that my child will be any less healthy or nourished or smart if I wean at a year.  There could very well be health benefits to extended nursing, but as far as I can tell, they haven’t been described in the scientific literature.  I doubt if that will change in the near future, since extended breastfeeding is probably not much of a research priority.

However, as I started delving into the research on this topic, I realized that the mother in me didn’t really care what the data saidI know, shocking, right?  In this case, I just know that BabyC and I are both still enjoying breastfeeding, and I’m in no hurry to stop.

How long will we breastfeed?  I don’t know.  I haven’t been counting the days to her first birthday so that we can meet the AAP recommendation, but I’m not planning to breastfeed her until kindergarten either.  I’ve heard that many babies wean themselves within the first couple of years of life, and my hope is that BabyC will stop nursing when she’s ready.  But if BabyC doesn’t make that choice herself, there will come a time when I will be ready to stop.  I admit the thought crosses my mind during some nursing sessions when BabyC is intent on fish-hooking my mouth with her finger and beating on my chest.

But I’m not ready yet.  I love nursing BabyC.  She is not a particularly snuggly baby.  She prefers to be on the go.  Even when she is exhausted, she will rarely rest her head on my shoulder.  Rather, exhaustion seems to compel her to throw her body around wildly.  So our moments of nursing are often our only snuggly times together.  It is the time when we both stop moving.  I drop whatever I am intent on accomplishing, and she settles into my lap.  It is our time to reconnect, talk or sing quietly, and study each other.  When she’s done, BabyC will pop up, smile at me, and start babbling happily, looking refreshed and ready to play again.  I imagine that I will value this time even more as BabyC enters toddlerhood, as I’m anticipating her to move faster and farther away, asserting the independence that I see growing in her.  I think she will value being able to come back to our quiet place together, too, but I admit that nursing is as much for me as it is for her.  She will grow up way too fast as it is, so why rush it now?

As to the potential health benefits, a few have been mentioned to me anecdotally through comments on my previous post and conversations on Facebook and Twitter.  Several mamas have said that breast milk worked great as a treatment for conjunctivitis (pink eye), so it may be useful to have available if we get hit with that. (I wrote about the science behind this here.) Others have mentioned that a toddler sick with a cold or stomach bug may not feel like eating or drinking much, but she will often still nurse.  Breastfeeding a sick child could help keep her hydrated and nourished and might help her recover faster (though I couldn’t find studies on that either).  These are all bonuses to me.

BabyC just recently started signing for “milk” when she wants to nurse, although she usually just makes the sign at our normal nursing times.  I LOVE that she has started signing.  It means that she can ask for something calmly, without crying or whining, and she LOVES that she gets what she wants (most of the time).  I’ve heard many people say that it is time to stop breastfeeding once the child can ask for it.  This makes me laugh, because even though BabyC just learned to ask for milk with a sign, she’s been asking for it from Day 1.  The language that she uses to make that request is evolving, but it is all the same to me.   And for now, I’m happy to oblige.

20 Comments
  1. Your previous post got me wondering about what’s out there in the literature, too. But the first thing that came to mind was that it’s not necessarily about the medical benefits (whether or not those exist beyond a year of age); it’s about the intangibles. For instance, you mentioned (in the previous post) that mothers of extended breastfeeding babies reported more satisfaction with their babies’ behavior than mothers of non-extended breastfeeding babies reported. That’s big, I think. It means that (whether or not there’s a measurable, clinical difference in behavior) the mothers who kept breastfeeding FELT MORE SATISFIED with their babies’ behavior. I don’t know if BabyC is starting to display frustration/anger tantrums occasionally, but W is. Nursing helps. I wouldn’t want to face toddlerhood without it in my bag of tricks! And I think you hit the nail on the head in this post; it’s something the babies love, it’s beautiful time together (mostly…though I agree that the nose picking and the dental exams aren’t always restful), and it’s clearly meaningful to them. For me personally, it’s also (still) an amazing hormone rush that helps to relax and recharge me in the midst of my sometimes hectic day.

    I honestly wonder sometimes why people go to such lengths to create a medical justification (because like you, I haven’t found any developed world studies yet) for extended breastfeeding as though that legitimizes it. The bottom line in my mind is that it legitimizes itself; I can’t imagine a better justification for breastfeeding than that it is so deeply meaningful and comforting to mama and baby. There’s nothing the literature could ever show me that would make it more worth it to me to keep at it until W and I are both ready to stop.

