The benefits of breastfeeding a toddler and beyond
If you’re a mom to be, a current breastfeeding mother, or just someone who would like to know learn more about breastfeeding, you may be wondering whether an older baby or child should still be breastfeeding, and you may also wonder about the benefits of breastfeeding a toddler or older child.
The recommendations on breastfeeding duration
The American Academy of Pediatrics (AAP) recommendations
The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond.
The World Health Organization (WHO) and the United Nations Children’s Fund UNICEF recommendations
The WHO and UNICEF recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life – meaning no other foods or liquids are provided, including water.
Infants should be breastfed on demand – that is as often as the child wants, day and night. No bottles, teats or pacifiers should be used.
From the age of 6 months, children should begin eating safe and adequate complementary foods while continuing to breastfeed for up to two years of age or beyond.
How long should children breastfeed for?
Studies have found that the average age of weaning in human babies is between the ages of 2.5 and 7 years, with the average being 4-5 years old. Some may even breastfeed for longer than that.
It’s very rare for a child to wean before at least 2.5 years. If they do it may be because of external interferences such as pacifiers and the mother either knowingly or unknowingly, using weaning techniques.
The benefits of breastfeeding a toddler or child
Biologically normal
First and most importantly, breastfeeding a toddler or older child is biologically normal. Your child is born expecting to not only breastfeed, but to breastfeed until they naturally wean. It’s what all mammals do, including humans. You don’t have to force a child to stop breastfeeding if you don’t want to, they will do so on their own when they’re ready.
Kathrine A Dettwyler, PHD, an anthropologist and breastfeeding advocate, has done in-depth research on when mammals, including humans tend to wean.
Her findings:
– When they erupt their first permanent molars around 5.5-6 years of age.
– How large the mammals are. The larger the adults, the longer the term of breastfeeding relative to gestation.
For chimpanzees and gorillas, the two primates closest in size to humans and also the most closely genetically related, the relationship is 6 to 1. That is to say, they nurse their offspring for six times the length of gestation. In humans, that would be: 4.5 years of nursing (six times the 9 months of gestation).
– Once they quadrupled their birth weight. Usually around 2.5-3.5 years.
– One study of primates showed that their offspring were weaned when they had reached about 1/3 of their adult weight. This happens in humans at about 5-7 years.
– A comparison of weaning age and sexual maturity in non-human primates suggests a weaning age of 6-7 for humans (about half-way to reproductive maturity).
– Studies have shown that a child’s immune system doesn’t completely mature until around 6 years of age. It’s well known that breast milk helps develop and protect the immune system with maternal antibodies for as long as the child is breastfeeding.
The minimum predicted age for natural weaning in humans is 2.5 years, and the maximum predicted age is 7.0 years.
The benefits of breastfeeding a toddler for mothers
Many people believe that breastfeeding only holds benefits for the child, but studies have shown that there are many benefits for breastfeeding mothers as well.
Better sleep
Breastfeeding is associated with changes in the sleep and wake cycles for both the mother and the child. These changes help to reduce fatigue in the mother and may even prevent symptoms of depression.
One study investigated the sleeping patterns of postpartum women immediately following delivery and found that breastfeeding women slept on average 2.6 hours longer than women who bottle fed.
Mental health
Reduced anxiety
Breastfeeding provides a psychoneuroimmunological benefit to mothers that reduces anxiety, which is likely associated with the hormone prolactin. Prolactin is the hormone responsible for producing milk.
Decreases depression symptoms
Studies have shown that breastfeeding directly decreases the symptoms of depression. Early weaning eliminates this benefit.
Studies have also found that women who were breastfeeding at two months postpartum had a lower risk of postpartum depression at four months postpartum.
It was also found that more frequent breastfeeding at three months postpartum was associated with greater subsequent declines in depressive symptom levels up to two years postpartum.
Physical health
Weight loss
Pregnancy is associated with long-term weight gain. Breastfeeding on the other hand is associated with postpartum weight loss. A large prospective cohort study showed that longer exclusivity and duration of breastfeeding was associated with greater weight loss at 6 and 18 months postpartum in women of all BMI categories.
