Breastfeeding Your Toddler

Your baby is growing and getting bigger. They’re exploring their world and are on the move now. You have had to baby-proof the objects higher up in your house that your little one can now reach as they are walking and not just crawling. They are transitioning from babyhood and the first year postpartum into the toddler stage. 

Breastfeeding during the toddler stage continues to have so many benefits for both mom and baby. There are new challenges you may face nursing a toddler. Breastfeeding is a relationship and should continue to be enjoyable for you  and your baby. There are lots of ways to help make that happen.

Current recommendations on breastfeeding duration:

Both the American Academy of Pediatrics and the World Health Organization support continued breastfeeding along with appropriate complementary foods for 2 years or longer and as long as mutually desired by the mother and child.(1)

How does breast milk change after 1-2 years of lactation?

• After 18 months of lactation, carbohydrates are lower in breast milk
• Fat and protein increase after 18 months postpartum of lactation until 2 years postpartum and then remain stable.(2)
• Calcium in breast milk remains about the same, only slightly decreasing. If your toddler is eating a few servings a day of foods rich in calcium like leafy greens, tofu, yogurt or legumes, in addition to breastfeeding, there is no need to add in other milks.(3)
• Toddlers may take less breast milk overall, but still get many of their calories and energy from breastfeeding.
• Breast milk remains high in antibodies SIgA and IgG. These immunoglobulins continue to increase after the second year of lactation and support your child’s immune system.(2)

In the second year of life, 448 mL of breastmilk provides:(5)

• 29% of energy requirements
• 43% of protein requirements
• 36% of calcium requirements
• 75% of vitamin A requirements
• 76% of folate requirements
• 94% of vitamins B12 requirements
• 60% of vitamin C requirements

Benefits to your toddler

• Nursing toddlers get sick less often and when they do, they are getting the benefit of antibodies in their mother’s milk, making their cold symptoms less severe and they are sick for a shorter period of time.
• Children who breastfeed for 2-3 years have better problem solving skills.(6) 
• Children who breastfed longer have been shown to have higher IQs than babies breastfed for shorter periods of time or not exclusively breastfed. Longer breastfeeding has been shown to help some parts of the brain develop sooner and for a longer period of time and have better critical thinking skills.
• Longer breastfeeding can protect against allergies. There is some controversy out there on this topic, but there also seems to always be a missing link of mom’s gut health status and if she has done work for healing her gut which in turn helps her baby’s gut in addition to just cutting out an allergen.(4) Allergies are reduced when breastfeeding is extended beyond the first year and also ensure the baby is getting adequate nutrition when they may be eating fewer foods.(7)
• Longer breastfeeding protects children from developing asthma.
• Breastfeeding is a natural and effective way to continue developing your child’s sense of security. Your growing child is exploring their world which comes with lots of frustrations and stressors for your little one. Breastmilk is still the magic it always was, being able to help calm your little one, like pressing the reset button. Having their needs met and meeting their dependency needs helps them in becoming more independent as the years pass.
• Longer breastfeeding leads to more secure relationships with friends and partners later in life.
• As your baby is walking around and getting more bumps and bruises, breastfeeding delivers those wonderful hormones that help your baby calm down and they are able to be off and running and learning again!

Benefits for the mom/parent

• There are protective factors from different types of cancer for those who breastfeed their baby and more protection from breastfeeding longer than the first year. It reduces the risk of breast, ovarian and uterine cancers.(8)
• Nursing can continue to delay the onset of menstruation and the return of ovulation. The lactational amenorrhea method is considered >98% effective in the first 6 months postpartum when babies are exclusively breastfed on demand including middle of the night, are in contact with their mother for daytime and nighttime sleep, pacifiers are avoided and the baby nurses for comfort as well as no other practices that separate mom and baby or restricts nursing. Many people find that nursing even after complementary solid foods are introduced, ovulation continues to be delayed and pregnancies naturally spaced when nursing on demand and the other parameters continue to be followed.(9) As your baby gets older, this should not be the only form of birth control used. This along with following your natural fertility signals can be very effective for most people.
• During lactation, women lose 3%-5% of their bone mass, but this is short lived. It is a normal part of lactation and increased calcium intake does not change how much calcium is taken from the mom’s bones to be in the bloodstream during lactation. Studies show that between 3-6 months after weaning, bone loss is restored no matter how much was lost.(10) The recovery of bone loss begins before complete weaning takes place. As soon as the baby begins to take solid foods, calcium begins to be restored in mom’s bones. Breastfeeding can protect against osteoporosis. 
• Breastfeeding can lower the amount of insulin needed for some people.(11) The milk making glands become sensitive to insulin which is the hormone that allows cells to take in glucose. Glucose is pulled from the bloodstream when making milk so there may be greater blood glucose control while breastfeeding and may help prevent type 2 diabetes in the future.(12)

And, breastfeeding beyond a year is normal!

Breastfeeding is a relationship that offers more than just calories for a baby. It helps meet all their needs including emotional needs well past infancy. The natural age of weaning is between ages 2.5 years and 7 years old.(13) Other primates wean when the babies get their first molars which is between age 5-6 years for humans. Other mammals similar to humans nurse their young until they quadruple their birth weight which would be about 4.5 years old for humans.

When a child is ready to wean, they will do so all on their own. It does not need to be taught or forced. As a child gets older and develops more self regulation and has developed healthy attachment, they have less need for being nurtured at the breast and move towards self soothing and the ability to regulate their emotions.(14) It is nature's design for you and your toddler to continue breastfeeding until the need is fully met. Many of the timelines created for weaning are society made, not science based. You and your child together get to choose what your breastfeeding journey is.

Footnotes:

1. https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2022-057988/188347/Breastfeeding-and-the-Use-of-Human-Milk?_ga=2.108511044.779245121.1656515378-1437916945.1649173006?autologincheck=redirected
2. https://www.frontiersin.org/articles/10.3389/fped.2020.00428/full
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008960/
4. https://www.frontiersin.org/articles/10.3389/fped.2020.00428/full
5. https://www.sciencedirect.com/science/article/abs/pii/S003139550570287X
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096620/
7. https://erj.ersjournals.com/content/25/6/970
8. https://pubmed.ncbi.nlm.nih.gov/12704674/
9. https://en.wikipedia.org/wiki/Lactational_amenorrhea
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595236/#:~:text=The%20recommended%20calcium%20intake%20in,Department%20of%20Agriculture%2C%202004)
11. https://www.endocrinepractice.org/article/S1530-891X(20)40760-8/fulltext
12. https://www.sciencedaily.com/releases/2020/08/200825110800.htm
13. https://www.health-e-learning.com/articles/A_Natural_Age_of_Weaning.pdf
14. https://www.ncbi.nlm.nih.gov/books/NBK225568/