The Benefits Of Extended Breastfeeding
What Moms Really Should Know About Breastfeeding Before Giving It Up
Happily breastfeeding my 16 month old son to sleep.
The current recommendation from the American Academy of Pediatrics (AAP) is to “exclusive breastfeeding for approximately 6 months followed by continued breastfeeding with complementary foods for at least 2 years and beyond as mutually desired.”
And yet, culturally, there still seems to be a stigma about breastfeeding babies after their first birthday. I’ve heard many times that “if the baby can ask for milk, they’re too old for it.”
I mean, what?
There’s nothing taboo about breastfeeding and, in my opinion, it’s incredibly special to have my son (who is 17 months old at the time of writing) ask for milk. Plus, it’s an incredible tool to have in my back pocket. I literally cannot imagine parenting without breastfeeding.
Today, we’re talking about the many ways that “extended breastfeeding” (and breastfeeding in general) is beneficial to babies and moms. Bordering on magical.
Buckle up, this is a big one!
How Many American Mothers Breastfeed for a Full Year?
Breastfeeding past baby’s first birthday is considered “extended breastfeeding,” which gives a connotation that it’s not the norm. I wanted to find out just how unusual I am for breastfeeding my 17 month old.
Turns out, the data on breastfeeding rates in general is even more shocking than I expected.
According to an NIH study, only 35.9% of babies are still being breastfed to any extent at 1 year old.
Now, recall that, for what it’s worth, the AAP recommends breastfeeding for at least 2 years or beyond.
It’s abundantly clear that a huge reason many women quit breastfeeding is related to socioeconomic status. Part of it seems to be a lack of access to information about the benefits, but more than that, it seems to be a symptom of mothers having to return to work.
It makes sense.
I restructured my career so I could raise my son full-time. I work from home in little pockets of time while he sleeps, but I’m always available to meet his needs.
I can completely understand why many working moms quit breastfeeding in less than 12 months. I’m sure that stepping away from your workstation several times a day to pump is a huge hassle, even with a supportive employer.
Personally, I did not care for pumping. I probably did it less than 20 times, all in the first 6 months, and then gave it up entirely because it’s just such a pain to wash and sanitize everything. On top of that, my son strongly preferred to get his milk directly from the source, so most of the milk I pumped either went down the drain or into the freezer (to eventually be thawed and, you guessed it, go down the drain).
I don’t necessarily regret pumping because my husband really loved the times he was able to feed our son. It also made it possible for my mother-in-law to watch him in the early months when I had to be away for business meetings.
What I regret is being duped into thinking that every woman needs to pump to “keep their supply up” or to build a coveted “freezer stash” or any of the other mistruths propagated by people who don’t believe it’s possible to meet your child’s needs by exclusively breastfeeding.
As if mothers haven’t been doing exactly that for thousands of years.
What made the most sense for me was feeding my son right before we had to be apart and limiting the time I was away from him. Again, this was possible for me because I restructured my career around being a stay-at-home mom, which I know (tragically) isn’t possible for everyone.
US Breastfeeding Stats
Ok, so let’s dig into the numbers a bit more.
The table below is from the Centers for Disease Control.
There are so many stats on this table that shocked me.
Nearly 1 in 5 babies are never breastfed.
They never get the incredible benefits of breastmilk and the mothers never get to experience the beauty of breastfeeding.
20% of babies are given formula within the first 2 days of life.
There’s no way this doesn’t have a negative impact on breastfeeding.
I mean, it’s literally a supply and demand game, so if you immediately reduce the demand for your milk by supplementing with formula, you’re going to reduce your supply.
Is it any wonder that women jump through so many hoops to try to make more milk? Pumping, lactation cookies, lactation tea—all of it creates unnecessary stress that probably also reduces supply.
The answer is on-demand breastfeeding from the day your child is born.
For the vast majority of women, it’s really as simple as that, and I will die on this hill.
Only 25.4% of US babies are exclusively breastfed through the first 6 months (which, remember, is the AAP recommendation).
Twenty-five point four?! That was shocking to me.
According to a Unicef report, the global rate of babies exclusively breastfed is 48%, which is still behind their target.
That begs the question, why in the world aren’t American mothers breastfeeding more?
Do we fancy ourselves so developed and advanced that we laugh in the face of nature’s perfect design?
Can we really look at the sky-high rates of childhood obesity (1, 2), autism, and mental health issues (1, 2,) and still scratch our heads about the cause? Throw our hands up in the air and pretend it’s a conundrum we just can’t solve?
To be fair, our entire food supply is poisoned. It’s obviously a major factor in children’s health and in a mother’s ability to produce sufficient milk, but there’s just NO WAY that choosing formula over breastmilk isn’t having an effect on the lifelong health of our children.
