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Full Term Breastfeeding

posted Jul 2, 2015, 12:42 PM by Carolyn Honea, IBCLC, CLC   [ updated Jun 1, 2017, 2:20 PM ]
The old weaning joke is that "no child goes to college still breastfeeding." In other words - everybody weans from breastfeeding eventually. All children gradually lose interest in breastfeeding and self-wean. But many wonder how long is long enough - and how long is too long? We can look at historic norms, present day cultures around the world, and scientific knowledge to help us figure out how long nature intends for human mammals to breastfeed. In the lactation world, we refer to this as Full Term Breastfeeding. (Just like a baby born near his due date is considered "full term"...not pre-term or premature...we use the same language for breastfeeding duration.) Babies have the best outcomes when they are born full term and also breastfeed full term. 

Historic Cultural Norms
If breastfeeding didn't "work" for our ancient relatives millennia ago, humans wouldn't have survived. In the rare case of lactation failure, wet nurses filled in the gap. Breastmilk truly kept young children alive before bottles and formula ever existed. Most ancient cultures co-slept with their babies and practiced very frequent breastfeeding with almost constant breast access. Studies of ancient civilizations seem to indicate a range of 2-7 years of breastfeeding as the norm. Many cultures had special ways of celebrating a child's weaning as an important childhood event. [Dig Deeper]

Present Day Norms
In the United States, babies are breastfed for an average of 3 months, with only 27% of US babies still breastfeeding at 12 months. Short breastfeeding duration became increasingly common after the Industrial Revolution when doctors started promoting bottles and new artificial milks made from "formulas." Weaning ages vary widely in other parts of the world, with the longest breastfeeding rates seen in traditional cultures and shortest rates in western cultures. According to Katherine Dettwyler, an anthropologist who studies breastfeeding, "It is true that there are still many societies in the world where children are routinely breastfed until the age of four or five years or older, and even in the United States, some children are nursed for this long and longer. In societies where children are allowed to nurse 'as long as they want' they usually self-wean, with no arguments or emotional trauma, between 3 and 4 years of age." [Dig Deeper]

Scientific Knowledge
Many researchers have tried to use scientific data to come up with the "natural" weaning age. Often they look at mammal primates to see how long they nurse their young compared to their pregnancy length, baby's size, mother's size, age of starting other foods, etc. When this data is put in human terms, it usually concludes a full-term weaning age is around 3 years, although this can vary widely. Studies confirm that young children continue to gain many benefits from breastfeeding. For example, a toddler's immune system is still developing and is protected by continuing to receive the immune boosting antibodies in breastmilk. Many mothers report behavioral and relational benefits to breastfeeding their young children. Because of the scientific data, the American Academy of Pediatrics recommends breastfeeding at least one year, "or longer as mutually desired by mother and infant." The World Health Organization recommends breastfeeding at least two years or beyond. [Dig Deeper]

Setting a Personal Goal
Its often helpful to start with the knowledge of what is normal historically and in other cultures (breastfeeding for several years) and what is the currently recommended minimum (at least 1-2 years) when trying to set personal breastfeeding goals. But just because extended breastfeeding is "normal," doesn't mean you should feel pressure to breastfeed for years instead of months. Modern mothers are blessed with many choices, including the ability to provide safe, nutritious food for their babies in place of breastmilk. You can take into account your lifestyle, support system, and personal preferences when deciding how long to breastfeed. It helps to have a goal in mind so that if/when difficulties come up, you'll be motivated to seek help to ensure you reach your goals. If you are feeling particularly nervous about breastfeeding, a reasonable starting place may be a goal of exclusive breastfeeding for two months and then reevaluate once you get there. For others who are confident and excited to breastfeed, having a goal of breastfeeding at least 12 months and then reevaluating is wonderful. Its important to define "successful breastfeeding" as a woman reaching her personal breastfeeding goals, and acknowledging that it is going to look very different for each of us. (Read here about my personal story of my last baby weaning from breastfeeding.)




Further Reading (see also Dig Deeper links above):