If you are reading this thread I’m going to assume you’re approaching the six month mark and if that’s the case take a moment to congratulate yourself. You may have found the experience of breastfeeding pretty straightforward or you may have struggled – however you got here give yourself a pat on the back and take a moment to appreciate what you’ve experienced. Not every mum is lucky enough to be in your position of having the choice of whether to continue past 6 months.
Take a moment.
Now...
Many people have a goal of getting to six months because the benefits of exclusive nursing for the first half of your baby’s life are talked about quite widely but what about the next 6 months – or even beyond?
Your decision obviously will depend on your experiences. You may have been desperately counting down the weeks to get this far or perhaps you’re about to start back at work and can’t imagine how breastfeeding might continue. Or you may be having a great breastfeeding relationship and just wonder whether 6 months is the time when people are expected to stop.
Firstly, you need to make the choice that works for you and your family but it may help to know that feeding beyond 6 months will be a different experience – the intervals between feeds will get longer and you will have more flexibility about how you organise your day. If you have to go back to work, many mothers combine breastfeeding and working successfully. There are lots of tips about pumping on this useful site:
http://www.workandpump.com. You may choose not to pump during the day but remain breastfeeding when you are with your baby – mornings, evening and weekends. Many mums enjoy continuing to nurse in order to keep the closeness that breastfeeding can offer when they are otherwise away from their baby. It is possible to maintain a milk supply while offering only 1 or 2 feeds a day.
So what are the benefits of continuing to breastfeed?
(I’ve wanted to be clear about where my information has come from so apologies for all the references):
The practical stuff: For the first year of life milk plays the most significant role in baby’s diet. That means up until 12 months you will need to switch to formula milk if you are not breastfeeding (some doctors in other countries are prepared to suggest cow’s milk for under 12 months to drink but this is something you should never offer without discussing it with your doctor first). Formula milk is not cheap and bottle-feeding means many hours spent with bottle-brushes and sterilisers. It is also something that needs to be carried around as you go away from home whereas presumably your boobs are coming with you anyway!
Secondly, the health benefits for your baby. The American Academy of Pediatrics (AAP) in their breastfeeding statement say:
“It is recommended that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired” Source: http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b100/6/1035 AAP breastfeeding statement update at:
http://pediatrics.aappublications.org/content/129/3/e827.shortThe World Health Organisation (under the umbrella of the United Nations organisation) says
“infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond.”http://www.who.int/topics/breastfeeding/en/This advice is for mothers in the developed world as much as for developing countries.
Now if 2 years seems unlikely in your mind (!), let’s just focus on the next few months.
The WHO goes on to say:
“Breastmilk is the natural first food for babies, it provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one-third during the second year of life.
Breastmilk promotes sensory and cognitive development, and protects the infant against infectious and chronic diseases. Exclusive breastfeeding reduces infant mortality due to common childhood illnesses such as diarrhoea or pneumonia, and helps for a quicker recovery during illness. These effects can be measured in resource-poor and affluent societies”The benefits of breastmilk before 6 months in essence remain. It offers a wide range of nutritional benefits: In the second year (12-23 months), 448 ml of breastmilk provides:
o 29% of energy requirements
o 43% of protein requirements
o 36% of calcium requirements
o 75% of vitamin A requirements
o 76% of folate requirements
o 94% of vitamin B12 requirements
o 60% of vitamin C requirements
Dewey 2001
The protection against disease and illness also remains. The immunological ingredients in breastmilk have been found to remain high throughout the first and second years of breastfeeding (Goldman 1998; Goldman 1983) and bear in mind some aspects of the child’s immune system may not be fully functioning until 18 months (in the case of secretory IgA) or even beyond (Fitzsimmons 1994).
Breastfeeding for at least one year has been associated with better oral development. The dental arch is wider in the breastfeeding baby, because the mouth and tongue action differs. Breastfeeding has been associated with fewer speech problems (Broad and Duganzich 1983). Breastfeeding toddlers between 16 and 30 months old have been found to have fewer types and shorter duration of illness and to require less medical care than their non-breastfeeding age mates (Gulick 1986). The health benefits of having been breastfed as a infant continue into adulthood – recent research suggests if you were breastfed as a child this helps to reduce your chances of developing breast cancer.
Source: LLL breastfeeding answer book p.203
If your family suffer from allergies there may be particular benefit to you continuing to breastfeed: Many studies have shown that one of the best ways to prevent allergies and asthma is to breastfeed exclusively for at least 6 months and continue breastfeeding long-term after that point (ref. below).
Breastfeeding can be helpful for preventing allergy by: reducing exposure to potential allergens (the later baby is exposed, the less likely that there will be an allergic reaction), speeding maturation of the protective intestinal barrier in baby's gut, coating the gut and providing a barrier to potentially allergenic molecules, providing anti-inflammatory properties that reduce the risk of infections (which can act as allergy triggers).
There are benefits of continuing for mother’s health too. There is a direct relationship between the length of time you breastfeed and your chance of developing breast cancer (ref. below). It also reduces the risk of uterine cancer and ovarian cancer, osteoporosis and rheumatoid arthritis.
All that information is probably quite overwhelming. As said in the book, “So that’s what they’re for” - if you plan to continue,
“science is definitely on your side” (p.323). However the decision isn’t just about science it’s about the life of your family as whole.
For me, choosing to continue beyond 6 months and beyond a year I can honestly say has been one of the best decisions of my life. However, not everyone is lucky enough to have such a positive breastfeeding experience. Your mothering is about all of you – not just your milk. It is often said on this site that a happy mother helps to make a happy baby. But remember breastfeeding doesn’t have to be all or nothing for an older baby. If you feel you need to introduce formula even just one breastfeed a day has clear benefits. Just don’t rush into the decision to wean as it may be difficult to go back if you regret it. At the end of the day your mommy instincts will help you make a decision that is right for you. Whatever you choose feel justifiably proud of having reached 6 months - Well done!
Some references:
Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002 Jul 20; 360(9328): 187-95.
Barba M, et al. Premenopausal women who were heavier than average at birth or had not been breastfed as infants appear to be at increased risk for developing breast cancer. Reported at the American Association for Cancer Research 2005 annual meeting in Anaheim, CA.
Allergies:
Hanson LA, Korotkova M, Telemo E. Breast-feeding, infant formulas, and the immune system. Ann Allergy Asthma Immunol. 2003 Jun;90(6 Suppl 3):59-63.