And it’s not like American mothers are content with this. In fact, 60% of mothers do not breastfeed for as long as they plan to.
Why? Here’s what the CDC has to say about it:
Challenges with lactation and latching
I wholeheartedly agree that education and support help make breastfeeding easier. When it’s available, yes, take advantage! But also, for thousands of years, mothers did not have professional lactation support. If they didn’t have a tribe of mothers around them, they simply had to figure it out or their baby wouldn’t survive. I’m certainly not saying we need to go to this extreme, but there’s definitely power in having your mind set upon exclusive breastfeeding and being unwilling to supplement with formula unless absolutely necessary.
Concerns about infant nutrition and weight
Perhaps losing weight in the first few days is nature’s design, and we need to adjust our expectations on when babies should be back up to their birth weight. Imagine how much less stress mothers would experience if they didn’t have professionals constantly weighing their babies, instead leaning into their intuition and trusting their babies to consume the amount of milk they need.
Concern about taking medications while breastfeeding
Very valid, but that still leaves so much to unpack, like why so many modern moms (and people in general) need to be medicated.
Unsupportive work policies and lack of parental leave
I mean, no one is surprised that separating mothers and babies makes breastfeeding hard, right?
Cultural norms and lack of family support
The insane pressure to wean at 1 year is not evidence-based. I truly wish previous generations of physicians and moms had better information when they were raising their kids.
Unsupportive hospital practices and policies
True story, I was basically forced to take home formula when my son was 2 days old because he’d lost weight. They all lose weight. My doctor told me he needed it, but, you know, I’m a rebel and was fully committed to EBF, so the formula sat in a closet until it expired. And guess what? He returned to birth weight within a few more days and has been healthy and THRIVING his entire life.
The Benefits of Extended Breastfeeding
I’m going to start this portion of the blog with a bold statement.
The slogan and movement behind the idea that “fed is best” is incredibly damaging. It makes moms think that formula is just as good as breastmilk, but it isn’t.
Breastfed is best.
My milk is perfectly tailored to my son. There is literally no replacing it.
Baby formula, especially the garbage sold in the US, is not only a poor substitute for breastmilk, it’s actually extremely detrimental to a child’s lifelong health.
Most mainstream formulas contain seed oils, are high in sugar (often in the form of corn syrup solids), and contain toxic heavy metals, pesticides, BPA, and genetically modified ingredients. It’s often hard for kids to digest and, according to some people, easy to overfeed, leading to higher rates of obesity.
I acknowledge that there are definitely times when formula is the only option for some families, but I deeply believe that it should only be used as a last resort. And this isn’t just me being a crunchy mom. The evidence is crystal clear that feeding with formula has a lifelong detrimental effect on kids (see the sections on gut microbiome, obesity, and brain development below).
Knowing the benefits of breastfeeding, I simply cannot comprehend how anyone would voluntarily choose to forego it in favor of formula.
From the NIH study on breastfeeding rates in the US:
“Benefits [of breast milk] for infants include reduced risk of Sudden Infant Death Syndrome, asthma, ear infections, childhood obesity, gastrointestinal infections, and necrotizing enterocolitis for preterm infants.
Breast milk has the ideal amount of fat, sugar, water, protein, and minerals needed for infants’ growth and development, contains protective antibodies, and is easier to digest than formula.
Maternal benefits include decreased risk of hypertension, type 2 diabetes, ovarian cancer, and breast cancer. Breastfeeding also releases oxytocin, a hormone that causes the uterus to contract. This helps return the uterus to normal size more quickly and reduces bleeding after birth.
Evidence suggests that women who planned to breastfeed and went on to do so were about 50% less likely to become depressed than mothers who had not planned to, and, did not breastfeed.”
The benefits it truly innumerable, but I’ll dig into a few that feel especially potent for my family and have the most significant benefits for all children and moms.
Facilitating Sleep
I’ve breastfed my son to sleep every night and for every nap for 17 months. I think modern moms realize that it’s not a “bad habit” like previous generations were told, right? It’s 100% biologically normal and, in reality, is a mama’s superpower. I mean, I can put my son to sleep anywhere with nothing other than snuggles and my milk. No dark room or noise machine needed (though if that’s what works for you, keep on keepin’ on!).
When I talk about not being ready to parent without breastfeeding, sleep is the number one reason why I’m nowhere near ready to wean. I simply cannot imagine trying to soothe my energetic son to sleep without breastmilk. Yes, we use singing and rocking and other sleep associations, but this is the non-negotiable one for me.
It also helps me soothe him to sleep effortlessly when he wakes up in the night because, yes, he still wakes up during the night and yes, that’s 100% biologically normal.
