• Breastfeeding Your Baby: How Long Should You Do It?

    HCA image for breast feeding A number of organizations, including the World Health Organization, the La Leche League, and the American Academy of Pediatrics, have tried to determine how long babies should be breastfed. Some say six months is enough, others say you can stop after one year, and some even say you can continue nursing toddlers. But the truth is, there is no magic number. Each baby is different and each mother must decide for herself and her baby how long to continue breastfeeding.

    Learning About the Benefits

    There is no doubt that breastfeeding is for most families the very best way to nourish your baby. Breastfed babies tend to be healthier and less susceptible to infection and disease. There is also evidence that breastfed babies have better brain development than formula-fed babies.
    Breastfeeding also benefits you, the mother. It will give you time to be close to your baby, which helps create a strong bond. It also delays the return of your periods, stimulates your uterus to contract back to normal, and helps you lose some of the weight you gained during pregnancy. Also, research suggests that if you breastfeed for 12 months or more, you may have long-term health benefits—like a reduced risk of breast cancer, ovarian cancer, type 2 diabetes, and postpartum depression.
    Then why don’t all mothers breastfeed? It is time consuming, for one. Newborn babies have to be fed 8-12 times a day or more for 15-20 minutes at a time. This may not seem like much of a problem at first when you are with your baby day and night. But, it can become quite a challenge if you are planning to go back to work within the first few weeks of giving birth. Once breastfeeding is well established, feedings usually become more regular and more widely spaced.
    Some mothers do not nurse their babies because they encounter challenges early on. Sometimes a newborn does not “latch on” immediately; other times the process of getting conditioned to breastfeeding is very painful for the mother. And, in some cases, the newborn does not seem to be getting enough milk from the breast. Each of these problems has one or more relatively easy solutions that can lead to successful breastfeeding.
    However, faced with obstacles involving comfort, convenience, or establishing normal child growth patterns, some mothers may become discouraged and give their hungry baby a bottle. This makes the problem worse because it is even harder to get babies who have been given bottles to begin nursing. If you face breastfeeding challenges, be sure to contact your local La Leche League or another source for breastfeeding support.

    Deciding About Breastfeeding

    If at all possible, begin breastfeeding your baby within an hour after delivery. The first milk you produce is called colostrum, which is packed with nutrients and disease-fighting substances that will help nourish and protect your baby against infections as he grows up.
    If you can, set a goal to exclusively nurse your baby for at least six months and anticipate the obstacles you will face. For example, if you are planning on going back to work after a month or two, decide how you will continue breastfeeding. You may choose to extend your maternity leave, leave work periodically to nurse during the day, work part-time or at home, or pump and store milk while you are at work. Mechanical breast pumps make it possible for women to mix breastfeeding with working life.
    Sometime during the middle of your baby’s first year, begin introducing solid foods, but continue breastfeeding for as long as you and your baby enjoy it. When you decide it is time to wean your baby, you can begin giving breast milk or formula in a bottle or a cup. Most experts recommend that weaning should begin gradually, taking place over several weeks or even months.

    Thinking About Weaning

    Experts have been reluctant to set down firm rules about when breastfeeding should stop. Different organizations have different recommendations. Here are some of these:

    American Academy of Pediatrics (AAP)

    The AAP advocates for six months of exclusive breastfeeding for optimal growth and development of your baby before introducing any other sources of nutrition. The AAP recommends breastfeeding for the first year of your child's life, but your choice of when to stop breastfeeding depends entirely on you and your baby. While some babies begin to lose interest in breastfeeding between 9-12 months of age, others are interested in breastfeeding well into the second year of life.

    World Health Organization (WHO)

    The WHO recommends exclusive breastfeeding for the first six months. After that, babies can have food (eg, thick porridge, well-mashed foods) in addition to breast milk. Children aged 1-2 years old can continue with this diet of mashed or chopped foods along with breast milk.

    La Leche League

    The La Leche League—a group that offers support to breastfeeding women—sets no time limit on breastfeeding. This organization says the longer a mother nurses her baby, the better. And if you and your child enjoy breastfeeding, there is no reason to stop. Experts here suggest letting your child wean naturally, gradually growing out of breastfeeding.

    Giving Up the Breast, Not the Bond

    By two years of age, the majority of children should probably be in the weaning process. While breastfeeding into the 3rd or 4th year (or beyond) will probably not be right for most families, don’t forget that our most serious breastfeeding problems are 1) not starting to breastfeed at all or 2) weaning too early (before six months). A good guide is to use the second year of life as a target for weaning.
    After you have stopped breastfeeding, you may feel sad about giving up the bonding time with your baby. To help ease this transition, make it a point to spend even more quality time with your baby, and remember that weaning is just a natural part of growing up.

    RESOURCES

    American Academy of Pediatrics http://www.aap.org

    World Health Organization http://www.who.int/en

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/index%5Fe.asp

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    Breastfeeding. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 27, 2011. Accessed December 13, 2011.

    Breastfeeding has minor effect in reducing risk of childhood overweight. National Institutes of Health website. Available at: http://www.nih.gov/news/pr/may2001/nichd-15.htm. Published May 15, 2001. Accessed August 14, 2003.

    Breastfeeding: hints to help you get off to a good start. Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/pregnancy-newborns/caring-for-newborns/breastfeeding-formula/breastfeeding-hints-to-help-you-get-off-to-a-good-start.html. Updated August 2010. Accessed December 13, 2011.

    How long should a mother breastfeed? La Leche League website. Available at: http://www.llli.org/FAQ/bflength.html. Updated October 14, 2007. Accessed December 13, 2011.

    Up to what age can a baby stay well nourished by just being breastfed? World Health Organization website. Available at: http://www.who.int/features/qa/21/en/index.html. Accessed December 13, 2011.

    7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Schwarz EB, Ray RM, Stuebe AM, et al. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol. 2009;113:974-982.

    3/18/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Martin RM, Patel R, Kramer MS, et al. Effects of promoting longer-term and exclusive breastfeeding on adiposity and insulin-like growth factor-I at age 11.5 years: a randomized trial. JAMA. 2013 Mar 13;309(10):1005-13.

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