Breastfeeding may not always be easy at first, but as the months go by many mothers find it is an important and enjoyable part of their relationship with their child, one neither of them is ready to bring to an end quickly. However, society is not always accepting or understanding of mothers nursing older children and women can find themselves under pressure from others who feel breastfeeding beyond infancy will be in some way detrimental.
Sometimes mothers worry that they need to stop breastfeeding and have a number of questions and concerns about “full-term” breastfeeding and the criticisms they face. This article addresses some of them.
At what age “should” a baby be weaned?
There is no definite age at which a baby will wean: just as with other areas of development, there is a wide range. Some babies will need the comfort of breastfeeding much longer than others and ideally nursing will continue until both mother and baby feel the time is right to wean. This can’t always happen and sometimes a mother needs to wean earlier, but if the nursing dyad is happy, there is no reason to stop.
Historically, until relatively recently, “extended” – or to better describe it “full-term” – breastfeeding was the cultural norm. According to anthropologist Kathy Dettwyler, in societies where children are allowed to nurse as long as they want, self-weaning usually happens between 3 and 4 years of age. Her research on breastfeeding duration in non-human primates (based on a number of variables such as length of gestation, weight gain, age at sexual maturity and dental eruption) places the natural duration of breastfeeding in modern humans between 2.5 and 7 years.
For example, Dr. Dettwyler explains how, according to one study, weaning in non-human primates’ offspring happened when they had reached about one third of their adult weight, which happens in humans at about 5-7 years. An analysis of weaning age and sexual maturity in non-human primates also suggests a weaning age of 6-7 years for humans (about half-way to reproductive maturity).[i] Dr. Dettwyler also says: “Many primates wean their offspring when they are erupting their first permanent molars. This occurs around five-and-a-half to six years in modern humans around the same time as achievement of adult immune competence suggesting that throughout our recent evolutionary past the active immunities provided by breastmilk were normally available to the child until about this age.”[ii]
Is it harmful to continue to breastfeed?
On the contrary, breastfeeding continues to provide comfort, security and protection against illness for as long as it continues.
The American Academy of Pediatrics states that increased duration of breastfeeding confers significant health and developmental benefits for the child and mother.[iii] These extend well beyond the period of breastfeeding and there is evidence that the longer a baby is breastfed the greater the protection from ill health and the more positive the impact on long-term health for both mother and baby.[iv]
The Academy of Breastfeeding Medicine states: “Claims that breastfeeding beyond infancy is harmful to mother or infant have absolutely no medical or scientific basis.”[v]
Can prolonged breastfeeding cause infertility?
As a baby grows older, he usually starts nursing less or having longer breaks between feeds and this often coincides with the mother’s own recovery from birth. A high-need or fragile child may nurse more frequently, and this can contribute to temporary infertility which ensures the baby is fully ready for a sibling.
Fertility usually returns around the time periods return, so if they haven’t returned and a mother is ready to for another pregnancy she may want to consider cutting out night nursing or having longer breaks between feeds. This will often kick-start fertility. An older toddler is unlikely to be feeding two-hourly.
A short luteal phase – from the day after ovulation until a period starts – can affect fertility. This is associated with high levels of prolactin and a doctor might be able to prescribe progesterone supplements to correct this.[vi]
If a mother needs to take fertility medications, there is usually no need to wean because most are safe for breastfeeding. Although treatment may be less effective, it’s a personal decision to weigh up a baby’s need for breastfeeding against the wish to have another baby right away.[vii]
Suckling has become painful
Babies are usually pretty good at adjusting their latch as they grow and their teeth come through, and many babies never bite. Sometimes they need to learn how to adjust the way they nurse and if they occasionally forget, there are suggestions which can help. A baby can’t bite while actively sucking.
Sometimes mothers find they have sore nipples when they are feeding an older baby and there may be many causes for this – a chipped tooth, food sensitivities or a gymnastic nursing baby! Sore nipples at this stage tend to heal quickly once the cause is found and it’s possible to chat to a baby of this age, explaining it hurts and asking her to be gentle.[viii]
Am I making my child too dependent on me?
It’s a common misconception that nursing an older child makes him less independent; we know of no evidence to support the comments that breastfeeding an older child leads to over-dependence on the mother.
It’s not possible to force a child to be independent before he is ready. In fact independence, not dependence, is one outstanding trait that breastfed children who self-wean have in common.[ix] Natural weaning reflects differences in children and it’s a natural process for children to outgrow breastfeeding on their own, at their own pace. When a child weans gradually he feels emotionally attached to his mother for his comfort and security. Many weaned toddlers and pre-schoolers continue to have a need to suck for comfort, as shown by the continued use of a dummy or thumb, as well as the attachment to an inanimate object like a cuddly toy or a blanket.
