Extended breastfeeding facts

Extended breastfeeding in the United States is breastfeeding beyond 1 year of age. How long to continue breastfeeding for is a personal decision for each family to make. The American Academy of Pediatrics recommends breastfeeding as the sole source of nutrition for your baby for about 6 months and can be continued for as long as both mother and baby desire it. The World Health Organization (WHO) recommends exclusive breastfeeding (i.e. no other fluids or solids) for six months and then continued breastfeeding combined with solid foods for 2 years or as long as mother and baby desire. In the United States, most new moms (about 80 percent) start breastfeeding. More than half (about 58 percent) of moms breastfeed for 6 months. About one-third of new moms (36 percent) breastfeed for 12 months.

Your baby’s first tooth probably will appear after six months, though some babies are born with one or more teeth and in other cases teeth don’t appear until the child is almost a year old. Many mothers decide that it’s time to stop breastfeeding when they first notice a tooth. Usually this is because the baby has nipped the breast at the end of a feeding session or because the mother fears she will be bitten. Yet many babies with teeth (or those who are teething) never bite when breastfeeding. An actively nursing baby will not bite, because her tongue covers her lower teeth. A baby who nips the breast as he starts to pull away near the end of a feeding can be taught to stop. If your baby has sprouted a tooth and you are concerned that she may nip you as a feeding ends: Keep your finger ready to break the suction and remove your breast as soon as her rhythmic suckling stops (and before she starts to drift off or feel playful). If she has already bitten: Say no firmly and then remove her from your breast. Try to keep this action as bland and matter-of-fact as possible. Too much anger or even amusement may interest her enough to make her want to repeat the experiment again. Once she realizes that biting means no more breast, she will learn to stifle the impulse. (Meanwhile, don’t forget to offer her a one-piece teething ring when she is not nursing.)

If your child weans when she is ready, you can feel confident that you have met your baby’s physical and emotional needs in a very normal, healthy way. In cultures where there is no pressure to wean, children tend to breastfeed for at least 2 years. The World Health Organization and UNICEF strongly encourage breastfeeding through toddlerhood: ‘Breastmilk is an important source of energy and protein, and helps to protect against disease during the child’s second year of life.’ Human biology seems geared to a weaning age of between 2 and a half and 7 years. It makes sense to build your child’s bones from the breast milk that was designed for them. Your breast milk provides nutrients, anti-infective factors and other protective substances as long as your child continues breastfeeding. Mothers who breastfeed long- term have a still lower risk of developing breast cancer. Breastfeeding is a parenting factor which has been associated with child emotional development – in particular the attachment between children and their mothers. Breastfeeding eases both of you through the tears, tantrums and tumbles that come with early childhood. It helps ensure that any illnesses are milder and easier to deal with. It’s an all-purpose mothering tool you won’t want to be without. Don’t worry that your child will breastfeed forever. All children stop on their own, no matter what you do, and there are more breastfeeding youngsters around than you might guess.

Whether you breastfeed for a day or for several years, the decision to breastfeed your child is one you will never regret. And whenever weaning takes place, remember that it is a big step for both of you.

If you breastfeed your baby for just a few days, he will have received your colostrum, or early milk. By providing anti-infective factors (eg antibodies) and the food his brand-new body expects, breastfeeding gives your baby his first — and easiest — ‘immunization’ and helps get his digestive system working smoothly. Breastfeeding is how your baby expects to start and he is born with the instincts to help guide this process. It also helps your own body recover from the birth. Given how little it takes to offer it, and how very much your baby stands to gain, it makes good sense to breastfeed for at least a day or two, even if you plan to bottle-feed after that.

If you breastfeed your baby for 4 to 6 weeks, you will have eased him through the most critical part of his infancy. Newborns who are not breastfed are much more likely to get sick or be hospitalized, and have an increased risk of SIDS than breastfed babies. After 4–6 weeks, you’ll probably have worked through any early breastfeeding concerns, too. Make a serious goal of breastfeeding for a month, call the Breastfeeding Helpline or an international board certified lactation consultant (IBCLC) if you have any questions and you’ll be in a better position to decide whether continued breastfeeding is for you.

If you breastfeed your baby for 3–4 months, her digestive system will have matured a great deal, and she will be much better able to tolerate the foreign substances in formula. Giving nothing but your breastmilk for the first 6 months helps to protect against infections (eg ear, respiratory and gastrointestinal).

