Breastfeeding After 12 Months: Benefits and What to Expect with Katie James, IBCLC

Congratulations! You've made it to 12 months of breastfeeding your baby! But now he's still waking up a lot through the night, your friends are mostly all using formula and telling you that their baby sleeps all night long. Some of them even go from 7pm to 7am without a peep! You're exhausted from getting up and nursing through the night. You're cranky with your partner, cranky with your baby and no one is happy.

People keep telling you to just give your baby a bottle of formula to help him sleep through the night so you're all happy, but you're not sure. What to do….

How Long Should You Breastfeed For?

The World Health organisation recommends keeping breast milk in your child’s diet for 2 years and beyond for good reason, not just to annoy those who think breastfeeding past 6 months is unnecessary! Long term breastfeeding seems to be talked about in terms of between the ages of 6-12 months but actually longer term breastfeeding is describing breastfeeding into toddlerhood.

Humans, like our primate counterparts, are designed to self-wean between the age of 2.5 -7 years (Dettwyler 1995). I’m not advocating that everyone must breastfeed until their child is 7, heck, I am not trying to force anyone to breastfeed for any length of time apart from that which suits you and your baby, this is just to explain that it is actually human nature to breastfeed for much longer periods than the 6 or 12 months which is seen as the ‘norm’ nowadays.

Does Solid Food Replace Breastfeeding?

The guideline of introducing solids around 6 months is just that, a guideline; some babies may want solids at 5.5 months and others are not ready until 7 months. As in all things in life we do not all fit the textbook version. So, if you have been introducing solids around this time you have probably noticed that initially the amount of breastfeeds did not decrease. This is because it is an introduction to solid food not a replacement. Babies take a couple of months to start taking decent amounts of solids which may replace a breastfeed. 

There is a saying that 'food before one is just for fun'and for a lot of babies you will find that they like to play with their food, but it doesn't seem like they actually swallow all that much! Don't worry, this is completely normal. Your child is getting used to different tastes and textures and developing their fine motor skills. It's messy but very beneficial for them from a developmental point of view.

How Often Does a 1 Year Old Breastfeed?

By 12 months you are likely feeding 3 'meals' a day and a few snacks in between but may still be breastfeeding anywhere from twice a day to 5-7 times a day, as well as at night, depending on your baby. So what is right? Well to be honest the longer you breastfeed your child the better. Breastmilk is a marvellous substance and its benefits are dose dependent, which means the more your baby breastfeeds, the better. 

Benefits of Breastfeeding After 12 Months

The longer you breastfeed the better the protective effects for life. The protective antibodies do not disappear overnight at a fixed time point, in fact at around 6 months they increase! Why? Well what is your child doing at 6 months and onwards? Moving around, picking up things, putting stuff in their mouth to help them cope with teething, getting dirty, interacting with other children and babies. Dirty work! In fact, it is common for children to have between six and ten viral illnesses a year in the first few years of life. Hence the increase in protective benefits from breastmilk, clever huh? 

The American Academy of Family Physicians notes that children weaned before two years of age are at increased risk of illness (AAFP 2008) and the World Health Organization states “a modest increase in breastfeeding rates could prevent up to 10% of all deaths of children under five: Breastfeeding plays an essential and sometimes underestimated role in the treatment and prevention of childhood illness.”

Nutritional Benefits of Breastfeeding After 12 Months

A lot of people worry that breastfeeding past one year is pointless as there is no nutritional benefit. However, Dewey (2001) found that breastmilk was still of nutritional importance well into the second year of life (12-23 months). They looked at a sample of 448 mL of breastmilk and what it continues to provide the growing child:

• 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

The Emotional Effects of Breastfeeding Past 1 year

But sometimes it’s not the just the health benefits which are really troubling you whether to wean or not, but the emotional pull to both your child and back to your family/partner. 

Longer term breastfeeding for many women feels right, feels wonderful, and feels like you never want to stop. Sometimes the pull is from your partner who wants you back to him/herself. Breastfeeding for many women may have put a dampener on your sexual relationship. The prolactin hormone (responsible for making the milk) pulsing through you can often make women very nurturing and loving towards their child, but not necessarily enhance sexual feelings towards a partner. 

Nature works in clever ways really, prolonging breastfeeding delays your return to fertility and can reduce desire for sex, therefore perhaps prevent a further pregnancy too soon. In our modern lives this is not necessary anymore but evolution does not appear to have caught up with our modern knowledge of contraception just yet. There is no easy solution to this conundrum.

What we do know is that longer term breastfeeding enhances the mother-child relationship in many ways, which have lifelong benefit. This period of breastfeeding is actually only a short amount of time in the whole scheme of our lives and we only get one opportunity to have this special time with this child. 

Many women describe feelings of mourning when they wean an older child and talk so fondly about their memories of this amazing bond during the feeding times. I’ve heard women describe it as their special time out together, which no one else could take away, that they looked forward to those, almost secret, night feeds where she would stare lovingly into her baby’s eyes as they shared their special time together.

I also talk to women who tell me of how they are planning to feed “this” baby much longer than the others, as this will be their last child, and it makes them sad and thoughtful to think that this will be the last baby they get to breastfeed. When you talk to women who are feeding beyond 12 months, they never tell me they do it for the benefits, yet they talk with such love and a sparkle in their eyes, like they have been given a gift to be able to have the chance to continue breastfeeding.

When Should You Stop Breastfeeding?

In short, whenever is right for you, and your baby…and your family. It is not always an easy decision to continue breastfeeding past 12 months in our current society, but it is a valuable and important one. 

Humans are designed to breastfeed past 12 months, we just seem to have forgotten that along the way. If you are struggling with stigma or peer pressure to stop breastfeeding find a support group full of like-minded women to keep you smiling, practice mindfulness during your feed times so you really enjoy those moments, no matter how long you choose to breastfeed for, and try to talk openly with your partner about some of the issues mentioned here to help them understand your choice and that it is only for a short period in time, relatively. 

Whatever you choose to do, make sure you feel ready when you eventually do wean your child. We all make decisions based on what else is going on in our lives at that time, so make sure you are able to talk through your choices with someone supportive and non-judgemental. Lastly if you have weaned before you wanted to, then don’t look back; as women we seem to be very good and putting guilt onto ourselves! This has no benefit to anyone and least of all you or your baby. You did what you felt was right at the time. We can all change our views when we have more knowledge, but until then we do what we feel is right at the time. Don’t look back and wish for ‘what if’… 

Know that any amount of breast milk is amazing and a marvellous gift you gave to your baby.

References:

Stuart-Macadam, P. and Dettwyler, K., ed. Breastfeeding: Biocultural Perspectives, New York: Walter de Gruyter, Inc., 1995

Dewey KG. Nutrition, Growth, and Complementary Feeding of the Breastfed Infant. Pediatric Clinics of North American. February 2001;48(1)

About the author

Katie James, IBCLC has helped thousands of women through their breastfeeding challenges during those early newborn days. Katie's extensive knowledge and experience, coupled with her down to earth, practical approach is reassuring and empowering for new mums.  Find out more about Katie here.