Breastfeeding provides feelings of love, comfort, and protection. When a mother is there to nurse her child through a situation that he can’t handle alone, he will likely develop independence based on faith that his mother will be there to help.[x] Allowing a child to nurse (or wean) at his own pace is an expression of trust that contributes to his self-esteem.[xi] Breastfeeding mothers benefit from being near their children, and children love the comfort and security that comes from being close to their mothers.
Mothers are sometimes told they will “spoil” their children by responding to them but in fact it’s been found that when mothers respond to their children they are less likely to cry.[xii] When babies are small their “wants and needs” are the same thing. As a child grows he can’t always tell the difference between what he wants and what he needs, but knowing his mother is there for him helps him feel secure and to learn with kindness how to respond.[xiii]
I’d like a bit of time to myself
Mothers of young children are often urged to separate from them and being “too attached” is sometimes seen as a negative. Strong attachment to a parent is a normal need that is part of children’s development.[xiv] It is perfectly normal for children to like being close to their mother; they will grow to be independent by feeling secure, not through forced separation.
Over the past few decades, many eminent child psychologists have found that children thrived better if parents acknowledged their offspring’s feelings and understood the need for attachment. Communicating with children about how they feel has been found to lead to a better relationship than an authoritarian approach.[xv]
English psychiatrist Dr. John Bowlby developed the concept of “attachment theory” according to which a warm, close, enjoyable and continuous relationship with a child’s mother (or permanent mother-substitute) has a positive effect on a child’s well being.[xvi]
Older nurslings are usually able to cope well with their mother doing other things and to understand how their relationship works, because they know they feel secure. There is no reason why a mother can’t have some time to herself while still enjoying their breastfeeding relationship.
If a mother returns to paid work her older nursling is usually able to adapt well to being away from her, in the knowledge that when they are both home again he will have the comfort of breastfeeding. Mothers enjoy that special reconnection too.
You can read more about separation here:
Doesn’t my child need to learn to “self-soothe”?
It is interesting that the term “self-soothe” is so often used as something children need to learn, when it was actually a word invented in the 1970s during research undertaken by Dr. Thomas Anders of the University of California, Davis Medical Center. He used it to describe children who went to sleep on their own after waking, as a contrast with babies who cried when they woke up. He called this “signaling”. He wasn’t trying to say self-soothing was something to aim for, but the description has come to be adopted as a fact rather than a research term, with far more meaning than was intended.
When a child is left to cry himself to sleep, there is no way of knowing if, when they stop crying, they have fallen asleep or have simply gone into a “withdrawn” state where they have given up hope of being responded to.[xvii] While babies may indeed stop crying if left unattended long enough, they are not learning to “self-soothe”, they are simply giving up on the hope that comfort will come.
It’s acknowledged that adults in relationships enjoy being close to each other and sleeping in the same bed. It is comforting to wake in the night and feel the presence of someone we love next to us. This raises the question of why babies or children should be expected to sleep alone, left to cry and “self-soothe” when adults aren’t.
Will still breastfeeding mean he won’t eat enough solid food?
Nearly all babies can make the gradual adjustment to eating solid food without any trauma, while continuing with the comfort of breastfeeding. Mothers are sometimes told that the longer they breastfeed, the harder it will be to transition their child to solid foods. We know of no evidence to support this, as most babies will be ready for solids sometime after six months of age. Just because a baby continues to breastfeed doesn’t mean he isn’t eating other food too. Breastfeeding a toddler is very different from nursing a newborn.
The World Health Organization (WHO) recommends mothers worldwide to exclusively breastfeed infants for the first six months of their life in order to achieve optimal growth, development and health. It also recommends that infants continue to be breastfed for at least two years, and as long as mutually desired, while being given nutritious complementary foods.[xviii]
Can prolonged breastfeeding cause malnutrition and low energy?
The physiological process of weaning is complex and involves microbiological, biochemical, nutritional, immunological, and psychological adjustments for both mother and child.[xix]
Most importantly, during the weaning process the composition of human milk adjusts to meet the needs of the growing child so that, although the volume is decreasing, an appropriate level of nutrients remains present and immunological protection is not compromised.[xx][xxi]
If an older child is being offered a variety of healthy foods alongside breastfeeding, there is usually no cause for any concern. It’s often overestimated how much food a young child needs, and children who have stopped breastfeeding can also have small appetites. There is some evidence to show that breastfeeding might protect against obesity by helping a child to better regulate their food intake.[xxii]
Breastmilk is also invaluable when an older child is unwell and can’t take solid foods.