Bonding
Breastfeeding is well known for mother-infant bonding.
There is evidence of a biologic link between breastfeeding and bonding emerging as breastfeeding mothers had higher brain responses to their own infants’ cry and exhibited more sensitive behavior than formula-feeding mothers.
Protection against Rheumatoid Arthritis
One study found that compared with those who had never breastfed, breastfeeding was associated with half the risk of Rheumatoid Arthritis. The risk was lower with increasing duration of breastfeeding when breastfeeding for at least 36 months.
Reduced metabolic risks
Pregnancy is associated with changes in glucose and lipid metabolism to support the growing fetus; however, these changes can be damaging to the mother’s health. Breastfeeding, on the other hand, is associated with positive metabolic changes.
Protection against osteoporosis
Sixteen to 20 years after giving birth, women who had breastfed for a total of more than 33 months in their life, regardless of the number of children, had greater bone strength estimates of the hip and the tibia. Owing to their greater bone size than mothers who had breastfed less than 12 months.
Protection against reproductive cancers
A decrease in risk for reproductive cancers has been observed among women who have breastfed, possibly reducing their reduced lifetime exposure to hormones such as estrogen.
The risk of breast cancer decreased by 4.3% for each year of breastfeeding, which indicates that longer breastfeeding may increase protection against breast cancer.
In another meta-analysis, there was a 28% lower risk of developing ovarian cancer among women who breastfed for at least 12 months compared to women who never breastfed.
The benefits of breastfeeding a toddler or children
Nutritional benefits
Breastmilk still provides a substantial amount of key nutrients well beyond the first year of life, especially protein, fat, and vitamins. Breastmilk also contains higher concentrations of protein, lactoferrin, lysozyme and Immunoglobulin A in the second year, in comparison to milk bank samples. It also contains lower concentrations of zinc, calcium, iron and oligosaccharides.
Breastmilk expressed by mothers who have been breastfeeding for more than 1 year has increased fat and energy contents, compared with milk expressed by women who have been breastfeeding for shorter periods.
In a study of 250 toddlers in western Kenya, breastmilk provided an average of 32% of the child’s total energy intake.
In the second year (12-23 months), 448ML of breastmilk provides:
29% of energy requirements
43% of protein requirements
36% of calcium requirements
75% of vitamin A requirements
76% of folate requirements
94% of vitamin B12 requirements
60% of vitamin C requirements
Social development
A couple of studies have shown a positive relationship between longer breastfeeding duration and social development. Breastfeeding for a shorter duration may be a predictor for adverse mental health outcomes in childhood and early adolescence.
Cognitive development
Research on the relationship between cognitive achievement (IQ scores and grades in school) and breastfeeding has shown the greatest gains for those children who breastfed for the longest duration.
Physical development
Breastfeeding helps the development of jaw muscles and alignment and airway development. This helps to lead to less orthodontic expenses and prevents TMJ pain and sleep apnea in adulthood. Breastfeeding also helps with jaw, teeth and speech development as well as overall facial development.
Health benefits
Immune protection by means of antibodies
The predominant antibody in breastmilk secretory IgA (sIgA), penetrates the gastrointestinal (GI) tract and promotes integrity of the intestinal barrier and competitively inhibits pathogen binding, thereby preventing inflammatory responses. This favorable gut microbiome resulting from breastfeeding protects the infant from pathogenic bacteria and has also been associated with reduced asthma and reduced obesity rates in children.
Additionally, the gut microbiota contributes to regulation of the expression of genes that affect fat metabolism and deposition.
Breastmilk contains hormones such as neuropeptides and growth factors that may affect growth, development, and self-regulation of food intake, contributing to the differences observed between breastfed and formula-fed infants. Leptin suppresses appetite, and infant serum leptin is positively correlated with maternal concentrations.
Protection against infections and illnesses
Breastfeeding helps protect children against respiratory infections and illnesses. It also helps protect them against GI infections and illnesses. Infants who are not breastfed, or who are breastfed for short periods of time before weaning, have a higher risk of infection and illness than those who are breastfed optimally.
This prospective longitudinal study suggests that breastfeeding may protect against ear infections as well as throat, and sinus infections well beyond infancy.
