Extended breast-feeding: How old is too old?

Shanna Garvey with her 4 1/2-year-old son and 21-month-old daughter. (image courtesy subject)

Shanna Garvey knew about the health benefits of breast-feeding her son when he was an infant, yet she continued beyond those years— until he was nearly 3 years old— in order to keep him calm in anxiety-inducing social experiences.

“It would be his way of coping with situations that weren’t comfortable for him,” Garvey, 39, of Massachusetts, said

Although the stay-at-home mom was happy to provide what she knew her son needed, she dealt with a lot of critical questions and comments from family, friends and other moms in parenting groups about how long she intended to breast-feed. Some would say, “He can tell you when he wants to nurse? Then you need to stop nursing.”

Although she felt embarrassed answering their questions, she never felt ashamed nursing her son on-demand everywhere and anywhere they went.

“He became a fixture on my hip,” she recalled.

Health benefits of breast-feeding

In many other countries, extended breast-feeding beyond the first year is much more common than it is in the United States, where 49 percent of moms breast-feed for 6 months and only 27 percent are doing so at a year, according to the Centers for Disease Control and Prevention (CDC).

The American Academy of Pediatrics recommends exclusive breast-feeding for the first 6 months and breast-feeding along with solids foods up to a year. Beyond the first year, they recommend breast-feeding should continue for “as long as mutually desired by mother and child.”

The World Health Organization recommends breast-feeding up to 2 years and beyond.

A common myth is that breast milk isn’t necessary after the first year, yet the truth is that the health benefits of breast-feeding during the toddler years are the same as those during infancy: less likelihood of allergies and asthma, a higher IQ and a strong immune system, especially because children’s immune systems do not become fully developed until years beyond toddlerhood.

“There’s no point at which you can’t say, ‘There’s no value to this,’” said Dr. Joan Meek, chair of the American Academy of Pediatrics’ section on breast-feeding and a professor of clinical sciences for the Florida State University College of Medicine.

Although the composition of breast milk itself doesn’t change as a baby gets older, the protein concentration in breast milk does slightly decrease after babies turn 9 months old and are eating high-protein solid foods.

“When breast milk is no longer the sole component of the diet, the protein needs aren’t as great,” Meek said.

Likewise, extended breast-feeding can also help moms reduce their risk for breast and ovarian cancers, heart disease and possibly ward off osteoporosis.

“The more total months of breast-feeding that a mother does throughout her lifetime, the greater the protection,” Meek said.

Although critics think extended breast-feeding is strange and will negatively affect children when they’re older studies show that children who are breast-fed into the toddler and preschool years have no adverse psychological effects.

Quite the contrary, extended breast-feeding can help children feel that their needs are being met, their mother is close by and a source of comfort. In fact, studies show that children who breast-feed into the toddler years develop a greater sense of security and confidence to explore their worlds.

“While they may seem to be dependent early on, some of the studies show that as they get older they’re actually more independent,” Meek said.

“You’re still breast-feeding?”

Experts say breast-feeding toddlers carries a stigma in the U.S. because it’s simply not the cultural norm.

Dr. Shoshana Bennett, a clinical psychologist, a perinatal specialist in Orange County, Calif. and author of “Postpartum Depression for Dummies,” said her clients who breast-feed after the baby’s first birthday actually wish that the word “extended” be dropped altogether.

“When we call it extended, what happens is the stigma continues,” she said.

What’s more, breast-feeding a baby at any age in public is not always an accepted practice and moms are often shamed when they do. In fact, 25 percent of women have been openly criticized or experienced prejudice while breast-feeding in public, a survey by Lansinoh found.

That being said, start breast-feeding a toddler or preschooler in public, and it’s a game changer.

“People can really get turned off at the playground when the 3-year-old runs over and wants to nurse when he fell off the slide,” Meek said.

As a result, many moms who choose to breast-feed do so at home, in a car, or in private place and may not even tell their child’s pediatrician if they know he’ll disapprove.

“I’ll never get her back!”
Extended breast-feeding can also cause conflict between spouses. Dads can feel jealous or left out of the bonding experience moms and their children have.

When it comes to sex and intimacy, it’s also common for dads to feel resentful.

“When the partner sees that the breast-feeding is going to continue into toddlerhood, there can be this hopelessness that sets in, [as in], ‘I’ll never get her back!’” Bennett said.

When is it unhealthy?

When extended breast-feeding is done for the wrong reasons, it can border on unhealthy.

For example, some women who have abandonment issues from childhood may overcompensate with breast-feeding.

“They’re feeling very good about it, but it’s very difficult for them to give it up, sometimes even when the child is ready to,” Bennett said. “It’s not about nutrition, it’s more about quelling her worries and her anxieties about losing the connection.”

How old is too old?

Shanna Garvey, who also has a 21-month-old daughter, says her child finds comfort in breast-feeding if the girl feels left out or needs reassurance in social situations.

Although it has required a lot of her own time, attention and energy, Garvey has no regrets.

“I enjoyed the process of being flexible with what they need and growing with what they need,” she said.

Although some women will continue breast-feeding well into preschool or beyond, studies show that when baby-led weaning happens, moms usually stop breast-feeding between 2 1/2 and 3 years of age on average, Meek said.

When deciding when to wean, moms should consider everyone’s needs: their child’s, other family members and of course, their own.

“Mommy should not be pressuring herself one way or the other or having a rigid idea of what ‘right’ looks like,” Bennett said. “Whatever is right for that particular mom, that dad and that family will be the right way to go.”