    Like

    October 31, 2011
    • The thing about the behavior study that you mention – there is only an association between longer breastfeeding duration and mothers giving their 6-7-year-olds higher behavior scores – no evidence that the longer duration of breastfeeding actually caused this difference. It could be that women who breastfeed longer also happen to practice more “positive parenting,” be more patient with their kids, etc. These are the same confounders that are just impossible to account for in almost all breastfeeding studies. Again, I wouldn’t be surprised if the effect that you describe is also happening, but both you and I are just speculating about the possible causes for this association…

      Totally hear you about the usefulness of nursing as a sort of “reset” button for a frustrated toddler. I’ve heard that from many moms, and I’m glad that we’ll have that as an option, too. I’m personally a little hesitant to pull out a boob every time BabyC is struggling with something, because I want her to learn other ways to cope, but I’m sure it will be useful at times. Also, she is so easily distracted now that I have to kick the cat and dog out of the room before we nurse, or she comes on and off the boob all the time to see what they are doing. Nursing in public is pretty much out of the question now, as BabyC is just too interested in other things. So if she throws a fit at the park, I don’t know if nursing will help with that.

      As to the intersection of science and instinct when it comes to making parenting decisions, this “exercise” in looking at the BF literature has made me think about that a lot, too. The scientist in me always appreciates good research, and I think if there was more research on this topic, it might highlight extended breastfeeding and encourage more women to consider it. But yeah, science didn’t have much if any of an impact on this decision for me. Much of my interest in this topic stems from the many websites (and the AAFP) that tell us that research says that extended BF will make our babies healthier. I just think it is important to present the science accurately. I hate to think of mothers who are no longer enjoying breastfeeding doing it out of guilt or pressure from their peer group, when it may not be the best thing for their relationship with their baby.

      Like

      November 1, 2011
      • Oh, gosh, yes. I totally agree that it’s important to present the science as such, and I agree too that I think there are a lot of things women feel compelled to do by quasi-science that they don’t enjoy. I’m actually brewing a post on AP-related topics with that bent.

        Like

        November 2, 2011
  2. I’ve been surrounded by breastfeeding moms for the last (geez) 15 years now? I havent really even given it a second glance (breastfeeding that is, and how long). But my first weaned at about 2 weeks after my second was born. She was 15 months.

    Like

    October 31, 2011
    • Interesting – was that #1’s choice to wean at that time? You’d think she’d be more resistant to weaning once the new baby came. My hope is that BabyC will choose to wean herself sometime before her 2nd birthday, because I’m not sure I wouldn’t want to keep going much after that, but then again, you never know.

      Like

      November 1, 2011
  3. Thanks for your post! This is timely for me because I’m coming up to the 6 month mark and have been planning on quitting pumping then, but as the deadline approaches I feel more anxiety and pre-guilt about stopping. I’ve started doing research about what people know for sure about benefits of breastmilk over formula (my husband isn’t a fan of continued pumping after 6 months but says he’d be more on board if he knew there were substantial or clear benefits), but I’m realizing that even though I don’t get to nurse my daughter I still have a huge emotional investment in producing and providing the milk she drinks. I feel like I’d have this vague, underlying “must keep giving Baby milk” feeling even if I couldn’t find anything to justify it, and it’s interesting to me that I have these desires even though the act of feeding my baby would be the same if we were using formula.

    Like

    October 31, 2011
    • First of all, you are AMAZING for exclusively pumping for 6 months! And it is interesting and not surprising at all that you have an emotional investment and biological urge to provide for your daughter, even though you aren’t nursing her directly. I don’t want to influence your decision about how long to pump – that seems like a very personal choice. I haven’t done a thorough review of the literature on the benefits of breastfeeding beyond 6 months, but my sense is that baby has reaped the most important benefits at 6 months. I think your feelings about pumping and how it affects your stress, etc, are just as important to consider at this point. If it is something you don’t mind and it actually makes you feel good about how you are providing for your baby, to me that is a clear benefit. If you hate it, that seems like a good reason to stop! Above all, one thing that I have learned about being a mother is that you have to do whatever you feel the most comfortable with, so if you don’t feel quite ready to stop, then there’s nothing magical about the 6-month-mark. Give it another few weeks or months and reassess. Also, have you seen the Fearless Formula Feeder blog? It is smart and thoughtful and it might give you some perspective. http://www.fearlessformulafeeder.com/ More than anything though – kudos to you!

      Like

      November 1, 2011
      • Catherine #

        Thanks! But I think that nursing mothers are at least as amazing. Either way the baby gets it, it’s a labor of love. And I’ll definitely check out that blog.

