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Ask Anne...
Question:
What are the benefits of nursing beyond the first year?
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 beyond a year? I understand the benefits
of nursing your baby until twelve months, but am curious as to the reasons
for nursing beyond that. Sorry if this is a stupid question.
Answer:
This is not a stupid question at all. 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. Once they reach that milestone,
they often find that they want to continue nursing for a variety of reasons.
Of course, many mothers never reach their target breastfeeding goal to
begin with, primarily due to lack of information and support.
In the US, 64% of mothers initiate nursing at birth, but
only 29% are still nursing at six months, and 16% at one year. This is
in spite of the factthat 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" breastmilk 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 breastmilk.
Breastmilk 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 others 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 six to nine 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". Breastmilk 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.
Breastmilk 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. Breastmilk 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 30% 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
tocomfort him. Often a sick child will accept breastmilk 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 (see article “Why
Breastfeed?” for more details).
-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.
There are several articles on my website that have more
detailed information about the benefits of extended breastfeeding and
weaning: "Why Breastfeed?", "Weaning", and "Benefits
of Breastfeeding: How They Add Up".
I hope that you decide to nurse your son for at least the
first year. There are so many reasons to continue nursing.
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 bugging
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 if that’s what feels right
to you. It is the lucky baby in this country who gets to nurse past six
months or a year, so do what you are comfortable with, 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.
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Anne" Columns
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