If you breastfeed your baby for 6 months without adding any other food or drink, you will help ensure good health throughout your baby’s first year of life, reduce your little one’s risk of infection, and reduce your own risk of breast cancer. Exclusive, frequent breastfeeding during the first 6 months, if your periods have not returned, provides 98% effective contraception. The National Health and Medical Research Council and the World Health Organization recommend waiting until about 6 months to start solids.

If you breastfeed your baby for 9 months, you will have nourished him through the period of his fastest and most important brain and body development on the food that was designed for him — your milk. Weaning may be fairly easy at this age … but then, so is breastfeeding! If you want to avoid weaning this early, be sure that, from the start, you breastfeed willingly to provide comfort, not just to provide food.

If you breastfeed your baby for 12 months, you can avoid the expense of formula. A one-year-old body can probably handle most of the family foods your family enjoys. Many of the health benefits this year of breastfeeding has given your child will last her whole life. She will be less likely to need orthodontic treatment and have a reduced risk of some childhood cancers such as leukemia. The National Health and Medical Research Council recommends breastfeeding for a year, or for as long as mother and baby desire, because it helps ensure normal nutrition and health for your baby.

How to prevent baby-bottle tooth decay

Once your baby’s teeth have begun to come in, it is important to keep in mind that even breastfeeding babies are sometimes susceptible to baby-bottle tooth decay, a major cause of dental cavities in infants that can also cause serious damage to permanent teeth later on. Baby-bottle tooth decay results from teeth being coated in almost any liquid other than water for long periods, and occurs most commonly among babies who are put to bed with a bottle of formula or juice.

Research shows that human milk by itself does not promote tooth decay. But breastfeeding infants who fall asleep while nursing with unswallowed milk in their mouths are also vulnerable to tooth decay. Beyond the first year, dental caries—tooth decay—can occur in toddlers who receive sugary liquids in a bottle or who are nursing and eating foods with sugar and carbohydrates. Make a point of removing your breast from your baby’s mouth once she has fallen asleep.

Tips to promote dental health from the start

Your pediatrician will check your baby’s teeth as part of the well-child visits during the first year of life and beyond.

• To stimulate healthy gums and good oral hygiene: Wipe the gums at least once a day, beginning at birth, even before any teeth have erupted in your child’s mouth.
• After teeth erupt: Wiping her gums and teeth with a piece of gauze or a damp cloth after feedings and before bedtime will help maintain good oral hygiene.
• Once you are able brushing: Start using a smear (grain of rice sized) amount of fluoridated toothpaste and a soft bristled, child-sized toothbrush for daily cleaning (two times per day).
  • Fluoride is an important way to protect your child’s teeth from cavities. Your pediatrician or dentist can help guide you on the optimal amount of fluoride for your child. It is important to use fluoridated toothpaste in the appropriate amounts for age, drink water with fluoride (most tap water), and have your child’s pediatrician or dentist apply fluoride varnish as needed.
• Try to take your baby to the dentist by age 1: You can form a relationship with your dentist to help keep your baby’s mouth healthy.

Benefits of extended breastfeeding

If you are still breastfeeding your child through his first birthday, you can congratulate yourself on having provided him with the best nutrition he could possibly receive. Now that he is consuming a wide variety of solid foods, your breast milk has become somewhat less critical from a nutritional perspective. Some toddlers continue to consume a moderate amount of breast milk (and thus the nutrients it contains), while others “graze” and ingest smaller quantities, getting most of their nutrition elsewhere. Certainly there is no known point at which breast milk becomes nutritionally negligible. What scientists do know is that as your child moves from babyhood toward toddlerhood, breastfeeding continues to act as a source of profound comfort and security, laying the groundwork for a confident, happy, and healthy future. For this reason, as well as the continued nutritional and immunologic benefits of breastfeeding, the American Academy of Pediatrics advises mothers to continue nursing beyond the first year for as long as mutually desired by mother and child ¹⁾.

If you breastfeed your baby for 18 months, you will have continued to provide nutrition, comfort, and illness protection for your baby, at a time when illness is common in weaned babies. Your baby is probably well established on family foods, too. He has had time to form a solid bond with you — a healthy starting point for his growing independence. He is now old enough that you and he can work together on the weaning process, at a pace that he can handle.

