Until what age should a child be breastfed: pros and cons of different approaches

“Are you going to feed him before school?” “What if my breasts sag?” What do women who decide to continue breastfeeding hear? Moreover, not only the mothers I know on the playground look askance, but also relatives. In order not to be categorical, we will talk about different world approaches to this issue, the advantages and disadvantages of long-term breastfeeding and will help you finally understand when it is time to stop breastfeeding your baby.

Play-Doh

Four positions: until what age should you breastfeed your baby?

Parental

Most often, women are advised to stop breastfeeding early by their mothers or grandmothers. In their times, employers gave them a maximum of 3–6 months to recover after childbirth. And after this period, mothers sent their babies to nurseries, switched them to formula milk or introduced early complementary feeding, and they themselves went to work. But this approach was not based on any scientific research on the benefits of breast milk and the impact on the health of newborns: there was only one motivation for early weaning - not to lose your job.

Soviet

In Soviet times, doctors believed that from the age of 2–3 months, a child could be given juices and water, gradually replacing breast milk with complete complementary foods. Modern pediatricians are against such views and recommend feeding babies until at least six months: in the first 6 months, the baby fully satisfies its nutritional and food needs and does not need additional supplementation with other liquids. And once she reaches this age, the mother has the right to decide for herself whether she should continue breastfeeding or whether it’s time to “wind down” lactation.

American Pediatrics Association Opinion

American pediatricians advocate exclusive breastfeeding for up to six months. During this period, the child cannot be given complementary foods and is also not allowed to drink water.

American pediatricians suggest feeding a six-month-old baby with baby purees. At first it can be ground vegetables and fruits, and then meat and seafood.

It is worth weaning off gradually, first you need to reduce the number of night feedings, and then completely abandon them.

American

The American Academy of Pediatrics recommends breastfeeding your baby until age 1:

up to 6 months, a newborn necessarily needs only breast milk;
after six months, complementary foods are added to his diet;
After he reaches 12 months, when he eats almost everything, his mother can stop feeding him.

WHO

The World Health Organization has drawn up its own rules for how many years to feed children breast milk. According to doctors, lactation should be maintained for two years. And these recommendations are not accidental:

up to six months, the ideal food for a child is exclusively breast milk;
at 6 months, complementary foods are gradually introduced and breastfeeding continues at the same time, since the baby’s diet is not yet varied enough;
after a year, mother’s milk is no longer the basis of nutrition, but continues to be beneficial for the child;
after two years, you can feed, but this is more at the discretion of the woman.

Supporters of this position are confident that these rules are universal for any country, while opponents believe that the WHO, speaking about breastfeeding up to two years, was focused primarily on third world countries: there breast milk is almost the only way for babies to survive during total hunger and protection from disease. The organization’s document itself actually states that feeding up to one year is preferable, and after that it is necessary precisely for those groups of the population that are susceptible to various infections.

How long to breastfeed?

One of the most common questions moms have is how long to breastfeed.

Official documents:

WHO website, recommendations for 2021 https://www.who.int/mediacentre/factsheets/fs342/ru/ - exclusive breastfeeding (that is, WITHOUT supplementary feeding and WITHOUT supplementing healthy children) for up to 6 months.

“National Program for Optimizing Breastfeeding” - “the minimum period for introducing complementary feeding products is 4 months, and the optimal period is 4-6 months. It is advisable to continue breastfeeding until 1-1.5 years.” https://www.pediatr-russia.ru/sites/default/files/nacprog.pdf

Thus, researchers and practitioners believe that until 4-6 months, a child should receive only mother's breast milk (from the breast or expressed), donor breast milk or breast milk substitutes (adapted formulas). Feeding children under one year of age with whole animal milk or cereal decoction is not recommended, as it can lead to gastrointestinal diseases and allergic reactions.

It turns out that the minimum period of feeding only breast milk (before introducing complementary foods) is clearly formulated - 4-6 months.

How long to continue feeding?

From the above-mentioned sources it is clear that the duration of breastfeeding is not strictly specified and remains at the discretion of the mother and child. WHO writes about feeding up to two years or more (and this is a recommendation NOT for developing countries, but for all people), the National Program is about 1-1.5 years (which is rather a nod to retrogrades).

Historical reference

From archival documents it is known that in Russia it was customary to feed “three long fasts,” which corresponds to 1.5-2 years. If the end of feeding was in the summer, then the child continued to be fed until the fall. This was important for the prevention of intestinal infections. Ancient religions also describe feeding children up to at least two years of age (Bible, Torah, Koran).

Modern research

The famous American anthropologist Katherine A. Dettwiler conducted research on human lactation. How did she find out how much to feed a human baby? She compared the duration of pregnancy, body weight at birth, growth rate, age of puberty, age of teeth appearance, life expectancy, some other parameters and the age of weaning of primates and humans. As a result of the analysis, it turned out that in a person the period of weaning can range from 2.5 years to 7 years. Unfortunately, in modern living conditions, few people can afford to feed for so long. Therefore, official recommendations indicate the minimum period during which it is difficult for our babies to do without breast milk. But the minimum period is not optimal. And if mother and child feel comfortable continuing breastfeeding for longer than 2 years, that’s great! Of course, breastfeeding after a year lives by slightly different laws. Children already receive some adult food, know how to wait, and can be distracted by various things. In my opinion, it is important that breastfeeding at any stage does not become a source of conflict for intrafamily relationships.