(Total tangent, but @heysleepybaby on Instagram literally saved my sanity by informing my understanding of normal baby sleep, plus she’s just a great vibe for mom content.)
2. Healthy Gut Microbiome
As scientists discover more about the gut microbiome and its effect on nearly every aspect of health, it becomes glaringly obvious that we need to take steps to protect our baby’s gut health.
Several studies show how essential breastfeeding is for developing gut microbiota and the positive impact it has on a person’s lifelong wellness.
According to one, up to 88% of bacteria genera in breastmilk are found in a baby’s stool, indicating a direct transfer from mom to baby.
Feeding directly from the breast is even more beneficial than pumping and bottle feeding because about 10% of the beneficial bacteria comes from the skin around the mother’s areola. It also facilitates a healthy oral microbiota in the baby.
Having a healthy gut microbiome early in life is essential for developing a robust immune system, which in turn is associated with a lower risk for chronic diseases like asthma, obesity, allergies, dermatitis, inflammatory bowel disease, and neurodevelopmental disorders.
In addition to fostering baby’s healthy gut, we also need to take steps to avoid harming it.
The most common causes of gut microbiome disruption are cesarean delivery, antibiotic use during pregnancy or while breastfeeding, antibiotic use by the child, and feeding with baby formula.
For moms who get intravenous antibiotics during delivery (most commonly due to testing positive for Group B Strep), exclusive breastfeeding is absolutely essential to restore baby’s microbiome.
I think one thing that very few moms know is that introducing formula at any time in your child’s life can cause significant harm to the gut.
According to one study (which, btw, is FASCINATING and full of incredible information about the effects of breastmilk, so definitely check out the full study),
“Observational evidence indicates that exposure to small amounts of formula in the first days of life can significantly impact the composition of the microbiome at 3 months of age. Despite exclusive breastfeeding after leaving the hospital, infants who were fed formula in hospital had lower relative abundance of Bifidobacteriaceae in the gut microbiome at 3 months postpartum compared to infants who were exclusively breastfed throughout.”
An imbalanced gut microbiome, especially during the first 1,000 days of life, can have long-term consequences on your child’s health, including metabolic diseases, asthma and allergies, and altered neurodevelopment.
If you’re considering supplementing with formula for any reason other than the literal survival of your child, I urge you to do your research first.
For us, formula was not the right choice.
But what about medically necessary C-sections?
The only thing more important than human milk for the baby’s microbiome is vaginal delivery. Luckily, exclusive breastfeeding can help baby’s microbiome recover if born via cesarean.
“…infants born via cesarean section who were exclusively breastfed at 6 months of life had gut microbiomes that resembled infants who were born vaginally. This association was not observed for infants who received both formula and breastmilk.”
Exclusive breastfeeding (or not) can literally transform your child’s lifelong health.
I could go on and on, but I think you get the point.
3. Lower Rates of Obesity
According to the World Health Organization (WHO), in 2022:
37 million children under the age of 5 were overweight.
390 million children and adolescents aged 5–19 years were overweight.
43% of adults aged 18 years and over were overweight.
Do those stats scare you? They scare me.
So what can we do about it? Other than literally never feeding your children highly processed foods, you can exclusively breastfeed. Children who are exclusively breastfed for at least 4 months are less likely to be obese as a child. In fact, it lowers their risk of obesity by 22%.
We should all be interested in finding ways to help our kids maintain a healthy weight because, according to the WHO, 60% of kids who are overweight before puberty will be overweight as adults.
Being overweight or obese drastically increases your chances of having many health problems, such as:
Type 2 diabetes
High blood pressure
Heart disease
Stroke
Fatty liver diseases
Some cancers
Breathing problems
Osteoarthritis
Gout
Diseases of the gallbladder, pancreas, and kidneys
Fertility challenges
Sexual function problems
Mental health problems
I mean, no one wants to see their kids suffer like that, right? Breastfeeding is an incredible way to tip the balance in their favor.
4. Better Brain Development
Brain development early in life is a huge predictor of lifelong success.
As a former elementary educator, I am well aware that kindergarten readiness and early elementary success have a huge effect on lifelong learning. If you’re falling behind by the end of third grade, your chance of ever catching up to your peers decreases exponentially.
Study after study has found that breastfed babies perform better on IQ tests and have more brain gray matter than formula-fed babies (1, 2, 3).
But what really boggles my mind is the commentary on these studies.
People do a lot of mental gymnastics to discredit breastmilk as a factor in intelligence. They claim that socioeconomic status, the mother’s education level, and lifestyle choices play a huge role (no doubt they do), and so we cannot possibly surmise that breastfeeding has a positive impact on intelligence and brain development.