        Like

        November 1, 2011
  4. I had planned to nurse quite a while past Jake’s first birthday (coming up in a week!!!), for many of the same reasons you talk about here. Unfortunately, Jake has just decided to start biting me again. Actually, more like chewing. A LOT. I confronted the biting issue a couple of months ago, but I’m not sure I have the patience to go through it again, this time with teeth. It’s sad, because he begs to nurse when I walk through the door at night, pawing at my chest and making the milk sign (so freakin’ cute). But he’s gotten so bad about the chewing that I’m scared to even give him a chance. I finally started handing a bottle off to Ben in the evenings for bedtime. And with almost all the breast milk being given through the bottle, I’m counting the days ’til I can give him a sippy cup of milk. Kind of sad, but my girls are already thanking me. 😉

    Like

    November 1, 2011
    • Sorry, this sounds rough! We went through the biting thing a couple of months ago, and I had a lot of pain for probably about a month, even though she really only bit me a couple of times. One hard bite broke the skin and just wouldn’t heal. I hated that nursing had become painful and not at all pleasant for me anymore. I’m glad we stuck it out, because we are back to happy nursing again. You have to do the best thing for you, your girls 🙂 and your baby – something every mother has to weigh for herself. I can imagine it would be sort of nice to have your body back, though!

      Like

      November 1, 2011
  5. Sarah #

    With both my two bubs, they ended up ‘self-weaning’, one at 14 months, one at 2 years. In both cases, I was about 10 weeks pregnant, so I’m guessing the breastmilk started tasting different – their reactions were quite strong, in that they would push away. I wasn’t in a rush to stop, although I confess with my 2 year old, I was about ready to call it quits, and I think he was too. That being said, sometimes I get an instinct to pick up my little guy and pop him on the boob. Just not sure he would know what to do now! I also agree with the pinkeye comments – we had to buy eyedrops for the first time 2 months ago! My reason for breastfeeding beyond 1 year was probably more for that lovely feeling you get, rather than scientifically based. I’d be interested to know if there are any additional benefits for the mother (cancer risk etc)? (Not that the child isn’t important, it’s just, it works both ways!).

    Like

    November 1, 2011
    • Awesome question about benefits to the mother. That’s on my list to research too, but I got kind of tired of reading all of these studies that hadn’t looked at extended breastfeeding directly. I doubt if there is much research on duration of breastfeeding within a single lactation, but I know that the association with reduced risk of breast cancer is based on LIFETIME duration of breastfeeding. http://www.ncbi.nlm.nih.gov/pubmed/12133652 “The relative risk of breast cancer decreased by 4.3% (95% CI 2.9-5.8; p<0.0001) for every 12 months of breastfeeding in addition to a decrease of 7.0% (5.0-9.0; p<0.0001) for each birth." That is a definite benefit. I'll put in on my list of research topics and write a post on it someday…

      Like

      November 1, 2011
  6. Robin #

    I remember a great article I read correlating the maternal age and number of offspring and how that influenced nursing duration (in animals). Boiled down to younger first time moms nursed longer (individual nursingnperiod and age of offspring) due to greater reserves in health where older multiparous moms nursed for shorter periods and duration but nursed more efficiently. I’m going to have to dig it up.

    I just recently weaned my 2+yo son (my choice not his) after tandem nursing for 9+ months. It became too much. I have no plans on weaning my baby girl any time soon because at almost 1 she is still very much happy nursing, why stop at an arbitrary age or from a calculation of ‘nutritional value’? For me it’s a decision that should be made individually and could very well be different for each mom and each child, too many complecating factors on this one.

    Like

    November 27, 2011
  7. Jennifer #

    I have done some research on extended breastfeeding and the benefits it provides to both mother and child. Mostly due to the fact that I feel the need to defend myself and my decision, I still nurse my daughter and she turned three in March. She asks for milk and if it’s not a time to nap she will ask for “just a little boobie milk” and grab herself a quick sip and be on her way. She has never been sick and only goes to the doctor for her routine well-child check-ups once a year, she is very intelligent and pretty well-behaved as far as toddlers go. She has never bitten me so that hasn’t been an issue. I do get a lot of flak from her father who thinks she is too big to nurse but she seems to be in no rush to stop so why should I make her? She is happy and healthy and that’s what’s important to me, not other peoples opinions. Anyway here are a couple of links that I found to be interesting and informative.

    http://kellymom.com/ages/older-infant/ebf-benefits/
    http://www.kathydettwyler.org/detwean.html

    Like

    July 3, 2012
  8. Sherry #

    There are definite benefits of extended breastfeeeding for both mother and child: http://www.llli.org/docs/Outcomes_of_breastfeeding_June_2007.pdf

    Like

    September 24, 2012
  9. Hi there, I just stumbled across your site looking for info about moms in science and thought I’d take a look around (I’m a mom and former scientist myself). How cool! And congrats on your book!

    I’m wondering if you came across any research about the emotional benefits of extended breastfeeding. I imagine research on that aspect of BF is probably even more scarce, partly because it’s so hard to conduct and also because here in the developed world we seem to concentrate so much on the physical. I was happy to read that you discovered for yourself the true depths of BF advantages: “It is our time to reconnect, talk or sing quietly, and study each other.” Sounds like a good reason not to stop!

    Like

    December 12, 2012

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