It is better not to set yourself any long-term goal, even if it is a recommendation from authoritative sources

For a successful result, it is more correct when the goal is achievable. It is better not to think about the end in advance, but to live for today and the near future, meeting the needs of the child and your capabilities. Chat with breastfeeding friends, find an in-person or remote breastfeeding support group, friendly doctors who approve of breastfeeding, and reliable sources of information on feeding. Almost every mother, during the period of breastfeeding, encounters moments when it seems that the time for weaning has already come, that the baby is receiving too little milk, that the mother has run out of strength, that no one has been feeding for so long, and so on. What do I propose to do? Sit in a calm environment, take a piece of paper and divide it into two parts. Write down the pros and cons of your feeding. What benefits does breastfeeding give you? What disadvantages does it have? It’s the downsides that you need to work with - think about what exactly is interfering with a quiet life and how it can be corrected. Awareness of the problem is the surest path to success. And the only right decision is not always to wean the baby from the breast. It’s sad if a mother comes under pressure from others, but she herself is not yet ready to stop feeding. If the mother is not ready for the end of feeding, then a feeling of guilt may arise, which does not have a very good effect on the relationship with the child.

Criteria for possible termination of breastfeeding on the part of the child

Willingly eats “adult” food
Calms down not only with mom and not only with breasts
Calmly copes with the absence of his mother and stays with other people
Can fall asleep without sucking

Please note - after a year, milk is just as useful as in the early stages of feeding. The point of view that milk is “not so healthy” after a year has no scientific basis. The reason for it is the desire to socialize a woman as early as possible, to give her the opportunity to work for the good of society. In fact, breast milk for a one-year-old child is not so much a food product as a support for health, since its protein content, and therefore biologically active substances, is close to colostrum. The greater the child’s motor activity, the greater the concentration of protective factors in mother’s milk.

Unfortunately, in modern conditions it is not always possible to feed for as long as a particular child may need. A mother's confidence in the need to continue breastfeeding often decreases under pressure from relatives and medical workers who do not support breastfeeding. You can wean at any age, but you need to understand that if the child is not physiologically and psychologically ready for this, a difficult period awaits you. You will need not only confidence in the correctness of your actions, but also the support and help of your family. You should not wean an unhealthy baby. If weaning is caused by the desire to reduce the time that the baby spends with his mother, to teach the child to calm down without the breast, or to stop sleeping together, it is unlikely that the cessation of feeding will go smoothly. In the absence of a familiar way of calming down, existing difficulties are likely to worsen. Do not use extreme methods of weaning - bandaging the breast, leaving the mother, declaring the breast “sick”, “treating” with dyes (for example, brilliant green), using various tasteless products, for example, mustard. This gives the child a feeling of guilt (because of him, his mother got sick), fears (his mother suddenly disappeared), anxiety and uncertainty about the goodwill of the world around him.

Criteria for possible termination of breastfeeding by the mother

Feeding involves not only mother and baby, but also mother’s breasts. The breasts may also NOT be ready to stop lactation. Feelings of fullness, distension, tingling in the chest signal an untimely cessation of breastfeeding. In such cases, at the weaning stage, you have to express the “stuck” milk a little, instead of calmly continuing to feed further. There is a widespread misconception that medications can be used to stop breastfeeding. These drugs were developed to treat certain conditions and not to suppress lactation. The use of any medications must be justified. If the drug is prescribed by a doctor, the patient should be warned about side effects. Almost all mothers who stop feeding with pills complain of weakness, headache, and dizziness. Lactostasis (milk stagnation) often occurs after taking the pills. Medicines cannot be considered the optimal way to stop breastfeeding. You can think about using them only when the expected benefit clearly outweighs the risk of their use - in case of illness, sudden change in family circumstances, other emergency situations, and, of course, use only as directed and under the supervision of a competent doctor.

The weaning process takes different times - for some mothers and babies it takes several weeks, while for others it stretches out for months. There is no concept of normal throughout breastfeeding: each mother-child pair goes its own way. In order to develop a strategy for ending breastfeeding, to understand whether you really want to stop breastfeeding, or whether this desire arose from fatigue, you can contact a lactation consultant, reliable sources of information, and experienced nursing mothers.

You are not ready to stop breastfeeding if:

The breasts fill with milk if the baby takes long breaks between feedings
The child cannot sleep without the breast
It seems to you that the time has not yet come, but those around you convince you that it is time
The easiest and fastest way to soothe your baby is through the breast.

You can stop breastfeeding if:

You want to stop breastfeeding
The child is over two years old
There are almost no daytime feedings, night feedings are inconsistent and infrequent
The child eats “adult” food with pleasure
The child remains calmly without his mother

Photo by Tatyana Nesterova @Tanyanphotography

Benefits of long-term breastfeeding

For a child

After one year, antibodies are still present in the milk, especially immunoglobulin A, which protects the baby from pathogens in the intestines, mouth and urinary tract.