Really? We can’t imagine that feeding our children as we’ve evolved to do would be beneficial for their brain development?
It’s no secret that I’m pro-breastfeeding, but discrediting these studies does a lot of harm.
It keeps the information out of women’s hands and leads to lower rates of breastfeeding, particularly among mothers with lower education levels and socioeconomic status. These mamas and babies deserve the truth, not another free can of formula.
5. Comfort & Attachment
I think my favorite thing about breastfeeding is that it seems to make every one of my son’s problems disappear.
If he’s dysregulated for any reason (hungry, tired, experiencing a big emotion, etc.), a milky break is literally a magical cure.
It feeds him. Soothes him. Calms him. He gets my undivided attention for as long as he needs it.
I’ve seen a lot of chatter online about how there are no benefits to breastfeeding past 12 months of age. I hope I’ve debunked that already, but if not, comforting my son and building a strong foundation for his lifelong mental health is surely a good reason to continue.
Being a toddler is hard. There’s so much to learn and explore, and yet, my son’s body isn’t as capable as he’d like it to be. His communication is still developing and even his ability to understand what he’s experiencing is just forming. The big emotions that come with this stage of development are totally normal, and having a reliable way to provide him comfort in the midst of those challenges is amazing.
6. Breastmilk Remains an Important Source of Nutrition
I haven’t personally been told that my milk no longer provides nutritional benefit after my son’s first birthday, but I’ve seen a lot of moms on the internet tell stories about their pediatricians or other adults in their lives telling them that.
That could not be further from the truth!
Breastmilk is truly incredible because the composition changes throughout your child’s life to meet his or her exact needs.
“Human milk in the second year postpartum contained significantly higher concentrations of total protein, lactoferrin, lysozyme and Immunoglobulin A, than milk bank samples, and significantly lower concentrations of zinc, calcium, iron and oligosaccharides.”
— Perrin 2016
“Human milk expressed by mothers who have been lactating for >1 year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods. During prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant.”
— Mandel 2005
Even as solid foods become a larger portion of a child’s diet, breastmilk fills in important gaps. It provides essential protein, fat, and vitamins to fuel your child’s growth.
I mean, there’s long been a push to switch to cow’s milk after a baby’s first birthday because, presumably, solid foods aren’t enough to meet baby’s needs.
But… Why would I switch to cow’s milk when my body directly responds to every one of my son’s needs to produce the absolutely perfect food for him? It just doesn’t make sense to me.
7. Health Benefits for Mom
Many people focus on the benefits to babies, which are super important. However, extending breastfeeding beyond 12 months also has significant benefits for moms.
Did you know that breast cancer risk decreases by 26% in women who breastfeed for at least 12 months? That’s amazing!
I’ve read some crazy online conversations about extended breastfeeding being a mental illness or only for the benefit of the mother.
It’s clear by now that breastfeeding is beneficial to babies, but even if it was only beneficial to moms, is that a bad thing?
Pregnancy, delivery, and postpartum are objectively the most physically taxing experiences a human can undergo, so why shouldn’t mothers reap some long-term health benefits from it?
(I feel compelled to caveat this by saying breastfeeding should not be forced upon a child solely for the mother’s benefit, but like, how often is that possibly even happening? Very rarely, I imagine.)
Breastfeeding also reduces a mother’s risk for Type 2 diabetes, ovarian cancer, heart disease, osteoporosis, and postpartum depression.
Anecdotally, the release of oxytocin from breastfeeding is one of the best things about it. When my son is having a hard moment and I’m feeling frazzled about it, sitting down to nurse calms and regulates us both.
Breastfeeding makes me a better mother and, hopefully, will be protective of my health as well.
Science Backs The Benefits of Breastfeeding
I’m biased toward breastfeeding because I was breastfed by my mom and have successfully breastfed my son for 17 months so far. I’ve loved the journey and will be very sad to eventually close this chapter.
And yet, I acknowledge that there are very valid reasons to not breastfeed or to stop breastfeeding before 2 years. However, I hope that some of the evidence here has demonstrated the amazing benefits of breastfeeding for people who weren’t yet aware of them. I encourage moms-to-be or currently breastfeeding moms to think deeply about whether formula is the right choice for your family. As I’ve said, it was not the right choice for mine.
I think, in some major ways, increasing breastfeeding rates and lengths could have a massive positive impact on the health of our kids and the quality of life they experience, which is why I’m so passionate about it.
If you have questions about breastfeeding or just want to talk about how incredible it is, please reach out!
I also have a post about breastfeeding products that make your journey easier, and also products I think are overhyped and unnecessary. Check it out!