I’m ready to stop but my child isn’t
There are often ebbs and flows in a breastfeeding relationship. Sometimes older children can have times of intense need when, after having reduced how much they nurse, they suddenly seem to want to breastfeed a lot; sometimes mothers can feel overwhelmed by this and ready to stop nursing. If this happens, it is worth thinking about anything which might have unsettled the child – such as a change in family life, a move, more hours spent at nursery – and trying to meet the increased need for a while. Children often sense when their mother is no longer happy with the nursing relationship and this can make them feel insecure and even more interested in breastfeeding.
It can seem like life would be much easier without nursing, but it’s important to remember that even after weaning, your child will still need to be comforted, may still wake up at night, and will still need a lot of attention. Having a bit of time to yourself doing something you enjoy (like taking a bath, reading a book, going to an exercise class or taking a walk) while a trusted friend or family member plays with your child can be really helpful.
Spending time with like-minded mothers who understand how you feel and support you in your choices can make a big difference. Filling up our own “emotional reservoir” is very important to be able to meet the needs of our children.
Nursing is a relationship between two people and if it no longer feels right to you and you really want to stop breastfeeding, there are lots of gentle ways to wean your child. For example, some mothers choose to wean during the day but still nurse at night, or vice versa. Older children are surprisingly good at understanding and adapting to new nursing routines.
You can find lots of ideas about gentle weaning here:
I’m pregnant, do I need to stop breastfeeding?
Very rarely does a mother need to wean her child to maintain a pregnancy. With uncomplicated pregnancies, there is no need to wean and nursing will not harm the growing foetus.[xxiii] Women are sometimes told that the release of oxytocin during breastfeeding will stimulate uterine contractions resulting in early labour. However, oxytocin can be released for other reasons (such as orgasm and extreme happiness) which women aren’t cautioned against.
It’s not unusual for nursing mothers to feel some nipple tenderness or pain during early pregnancy. Later on, it’s very common for mothers to feel impatient when nursing their older child, also because a drop in their milk supply may make it uncomfortable to feed. This seems to be nature’s way of putting the new baby first, even though nursing doesn’t have any harmful effects on the growing foetus.[xxiv]
Whether to wean or not is a very individual decision. Some mothers decide to overcome any discomfort because they know nursing is so important to their child, particularly if he’s still young; others feel it is better to gradually wean. Some mothers wean during pregnancy, but start nursing the older child again after the baby is born. The “don’t offer, don’t refuse” weaning method is a good way to assess if a child is ready to wean. Some older children choose to wean as they lose interest due to the lack of milk or change in its taste.
A useful book on this subject is Adventures in Tandem Nursing: Breastfeeding during Pregnancy and Beyond by Hilary Flowers.[xxv] The Australian Breastfeeding Association booklet on Breastfeeding through Pregnancy and Beyond is also helpful.[xxvi]
You can find more information on this topic here:
What if my child starts asking “awkward questions” about nursing?
Sometimes mothers are told that if a child is old enough to ask to breastfeed then they are too old to do it. However, many mothers find nursing a child who is old enough to articulate a source of great joy. It can be a cause of happiness and contentment for both. Older nurslings often make both amusing and heart-warming comments about their need to breastfeed. Many a mother has got to the end of a difficult day and then sat down and nursed her child and been overwhelmed with love for her little one. It’s a great way to relax for both of you.
If they can ask, they can also understand that it might not always be appropriate to nurse. Many older babies are happy to nurse at home for quick “comfort stops”, unlike a younger child who needs to nurse straight away. Even if a toddler is so distressed that he needs to nurse quickly, mothers are great at finding ways to do this while out and about. It can be useful to have a family name for nursing that a child can use when out that allows for discreet toddler nursing if desired.
The sexualisation of breasts in today’s society can mean that mothers are sometimes warned that continued nursing might have future consequences for older nurslings, such as overstimulated sexual feelings. Sometimes mothers worry if their little boy has an erection when he is nursing. This is perfectly normal, can also happen during cuddling and can be ignored. Responding warmly to a child’s needs will add to his future security, not harm him.[xxvii]
Other people’s criticism is hard to cope with
It can be hard to deal with negativity and criticism from others, especially well-meaning relatives. A lack of understanding about why a child might continue to breastfeed can lead to people, even strangers, making hurtful and misinformed comments.
It can be especially hard if a partner no longer feels comfortable with an older child breastfeeding. Sometimes, when children are walking and talking and still nurse, partners worry that they may be too dependent on you.
It can help to listen to how your partner feels and to talk about why nursing is still important for you and your child, explaining how breastmilk is still nutritious, protects from illness and gives comfort and security. What seems like a long time now, will only be a short part of the childhood years. Sometimes it can be helpful for partners to talk to others whose children have nursed for longer, or to see children who have fed for a long time and are now outgoing and independent.
You can read more about dealing with criticism here:
Acceptance and support
Ideally, how long to breastfeed will be a mutual choice for each mother and baby. However, in order to breastfeed for as long as they intend, women need accurate information and appropriate help, as we work towards creating a society which accepts and supports breastfeeding as the norm for as long each mother-baby dyad wishes to continue.