Benefits of breastfeeding for your baby

Breast milk is the best food for babies in the first year of life. It helps them grow healthy and strong and protects them from infections and illness. For example:

• Breast milk has hormones and the right amount of protein, sugar, fat and most vitamins to help your baby grow and develop.
• Breast milk has antibodies that help protect your baby from many illnesses. Antibodies are cells in the body that fight off infection. Breastfed babies have fewer health problems than babies who aren’t breastfed. For example, breastfed babies don’t have as many ear, lung or urinary tract infections. And later in life they’re less likely to be overweight or have asthma, certain cancers and diabetes (having too much sugar in the blood).
• Breast milk has fatty acids, like DHA (docosahexaenoic acid), that may help your baby’s brain and eyes develop.
• Breastfeeding can reduce your baby’s risk for sudden infant death syndrome (also called SIDS). SIDS is the unexplained death of a baby younger than 1 year old.
• Breast milk is easy to digest. A breastfed baby may have less gas and belly pain than a baby who is fed formula. Formula is a man-made product that you buy and feed your baby.
• Breast milk changes as your baby grows so he gets exactly what he needs at the right time. For example, for the first few days after giving birth, your breasts make a thick, sticky, early form of
• breast milk called colostrum. Colostrum has nutrients and antibodies that your baby needs in the first few days of life. It changes to breast milk in 3 to 4 days.
• Breast milk is always ready when your baby wants to eat. The more you breastfeed, the more milk you make.

Breastfeeding benefits your baby’s immune system

Human milk provides virtually all the protein, sugar, and fat your baby needs to be healthy, and it also contains many substances that benefit your baby’s immune system, including antibodies, immune factors, enzymes, and white blood cells. These substances protect your baby against a wide variety of diseases and infections not only while he is breastfeeding but in some cases long after he has weaned. Formula cannot offer this protection.

If you develop a cold while breastfeeding, for example, you are likely to pass the cold germs on to your baby—but the antibodies your body produces to fight that cold also will be passed on through your milk. These antibodies will help your infant conquer the cold germs quickly and effectively and possibly avoid developing the cold altogether.

This defense against illnesses significantly decreases the chances that your breastfeeding baby will suffer from ear infections, vomiting, diarrhea, pneumonia, urinary tract infections, or certain types of spinal meningitis. Infants under the age of one who breastfed exclusively for at least four months, for instance, were less likely to be hospitalized for a lower respiratory tract infection, such as croup, bronchiolitis, or pneumonia, than were their formula-fed counterparts. Even infants in group child care programs, who tend to catch more germs due to their close proximity, are less likely to become ill if they are breastfed or fed their mothers’ milk in a bottle.

All humans have a very large number of bacteria that normally reside in their intestines. Some of the bacteria serve normal and healthy functions, and some can cause disease such as diarrhea. Human milk encourages the growth of healthy bacteria in the intestinal tract of the breastfed baby. It does this by promoting a generally healthy environment and, in part, through substances called prebiotics, which are found in human milk. Since human milk stimulates the growth of these “friendly” strains of bacteria, other bacteria such as E. coli, which are more likely to cause disease, are inhibited from growing, multiplying, and attaching to the lining of the intestine, where they can cause infection. It has been well established that formula-fed infants have much higher rates of diarrheal diseases which may require visits to the doctor or sometimes to the hospital for intravenous fluids.

Breastfeeding and allergies

Breastfeeding is recommended for many reasons. With regard to allergy prevention, there is some evidence that breastfeeding protects babies born to families with a history of allergies, compared to those babies who are fed either a standard cow’s milk based formula or a soy formula. In these “at risk” families, breastfed babies generally had a lower risk of milk allergy, atopic dermatitis (commonly known as eczema), and wheezing early in life, if they were exclusively breastfed for at least four months. It is presumed that immune components in maternal milk provide protection against these allergic diseases. Although the long-term benefits of breastfeeding on allergies remains unclear and studies have not carefully evaluated the impact on families without a history of allergy, exclusive breastfeeding is recommended as the feeding of choice for all infants.

Other illnesses

Transfer of the human milk antibodies and other immunologic substances may also explain why children who breastfeed for more than six months are less likely to develop childhood acute leukemia and lymphoma than those who receive formula. In addition, studies have demonstrated a 36 percent reduction (some studies show this reduction to be as high as 50 percent) in risk of sudden infant death syndrome (SIDS) among babies who breastfeed compared to those who did not, though the reasons for this are not fully understood. Recent research even indicates that breastfed infants are less likely to be obese in adolescence and adulthood. They are also less vulnerable to developing both type 1 and type 2 diabetes.

