Extended breastfeeding, or breastfeeding a child past the age of 1, is incredibly common in some cultures. And yet in others, like ours here in the United States, it isn’t. Many moms are told by family, friends, and even healthcare professionals that there’s no benefit to breastfeeding after 1, and that they should stop. This is about as far from the truth as it could be! Let’s break down the benefits to extended breastfeeding, and why you might want to keep breastfeeding after 1 year.
What is extended breastfeeding?
The World Health Organization recommends breastfeeding up to the age of two years and beyond. The American Academy of Pediatrics recommends breastfeeding for one year or longer as desired by the mother and infant. Here in the US, many women stop breastfeeding by the time their child is one. Anything longer than that is considered extended breastfeeding. This includes breastfeeding to 18 months, 4 years, or even 7!
The Benefits of Extended Breastfeeding
The science is pretty clear when it comes to the continued benefits of breastfeeding after 1 year. Just like when your baby is newborn, breastmilk continues to have huge benefits when your baby is a toddler. These range from improving your child’s immunity and decreasing serious risks of infection, to improving their cognitive development. Breastfeeding also plays an important role in your child’s mental and social development, and contrary to what many people may believe, it can actually improve your child’s independence as they grow.
The average child, if allowed to naturally wean, would breastfeed for 2-7 years. It is only since bottles and formula have come on the scene that the age of weaning decreased down to one year or less here in the US and many other nations.
Even though it has been said by many doctors, other healthcare professionals, and likely some of your family and friends, there is “no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer.” (AAP) Meaning that there is no reason not to breastfeed as long as you want, and every reason to keep going!
The complicated nature of breastfeeding
While breastfeeding is an amazing thing, there are many moms out there who for whatever reason are not able to, or do not desire to, breastfeed. This is not an article that is intended to go into any of those reasons, or to make anyone feel bad for not being able to breastfeed. But for those of you who DO want to, and are able to continue breastfeeding, there is little information out there about the benefits of it, and a lot of shaming or questioning in our culture. This article is intended to allay those fears without commenting on any of the other issues related to breastfeeding.
The concerns with extended breastfeeding
If you tell your pediatrician that you are planning to breastfeed past one, you may get pushback from them. The American Academy of Pediatrics recognizes the benefits to breastfeeding past one, but many pediatricians are simply not up to date with this recommendation. Let’s address some of the general concerns that tend to be expressed when someone says they plan to breastfeed past the age of 1.
Breastfeeding will interfere with eating
I’ve heard from many people that there is concern about children not getting enough food if they continue to breastfeed. There isn’t really any research to back this up. Breastfeeding continues to contribute ⅓ of calories to toddlers, and many other nutrients as well. Breastmilk has actually been shown to increase in fat amounts after a year to help toddlers meet their brain development needs!
If your child is breastfeeding many times throughout the day and night, this could start to interfere in their food intake, yes. But from a nutritional standpoint I would simply recommend trying to space out breastfeeding sessions so that your toddler has more time to get hungry and has a desire to eat.
After 6 months, breastmilk doesn’t have all the nutrients that babies need, and they do need to augment with complementary foods. But that doesn’t mean that breastmilk has no value or should be significantly cut back! It simply means that if your child seems to only want to nurse and not eat, it’s worth looking at your schedule.
If this happens while they’re sick, especially as a toddler, think of it as a great benefit you are able to offer them to help keep them hydrated and give them calories they wouldn’t be getting otherwise. But if it goes on for any longer than an illness, it’s worth evaluating.
Extended breastfeeding will cause cavities
There is some research out there that supports this claim, but there’s also a lot that doesn’t. The bottom line with this is if your child is still nursing at night time after their teeth have erupted, you do want to be paying closer attention. Rinse their mouth out with water at least after nursing if brushing their teeth is impractical.
While I am all for letting your child nurse at night, if they have teeth it is definitely worth considering trying to have most of your nursing sessions during the day. Early childhood cavities are no joke and can be very painful. But there are things that can be done that allow you to continue breastfeeding without causing an increased risk for cavities.
Children need cow’s milk to meet their nutritional needs
Cow’s milk can provide a good source of fat for kids, as well as a good source of calcium and vitamin D if the milk is supplemented. But it is still not breastmilk! Breastmilk is designed by our bodies to give our children exactly what they need. No cow’s milk or alternative can do that, they just are an alternative that we have come to rely on when most people are no longer breastfeeding.
