American Academy of Pediatrics - Extended Breastfeeding

[Guest guest]

Sorry this is taken off the course of yoga and the original question, but I feel

the need to post this informational article for anyone who joins in the future

and reads this thread.

 

Thank you.

 

The following is taken from Pediatrics: The Official Journal of the American

Academy of Pediatrics. You may read the entire article here:

http://pediatrics.aappublications.org/cgi/content/full/114/5/S2/1506 along with

the doctor's references.

 

You may also find more information on the topic at www.kellymom.com

 

In responding to Matthew's mother, several factors should be considered to help

her make an informed decision. The benefits of breastfeeding, especially beyond

1 year of life, her own feelings about extending the period of breastfeeding,

and Matthew's needs in relationship to his developmental level should be

considered. It is often helpful to discuss breastfeeding duration in a

historical and cultural context.

 

Breastfeeding beyond 1 year of age is considered extended breastfeeding in the

United States, and as the term " extended breastfeeding " implies, it is not the

customary practice. The age of weaning, however, ranges from 2 to 4 years in

many societies around the world. For example, in Guinea Bissau, West Africa, the

median time for weaning is 22.6 months,1 and mothers in India frequently

breastfeed their infants until 3 or 4 years of age (Anne Seshadri, personal

communication, 2002). Ancient Greeks, Hebrews, and Muslims all recommended

breastfeeding of infants for 2 to 3 years as found in the writings of Aristotle,

the Talmud, and the Koran.2–4 In sharing this information with Matthew's mother,

you allow her to view extended breastfeeding in a broader context.

 

Breastfeeding in the first year of life is protective against numerous

infections and the development of allergies.5 There is limited but increasing

evidence that breastfeeding beyond 1 year is also beneficial to the health of

the child and, possibly, the mother. The duration of an episode of otitis media

is shortened in children who are breastfeeding after 1 year of age.6 This

finding is consistent with the data that concentrations of lysozyme,

lactoferrin, and secretory IgA are stable and even increase in the breast milk

of mothers who are breastfeeding for longer than 1 year.7 Preliminary studies

suggest that extended breastfeeding may be protective against childhood lymphoma

and leukemia.8,9 Evidence is now accumulating that increasing duration of

lifetime breastfeeding reduces the risk of premenopausal breast cancer in the

mother.10,11 Reports that some children breastfed beyond 1 year were at

increased risk for malnutrition have been discredited because of poor study

designs.12 Most experts agree that, as long as a breastfeeding toddler is eating

a variety of grains, vegetables, fruits, and foods or supplements that provide

adequate iron and vitamin D, nutrition will be adequate and appropriate growth

and development will be ensured.

 

An important factor in helping Matthew's mother make her decision is an

understanding of her feelings about continuing to breastfeed. Often mothers in

her situation are subject to criticism from friends or family members who

intimate or state that Matthew is too old to breastfeed and that " he should be a

big boy. " Matthew's mother may feel guilty at this suggestion; however, she and

Matthew may enjoy the times they breastfeed at home in a quiet place.

 

Matthew is breastfeeding for comfort and reassurance in unfamiliar situations.

These are the same situations that are socially awkward for his mother to

breastfeed. One approach to this problem is to encourage Matthew's mother to

speak reassuringly to Matthew, encourage the use of a favorite blanket or

stuffed animal as a comfort object, and tell him they will " nurse " or

" breastfeed " at home. Toddlers of Matthew's age typically have ample receptive

language skills, even if their expressive vocabulary is limited; they understand

when spoken to in simple and concrete terms. Establishing routine times and

places, preferably in the home, will also make it easier for Matthew to

understand that he can no longer breastfeed on demand, especially when out in

public places.

 

Matthew's mother may also wonder when and how she will ever wean him if she

continues to breastfeed. A survey of 134 mothers who were attending a La Leche

League conference and who had breastfed beyond 1 year indicated that they weaned

gradually and described the process as child-led. The average age of weaning was

36 months in this group.13 In India, women often wean their 3- or 4-year-old by

putting the juice of a bitter gourd or melon on their nipples. The child

dislikes the taste and quickly gives up breastfeeding (Anne Seshadri, personal

communication, 2002).

 

For many mothers and toddlers, the major advantage of extended breastfeeding may

be found in their emotional well-being. A toddler is often competing for his or

her mother's attention in a very busy and harried life. A mother in my practice

who breastfed 2 children until 2 years of age explained that she would slow down

and give her undivided attention to her child several times each day when

breastfeeding. Her children knew that she always had time for those moments each

day. This time was also important to the mother for relaxing and unwinding.

 

I would encourage Matthew's mother to continue to breastfeed at home or in quiet

and private places. I would also suggest offering a comfort object such as a

blanket or a stuffed animal when Matthew needs a hug and something to hold onto

when it would be awkward for her to breastfeed. I would review Matthew's diet,

consider prescribing a vitamin D and an iron supplement, and review good dental

hygiene, including brushing the teeth before bedtime, and I would discourage

breastfeeding throughout the night. Finally, I would encourage Matthew's mother

to continue to breastfeed for as long as she and Matthew feel that it is right

for them.