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by McCoy K

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. Most agree that ideal goals are exclusive breastfeeding for the first 6 months, then slowly introducing other foods in addition to breastmilk. After 1 year, recommendations tend to split. Some encourage breastfeeding to 1 year while others encourage continuing to breastfeed until the child is not interested, which may last into toddler years. The reality is that there are several factors for both the baby and mother to consider when deciding how long to breastfeed. Each mother must decide for herself and her baby how long to continue breastfeeding.

Breastfeeding Benefits

There is no doubt that breastfeeding is, for most families, the very best way to nourish your baby. If at all possible, breastfeeding should begin within an hour after delivery. The first milk that is produced is called colostrum. It is packed with nutrients and disease-fighting substances that will not only nourish your baby but also protect against infections. Babies that continue to be breastfed tend to be healthier and less susceptible to infection and certain diseases as they grow such as obesity, diabetes, and asthma.
Breastfeeding also benefits the mother. It gives mom time to be close to the baby, which helps create a strong bond. It also delays the return of periods, stimulates the uterus to contract back to normal, and helps to lose some of the weight gained during pregnancy. Also, research suggests that breastfeeding for 12 months or more, may have long-term health benefits—like a reduced risk of breast cancer , ovarian cancer , type 2 diabetes , and postpartum depression .
Finally, breastfeeding can even save you money. You don't have to pay for breastmilk where formula can be expensive.

Challenges

The benefits of breastfeeding seem abundant, so why stop? For one, breastfeeding can be time consuming. 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 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, making scheduling a little easier.
Sometime early challenges can also discourage breastfeeding. Early challenges may include difficulty latching for the newborn or discomfort for the mother. In some cases, the newborn does not seem to be getting enough milk from the breast. Fortunately, each of these problems has one or more relatively easy solutions that can lead to successful breastfeeding.
If you face breastfeeding challenges, be sure to contact your lactation specialist, resources like La Leche League or another source for breastfeeding support. Small changes may help you and your baby continue breastfeeding for as long as you planned.
Although rare, some infants may not be able to get adequate nutrition from breastmilk or mother's health concerns may affect breastmilk. If breastfeeding is no longer in the best interest for mother and baby, talk to your baby's doctor about the best nutrition option for your baby.

Plan for Success

After you evaluate the benefits and challenges for you and your baby, decide how long you would like to breastfeed. If you can, set a goal to exclusively nurse your baby for at least six months.
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, work at home, or pump and store milk while you are at work. After six months, your baby will slowly be introduced to solid foods which will take some of the demand off of breastfeeding.
Again, look to breastfeeding organizations or other mothers to find tricks and tips to help you keep breastfeeding as long as you plan.

Thinking About Weaning

Experts agree that weaning should begin gradually, taking place over several weeks or even months, but there is no specific guideline on when breastfeeding should stop. Ultimately it is up to the mother to decide when it is best to start the weaning process but here are general recommendations from health organizations:

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 at least 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 a 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.
There are many factors to consider when deciding how long to breastfeed. Start by working with your doctor to make sure your baby is getting the right amount and type of nutrition. Then look to breastfeeding professionals, professional organizations and other mothers to help tackle any obstacles that arise. Give yourself and your baby a chance to adjust to challenges along the way, you may find that routine can erase some of the obstacles. Having all the information on breastfeeding benefits and methods will help you confidentially decide when it is right for you and your family to stop breastfeeding.

RESOURCES

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org
World Health Organization
http://www.who.int/en

CANADIAN RESOURCES

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org
Women's Health Matters
http://www.womenshealthmatters.ca

References

Breastfeeding. DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 11, 2013. Accessed September 13, 2013.
Breastfeeding: hints to help you get off to a good start. American Academy of Family Physicians Family Doctor 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 September 13, 2013.
How long should a mother breastfeed? La Leche League website. Available at: http://www.llli.org/FAQ/bflength.html. Accessed September 13, 2013.
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/factfiles/breastfeeding/en. Updated July 2013. Accessed September 13, 2013.
US Dept of Human Health and Human Services, Office on Women’s Health. Your Guide to Breastfeeding. US Dept of Human Health and Human Services, Office on Women’s Health website. Available at: http://www.womenshealth.gov/publications/our-publications/breastfeeding-guide/breastfeedingguide-general-english.pdf. Published January 2011. Accessed July 18, 2013.
7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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: 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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