Breastmilk does not have as much calcium as cow’s milk, but there are many other ways to get calcium in foods that are not milk. Check out the Grow Baby Grow Ebook for extensive food lists and discussion of how to meet calcium, as well as other important nutrient needs, with food.
Breastmilk also doesn’t have vitamin D, but just like cow’s milk is fortified, you can add a single drop of vitamin D to your baby’s day that will cover all of their needs.
At the end of the day, cow’s milk is a replacement for breastmilk. Not the other way around!
How much breastmilk does my toddler need?
I hear from a lot of parents wanting to know how many times they should be nursing if they aren’t giving any other milks. The general guideline for this is nursing 3-4 times a day (i.e. a 24 hour period) will give your child all that they need from milk.
If you are nursing more than that, especially right around the age of 1, it is still fine. Make sure you are considering food their number one source of nutrients after they are a year, though. Some parents will need to cut back on nursing amount if their child is hesitant to eat a sufficient amount of food. If you are only nursing 1-2 times a day between the ages of 1-2, I would recommend supplementing with another milk.
How to supplement breast milk with other milk
The best way to figure out how much you should supplement is to use 4 oz as a number for each breastfeeding session. The recommended amount of cow’s milk (or an appropriate alternative) is 16 oz. So if you are nursing 2 times a day, consider that 8 oz, and supplement with another 8 oz of cow’s milk.
Obviously we don’t know exactly how much your child is drinking at each nursing session, but simply use this number to help us get a ballpark for supplementing. Remember, the longer your child nurses, the stronger their suck is! So a toddler who only is at the nipple for a few minutes is still likely getting a substantial amount of milk!
Using pumped breast milk
If you are giving your child pumped milk after 1, aim for the 16oz mark. But as it is breast milk, there is more leeway here to give a bit more. The best way to regulate is to make sure that food is their primary source of calories. If you are giving 24oz of pumped/frozen breast milk and they aren’t eating many solid foods, then it is time to look at giving less.
When should you give breast milk?
It can be hard to figure out when it is best to nurse your toddler. There is no right or wrong answer! Let their food intake be your guide here.
At one, we want food to be their primary source of nutrition and milk to become supplemental. Which means that if you are always nursing before meals, it's a great idea to try and switch over to nursing after a meal. But as those of us who nurse our older kids know, that doesn't always work. As long as their nursing is not causing an issue with them being willing to eat food, I recommend just going with it.
I for one always nursed my toddler in the morning 30-60 minutes before breakfast. If you were to follow guidelines specifically, we'd want to see nursing after meals once they turn one. But as it has never interfered with her ability to eat a full breakfast, it was never worth changing our morning ritual.
Again, there's no right or wrong answer here. Aim to have breastfeeding be secondary to food, and work with your child to figure out the rest.
When should you add supplemental milk to the schedule?
If you aren't nursing 3-4 times a day, you will likely want to attempt supplementing with another form of milk. If that's the case, simply serve the appropriate amount of the other milk at a meal(s). Continue to breastfeed as you are. If you are giving pumped breast milk, I would also recommend offering it at meals.
If you are trying to supplement milk for your breastfed toddler, know that many of them do not take easily to it. Keep trying, but also know that you can rely on other foods and forms of dairy to help meet their needs in many cases.
Breastfeeding and snacks
If your child is still breastfeeding a lot, they might take longer to transition over to needing 2 snacks a day after they turn one. Don't be surprised if it's closer to 15-18 months before they show any interest. Start with just one snack and offer it consistently. It may take them a while to realize that they are actually hungry.
You can use breastfeeding as a snack intentionally, but I prefer to see food snacks offered too and then top up with nursing. Just as if you were to offer cow's milk as a snack I'd want to see another food with it, too. As I said above though, there's no right answer. It's okay to do what works for you and your child as long as they are still predominately getting their calories from food.
How long do I need to give milk to my child?
The general guideline here is 2 years old. If you breastfeed until 2 and then wean, you do not need to introduce cow's milk to your child, or a plant based alternative. If you have a child who is still not eating much food at 2, you can consider starting another form of milk. But if you make it to two, it's okay to just rely on a well rounded diet after that!
The Bottom Line
Breast milk is hands down the best milk you can give your child, regardless of age. If you are willing and able to continue nursing after 1, or even just giving your child your stash of pumped milk, then do it! Don’t let anyone make you feel like it is an inferior choice, as it is actually an amazing and nutritionally beneficial option.
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