Finding like-minded mothers, knowing you are not alone, that you are doing the right thing for you and your child and feeling supported in that choice, can make all the difference. It can give a mother the confidence to listen to the needs of her own child and not feel pressured by a society which may have different expectations as to how babies and toddlers behave. La Leche League group meetings are great places to find mothers who understand why some children breastfeed for longer than others.
You can find your nearest LLL group here:
Written by Anna Burbidge for LLLGB, April 2018
Further reading: Mothering Your Nursing Toddler by Norma Jane Bumgarner
[iii] American Academy of Pediatrics, Breastfeeding and the Use of Human Milk. Pediatrics, 2012; 129 (3). Available from: http://pediatrics.aappublications.org/content/129/3/e827 (accessed 6 February 2018).
[iv] The Lancet Breastfeeding Series Group. Breastfeeding in the 21st Century: epidemiology, mechanisms and lifelong effect. (Breastfeeding Series 1). Lancet, 2016; 387: 475-90. Available from: www.thelancet.com/series/breastfeeding
[v] Academy of Breastfeeding Medicine. ABM affirms breastfeeding beyond infancy as the biological norm. 15 May 2012, https://bfmed.wordpress.com/2012/05/15/abm-affirms-breastfeeding-beyond-infancy-as-the-biological-norm/ (accessed 6 February 2018).
Chantry, C.J. et al., ABM Position on Breastfeeding—Revised 2015. Breastfeeding Medicine, 2015; 10 (9): 407-411. Available from: http://www.bfmed.org/assets/DOCUMENTS/abm-position-breastfeeding.pdf (accessed 6 February 2018).
[vi] La Leche League International. The Womanly Art of Breastfeeding. 8th Edition, 2010; 322.
[vii] La Leche League International. The Womanly Art of Breastfeeding. 8th Edition, 2010; 388.
[viii] La Leche League International. The Womanly Art of Breastfeeding. 8th Edition, 2010; 199.
[ix] Ferguson, D.M. et al. Breastfeeding and subsequent social adjustment in six- to eight-year-old children. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 1987; 28: 378-86.
[x] Bumgarner, N.J. Mothering Your Nursing Toddler. Schaumburg, IL: La Leche League International, 2000.
[xi] La Leche League International. New Beginnings, May-June 2006.
[xii] Bell, S.M., Ainsworth, M.D. Infant Crying and Maternal responsiveness. Child Development 43, No 4 (1972): 1171-1190.
[xiii] La Leche League International. The Womanly Art of Breastfeeding. 8th Edition, 2010: p 130
[xv] Ginot, H. Between Parent and Child. New York: Three Rivers Press, 1965.
[xvi] Bowlby, J. The Nature of the Child’s Tie to His Mother. International Journal of Psycho-Analysis, 1958; 39: 350-373.
[xvii] Infant Sleep Information Source. Things to Consider – Potential Costs of Sleep Training. 3 December 2017, https://www.isisonline.org.uk/how_babies_sleep/sleep_training/considerations/ (accessed 6 February 2018).
[xviii] World Health Organization. Exclusive breastfeeding for six months best for babies everywhere. 15 January 2011, http://www.who.int/mediacentre/news/statements/2011/breastfeeding_20110115/en/ (accessed 8 February 2018).
[xix] Highton, B. Weaning as a Natural Process. LEAVEN, 2000-01; 36 (6): 112-114.
[xxi] La Leche League International. The Womanly Art of Breastfeeding. 8th Edition, 2010; 191.
[xxii] La Leche League International. The Womanly Art of Breastfeeding. 8th Edition, 2010; 6.
O’Tierney, P.F. et al. Duration of breast-feeding and adiposity in adult life. The Journal of Nutrition, 2009; 139 (2): 422S-425S.
[xxiii] Flower, H. Breastfeeding during Pregnancy and Tandem Nursing: Is it Safe? Recent Research. Breastfeeding Today, 11 April 2016. Available from http://breastfeedingtoday-llli.org/breastfeeding-during-pregnancy-and-tandem-nursing-is-it-safe-recent-research/ (accessed 24 April 2018).
[xxiv] La Leche League International. The Womanly Art of Breastfeeding. 8th Edition, 2010; 321.
[xxv] Flower, H. Adventures in Tandem Nursing. La Leche League International, 2003.
[xxvi] Australian Breastfeeding Association. Breastfeeding through pregnancy and beyond. July 2015, https://www.breastfeeding.asn.au/bf-info/breastfeeding-through-pregnancy-and-beyond (accessed 24 April 2018).
[xxvii] Diamond, S. Still Nursing? La Leche League International Information Sheet; 1982.