Children after one year of age who are fed breast milk do not lack vitamins A, B, folic acid, minerals - sodium, calcium, iron, potassium. Of course, this is only possible if the mother is well fed during this period.

Long-term feeding also helps children who are prone to allergies. Thanks to the special protective properties of breast milk, a dense film is created in the intestines, which prevents allergens entering the body from penetrating into the baby’s blood.

Breastfeeding after one year is also useful for developing a correct bite and preventing caries. Many researchers believe that children who suckle at their mother's breast for a long time begin to talk faster and pronounce sounds more clearly.

Some child psychologists who advocate long-term breastfeeding also talk about the mental health of babies: they are calmer, it is easier for them to adapt to a new group of children. A woman’s breasts are considered a natural antidepressant, which is why a child who has been in such close contact with his mother for more than a year is less capricious and cries.

Long-term feeding is very important for babies with neurological manifestations: when they suckle, their blood supply to the brain improves and unnecessary stress is relieved.

All breastfeeding in a woman can be divided into three phases: the colostrum period, mature lactation and involution, when milk production gradually decreases and dies out.

Usually the last phase begins after 1 year and 8 months and lasts up to 3 years. During this period, milk is similar in composition to colostrum: it contains a lot of leukocytes and immunoglobulins. A child who has received such breast milk for at least 1 month is protected from colds and infections for six months. It also contains the protein lactoferrin, which is “extracted” from women’s breasts and used to make medicines that slow down the growth of cancerous tumors.

Scientists have found that after two years of feeding, this protein in milk becomes much larger.

For Mom

Thanks to long-term breastfeeding, close emotional contact with the child is maintained. This feeding method is convenient for trips and trips. Sometimes breastfeeding helps calm your baby faster.

The older the child gets, the less need he has to suckle at the breast - feeding often occurs only at night. This amount - 2-3 times a day - no longer interferes with everyday activities and is easier to tolerate.

How much time does a child need to wean smoothly and naturally? Most experts believe that it occurs on its own after 1.5–2 years. If it also coincides with the involution of lactation in a woman, then this process becomes painless for everyone, both physically and mentally.

Long-term breastfeeding also helps prevent breast cancer for women.

Disadvantages of breastfeeding for more than one year

For a child

If a child has a clear connection “mom’s breasts = sleep,” then without it it is either more difficult for him or not to fall asleep at all.

Some psychologists talk about the possible appearance of an “Oedipus complex,” when children over three years of age experience sexual attraction to a parent of the opposite sex. But since every child is individual, this problem does not arise for everyone.

For Mom

It happens that a child older than 1–1.5 years, who already has many teeth, bites his mother’s breast very hard, causing her pain and creating small wounds.

Due to the child’s great attachment to the breast, a woman may experience irritability, not being able to relax alone, or cannot urgently go on a business trip, leaving the baby with other relatives.

Brief reminder on weaning

No matter what age the child is, it is important to postpone weaning when he is especially vulnerable - during illness, visiting, moving.
Don't let others criticize your baby for taking so long, in their opinion, to breastfeed. No one has the right to interfere in an intimate moment between you and your baby.
If you know about the obvious benefits of breastfeeding, but the process gives you discomfort or makes you depressed, then you shouldn’t endure it - it’s better to contact a breastfeeding specialist who will give proper feeding recommendations, or start “winding down” lactation.
How long to continue breastfeeding is up to you. If you don’t want reproaches and misunderstanding from loved ones, you can simply not raise this topic in conversations.
Remember: no matter how long you breastfeed your baby, you are still the best mother for him!

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Duration of breastfeeding in different peoples of the world

Cultural traditions regarding the timing of breastfeeding vary greatly from country to country. Currently, the following trend can be noticed: in Europe, the USA, Australia and China, babies are fed breast milk for a very short time. Most babies receive formula supplementation in the maternity hospital and soon switch completely to artificial feeding. The rare mothers who still breastfeed try to wean their child before his first birthday. In some countries (for example, England, Portugal, Israel), such a short period of breastfeeding is explained by short maternity leave. In others, the reason lies in generally accepted attitudes (in particular, in France, breastfeeding is rather an exception to the rule).

In Russia, the average feeding time is 1-2 years; this is due to the legacy of the Soviet period, when breastfeeding up to a year was considered optimal. Usually, after a year, mothers try to wean their baby from the breast.

In India, breastfeeding continues for quite a long time - 3-4 years, but mother's milk is considered not very healthy, and early complementary feeding is practiced (from the first days of life).

African children have been breastfed on demand for quite some time. In addition, they are constantly in contact with their mother, while in a sling behind her back. Thanks to this, African children are ahead of European children in development, but after a sharp weaning at 2-3 years they “lose ground.”

As for tribes and nationalities with a traditional way of life , long-term breastfeeding and gentle weaning are common among them - on average, at 2-4 years. However, there are also tribes that do not limit children’s feeding time and encourage breastfeeding up to 5-7 years.