Reduced risk of childhood cancer
There is some evidence that breastfeeding may reduce the risk of acute lymphoblastic leukemia. The duration of breastfeeding may also be important, as studies have reported that infants breastfed for more than 6 months had a 24% and 19% reduction in risk of acute lymphoblastic leukemia compared to those who weren’t breastfed. Those who breastfed less than 6 months only had a 12% reduction.
Childhood obesity
The two ways in which breastfeeding may protect against obesity in the child are through the components/composition of human milk and behaviors related to infant feeding. In one recent study, it appeared that breastfeeding resulted in a healthier BMI distribution overall as fewer children were either underweight or obese.
Reduces the risk of cardiovascular disease, heart disease and metabolic disease
In a meta-analysis of 7 studies, breastfeeding decreased the risk of type 2 diabetes by nearly 40% compared to formula-feeding. Fasting insulin values in later life were 3% lower among those who were breastfed, indicating an association with improved insulin-sensitivity. Breastfeeding may also decrease the risk of developing type 1 diabetes and high blood pressure later in adulthood.
The American Academy of Family Physicians notes that children who weaned before two years of age are at increased risk of illness.
Breastfeeding toddlers between the ages of one and three have been found to have fewer illnesses and illness durations and overall lower mortality rates.
Antibodies are abundant in breastmilk throughout the breastfeeding journey. Some of the immune factors in breastmilk increase in concentration during the second year and also during the weaning process.
Eco friendly
One study found that for the five environmental impact categories assessed, scores were 24–60% higher for 1 kg ready-to-feed infant formula compared to 1 kg breastmilk. In addition, they found that four months of feeding with infant formula compared to breastfeeding resulted in 38% higher global warming potential, 72% higher terrestrial acidification, 35% higher freshwater eutrophication, 59% higher marine eutrophication, and 53% higher land use.
Financial and economic benefits
In an earlier analysis of the costs of formula-feeding, other investigators found that, compared to 1,000 infants exclusively breastfed for 3 months, 1,000 infants never breastfed required 2,033 more office visits, 212 more days in the hospital.
Breastfeeding clearly improves the health of infants and mothers and seems to result in cost savings for parents, insurers, employers, and society, which means that the medical and economic value of breastfeeding is high.
Important notes on the benefits of breastfeeding a toddler or older child
It’s clear that breastfeeding for longer durations holds many benefits to both the mother and the child, and that older babies, toddlers and young children continue to benefit from breastfeeding. From development, bonding and health to financial and economic benefits. There are many reasons to breastfeed until your toddler or child naturally weans. They don’t need a big amount of breast milk to reap the benefits either. Breastfeeding matters for long-term health in breastfed children.
The research clearly shows us the importance of breastfeeding both babies and older children. There is more than enough proof of the benefits of extended breastfeeding. Breastmilk is the best nutrition for children, even after the first year.
Breastfeeding an older baby or child isn’t always easy and it may come with a lot of judgement from others, including our own family members. It’s important that you do what’s best for you and your child, there will always be misinformation out there. Just know that what you’re doing is perfectly normal and healthy. You can always share the benefits of breastfeeding a toddler or older child with them, you might be surprised that they appreciate being better informed.
If at any time during your breastfeeding journey you would like more information or need any breastfeeding support, contact an International Board Certified Lactation Consultant (IBCLC) or a healthcare provider experienced and knowledgeable in working with breastfeeding babies.
You can also find support from other mothers breastfeeding their children who may understand what you’re going through, or who may just be able to offer you some support when you may need it. A good way to find this type of support is by joining a local breastfeeding peer support group such as a local La Leche League International support group.
Additional information and resources:
The economic impact of breastfeeding
A Natural Age of Weaning by Katherine A Dettwyler, PhD
World Health Organization breastfeeding recommendations
Psychological effects of breastfeeding on children and mothers
Breastfeeding and Health Outcomes for the Mother-Infant Dyad
Updated AAP guidance recommends longer breastfeeding due to benefits
Lactation is associated with greater maternal bone size and bone strength later in life
Environmental Impact of Feeding with Infant Formula in Comparison with Breastfeeding
