What do health authorities say about breastfeeding past the first year?

August 7, 2014. Posted in: After the First Year

© Julia Shilova - Fotolia.com

© Julia Shilova - Fotolia.com

The World Health Organization supports breastfeeding past the first year and beyond…

The World Health Organization’s Global strategy for infant and young child feeding says:

“As a global public health recommendation, infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond.”

From WHO Fact Sheet No. 342: Infant and young child feeding:

“Exclusive breastfeeding for 6 months has many benefits for the infant and mother… Breast milk is also an important source of energy and nutrients in children aged 6 to 23 months. It can provide half or more of a child’s energy needs between the ages of 6 and 12 months, and one third of energy needs between 12 and 24 months. Breast milk is also a critical source of energy and nutrients during illness, and reduces mortality among children who are malnourished. Adults who were breastfed as babies are less likely to be overweight/obese. Children and adolescents that have been breastfed perform better in intelligence tests. Breastfeeding also contributes to the health and well-being of mothers; it reduces the risk of ovarian and breast cancer and helps space pregnancies… Mothers and families need to be supported for their children to be optimally breastfed.”

The American Academy of Pediatrics supports breastfeeding past the first year and beyond…

In the American Academy of Pediatrics 2005 Policy Statement: Breastfeeding and the Use of Human Milk, the AAP says:

“Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother, especially in delaying return of fertility (thereby promoting optimal intervals between births)… There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer.”

The American Academy of Pediatrics 2012 Policy Statement: Breastfeeding and the Use of Human Milk notes:

“The AAP reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.”

From the Breastfeeding Handbook for Physicians, 2nd ed. (AAP & ACOG, 2013) [Note: This is also AAP policy]:

p. 20:

“The question of whether there is an upper limit to the duration of breastfeeding has been asked. Data on the scientific foundation for an age above which it is inappropriate or harmful to the child to continue breastfeeding do not exist. Nor are there reported risks to this method of social/nutritional interactions.”

p. 122 (Breastfeeding in the Second Year and Beyond):

“Breastfeeding should be continued, with appropriate complementary foods, for as long as the mother and infant mutually desire. In societies where children are allowed to nurse as long as they wish, they usually self-wean, without emotional trauma, between 3 and 4 years of age. Physicians may be surprised to discover that their patients are actually nursing much longer than they believe. Mothers may fail to disclose that they are continuing to nurse an older infant or child because they perceive that their physician may not approve of or support their continued breastfeeding.”

“The studies demonstrating advantages of breastfeeding for infants and mothers suggest that many of the benefits are directly related to the duration of breastfeeding, The composition of human milk does not change markedly from 12 to 24 months, including most nutrients and bioactive factors. Because the human immune system may not mature completely for several years, the constituents of human milk continue to support the host defense of the infant. Breastfeeding promotes comfort and caring. A strong attachment to the mother during the early years may have a positive neurobehavioral effect. Long-term breastfeeding seems to be a mutually positive experience for mother and child.”

 

The American Academy of Family Physicians supports breastfeeding past the first year and beyond…

The AAFP’s Policy Statement on Breastfeeding says:

“As recommended by the WHO, breastfeeding should ideally continue beyond infancy, but this is not the cultural norm in the United States and requires ongoing support and encouragement. It has been estimated that a natural weaning age for humans is between two and seven years. Family physicians should be knowledgeable regarding the ongoing benefits to the child of extended breastfeeding, including continued immune protection, better social adjustment, and having a sustainable food source in times of emergency. The longer women breastfeed, the greater the decrease in their risk of breast cancer. Mothers who have immigrated from cultures in which breastfeeding beyond infancy is routine should be encouraged to continue this tradition. There is no evidence that extended breastfeeding is harmful to mother or child. Breastfeeding during a subsequent pregnancy is not unusual. If the pregnancy is normal and the mother is healthy, breastfeeding during pregnancy is the woman’s personal decision. If the child is younger than two years, the child is at increased risk of illness if weaned. Breastfeeding the nursing child after delivery of the next child (tandem nursing) may help provide a smooth transition psychologically for the older child.”

The Academy of Breastfeeding Medicine supports breastfeeding past the first year and beyond…

The ABM’s Position on Breastfeeding says:

“Optimal infant and young child feeding is exclusive breastfeeding for 6 months, and continued breastfeeding for at least 1 and up to 2 years or longer, with age-appropriate complementary feeding.”

From the ABM Press Release: ABM affirms breastfeeding beyond infancy as the biological norm:

“The average age at weaning ranges anywhere from six months to five years… Claims that breastfeeding beyond infancy is harmful to mother or infant have absolutely no medical or scientific basis,” says Arthur Eidelman, MD, president of the Academy of Breastfeeding Medicine. “Indeed, the more salient issue is the damage caused by modern practices of premature weaning.” The global organization of physicians further notes that “Human milk contains nutrients, antibodies, and immune-modulating substances that are not present in infant formula or cow’s milk. Longer breastfeeding duration is further associated with reduced maternal risks of breast cancer, ovarian cancer, diabetes, hypertension, obesity, and heart attack.”

References

AAP Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2005;115(2):496-506.

AAP Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-41.

Academy of Breastfeeding Medicine Press Release: ABM affirms breastfeeding beyond infancy as the biological norm. May 15, 2012.

Academy of Breastfeeding Medicine. Position on breastfeeding. Breastfeed Med. 2008;3(4):267-70.

American Academy of Family Physicians. Breastfeeding, Family Physicians Supporting (Position Paper). www.aafp.org/about/policies/all/breastfeeding-support.html Accessed 14 August 2014.

Schanler RJ, Krebs N, Mass S, eds. Breastfeeding Handbook for Physicians, 2nd Edition. Elk Grove Village, IL: American Academy of Pediatrics & American College of Obstetricians and Gynecologists; 2013.

World Health Organization. Infant and young child feeding (Fact sheet N°342, Updated February 2014). Retrieved from www.who.int/mediacentre/factsheets/fs342/en/ on 14 August 2014.

World Health Organization. Global strategy for infant and young child feeding. Geneva: World Health Organization; 2003.