Benefits of breastfeeding for mom

Release of good hormones

Many mothers feel fulfillment and joy from the physical and emotional communion they experience with their child while nursing. These feelings are augmented by the release of hormones, such as:

• Prolactin: Produces a peaceful, nurturing sensation that allows you to relax and focus on your child.
• Oxytocin: Promotes a strong sense of love and attachment between the two of you.

​These pleasant feelings may be one of the reasons so many women who have breastfed their first child choose to breastfeed the children who follow.

Health benefits

Breastfeeding provides health benefits for mothers beyond emotional satisfaction.

• Mothers who breastfeed recover from childbirth more quickly and easily. The hormone oxytocin, released during breastfeeding, acts to return the uterus to its regular size more quickly and can reduce postpartum bleeding.
• Studies show that women who have breastfed experience reduced rates of breast and ovarian cancer later in life.
• Some studies have found that breastfeeding may reduce the risk of developing type 2 diabetes, rheumatoid arthritis, and cardiovascular disease, including high blood pressure and high cholesterol.
• Exclusive breastfeeding delays the return of the mother’s menstrual period, which can help extend the time between pregnancies.

Note: Exclusive breastfeeding can provide a natural form of contraception if the mother’s menses have not returned, the baby is breastfeeding day and night, and the baby is less than six months old.

Maternal fulfillment

As welcome as all of these benefits are, though, most mothers put the feeling of maternal fulfillment at the top of their list of reasons for breastfeeding. Breastfeeding provides a unique emotional experience for the nursing mother and the baby. Breastfeeding is the one parenting behavior that only the mother can do for her baby, creating a unique and powerful physical and emotional connection. Your partner, the baby’s siblings, and other relatives can all appreciate the new member of the family being welcomed in such a loving way.​

Practical added bonuses

There are quite a few practical advantages to breastfeeding as well— bonuses the entire family can appreciate.

• Human milk is much less expensive than formula. During nursing you will need, at most, an extra 400 to 500 calories daily to produce sufficient milk for your baby, while formula can cost between $4 and $10 per day, depending upon the brand, type (powdered versus liquid), and amount consumed.
• At night, putting a baby to your breast is much simpler and faster than getting up to prepare or warm a bottle of formula. (Your partner can make night feedings even easier by changing the baby and bringing her to you for nursing.)
• It’s wonderful, too, to be able to pick up the baby and go out—whether around town or on longer trips—without having to carry a bag full of feeding equipment.
• Breastfeeding is also good for the environment, since there are no bottles to wash or formula cans to throw away.

Breastfeeding your toddler

Breastfeeding your toddler can provide ²⁾:

• 29% of his daily energy needs
• 43% of protein requirements
• 75% of Vitamin A requirements
• 60% of Vitamin C requirements.

How many breastfeeds?

Many new mothers wonder about how many times they should breastfeed their baby each day.

The answer is that babies vary a lot in terms of the number of breastfeeds they need in a 24-hour period. While it is common for babies to breastfeed 8 to 12 times in a 24-hour period, some babies may need fewer feeds and some more. A ‘breastfeed’ could be the baby feeding from one or both breasts, or from each breast more than once. Regardless of how many feeds a baby has in a 24-hour period, what is important to know are the signs of adequate milk intake.

The only true way to know how many feeds your own individual baby needs is to feed them when they need to feed. That is, by watching out for and responding to their feeding cues. The number of feeds in a 24-hour period depends on many factors. For example:

• The age of the baby. Younger babies tend to feed more frequently than older babies.
• A mother’s breast storage volume. This is the volume of milk a mother’s breasts can hold in between feeds. A mother may have a small storage volume, which means that her baby feeds more frequently than a baby whose mother has a large storage volume. However, this is only one factor as some babies of mothers with large storage volumes still need to feed frequently.
• The weather. In hot weather a thirsty baby may want to breastfeed more frequently but for shorter periods. This means they are getting more fluid.
• Babies may need comfort, reassurance and ‘connection’ with their mother, as well as breastmilk. Breastfeeding is much more than just the transfer of food.