A decade after their last update, the American Academy of Pediatrics (AAP) breastfeeding recommendations have been revised. The AAP currently recommends breastfeeding for at least two years. In the past, the AAP has suggested that infants be nursed exclusively for the first six months and then continue breastfeeding while introducing appropriate complementary foods for at least a year. The new recommendations are in accord with those of the American Academy of Family Physicians, the World Health Organization (WHO), and the Canadian Pediatric Society.
Despite more than 80% of U.S.-born infants receiving some form of breast milk, the vast majority are not fed solely by breastfeeding and are not nursed for as long as the AAP recommends. A CDC survey found that about 35% of babies are still breastfed at 1 year old, while 56.7% are still breastfed at 6 months.
Pediatricians play an important role as advocates and physicians, and the new AAP policy statement and technical report describe the health and neurodevelopmental benefits of breastfeeding.
Parental support is essential for any parent, but it is especially important for those caring for a toddler who is still nursing. Biologically, it makes sense for toddlers to continue nursing well past their first birthday.
Extended breastfeeding has many positive effects on the baby and the mother.
Extending breastfeeding through the first year (and even up to the second) has been linked to positive outcomes for mom and baby. For example, the AAP highlights research showing that breastfeeding mothers who continue for more than 12 months have lower incidences of type 2 diabetes mellitus, hypertension, breast cancer, and ovarian cancer.
The Centers for Disease Control and Prevention (CDC) reports that breastfeeding reduces the risk of infants developing otitis media, ear infections, severe diarrhea, and obesity. The AAP notes that this is due to the special makeup of human milk, which includes live cells and immune-regulating, anti-inflammatory, and antibacterial compounds.
There are a variety of beneficial effects connected with breastfeeding, including a reduced incidence of SIDS.
The AAP policy statement looks at breastfeeding from a public health point of view. It stresses that the bond between parent and child is just as important as the food for the growing child.
The societal stigma that still surrounds breastfeeding older children adds to the difficulties of breastfeeding a toddler.
Mothers who choose to breastfeed their toddlers face a lot of criticism and judgment from society. While breastfeeding for more than 12 months is considered “normal” in many countries, this is not the case in the United States.
Limited free time is another obstacle for working women who are breastfeeding their toddlers. In the event that, for instance, they continue to require private time for pumping breaks at the office, this provision may be made available. Tandem nursing, or feeding a toddler and an infant at the same time, has its own set of difficulties.
As they grow and mature into toddlerhood, they gain the ability to be more mobile while still actively nursing. Because of this, it may be awkward to breastfeed a child in public or when others are present.
This is especially troubling for parents of older infants who are teething. The truth is that a toddler will find nursing to be quite comforting. Unfortunately, many people’s conceptions of nurses and dental decay are false. How a baby feeds when nursing varies from how he or she takes a bottle. When newborns’ teeth come in or show signs of rotting, many advise they begin weaning them from breast milk or formula.
Limit your child’s nursing sessions and time spent in public spaces to teach him or her social skills. If your child is running and bouncing around, it’s time to put the breast pump away. Some parents have designated nursing rooms in the house.
You may need to adjust to a more comfortable position or remind your infant how to latch if they are experiencing discomfort from teething.
If I’m unable to breastfeed, what are my options?
If mothers are not provided with assistance, they are less likely to continue breastfeeding after experiencing challenges such as sore nipples, engorged breasts, soreness, and latching issues. Breastfeeding cessation is also prevalent when mothers worry their babies won’t get enough milk.
The lack of a sufficient milk supply was indicated by half of the mothers in national research as the main cause for weaning. Mothers who are unable to breastfeed shouldn’t feel awful about themselves. The onset of postpartum depression is linked to “failure” to breastfeed.
Breastfeeding Mothers Don’t All Get the Same Treatment
Significant socio-demographic and cultural disparities in breastfeeding are highlighted in the AAP report. Rates of initiation are lowest among people of African descent who are not Hispanic. Mothers with lower incomes, younger women, and those with less than a high school education also face disproportionate barriers.
In 2021, Breastfeeding Medicine dedicated a special issue to the problem of poor breastfeeding rates among Black mothers. Some University of Michigan Medical School researchers looked at the correlation between a mother’s demographics, her history of childhood trauma, her postpartum depression, and her lack of social support at the 6-month mark after giving birth and nursing.
Six-month breastfeeding rates were shown to be lower for Black moms compared to white mothers after controlling for all other risk variables. This shows that the lower breastfeeding rates among this population are at least partially attributable to factors specific to this population.
The authors argue that racism has multiple detrimental effects on public health, including systematic or structural racism in workplace policy and practice, unequal access to higher education, housing discrimination, and prejudiced healthcare.
Compared to moms of other races and ethnicities, Black mothers typically return to work sooner after giving birth and report less workplace flexibility.
Help Is Needed to Encourage Breastfeeding
The experts agree that many things must be altered before breastfeeding mothers can receive the social assistance they deserve. As a first step, it is recommended that all postpartum care for both the mother and the infant be administered in the comfort of their own home.
This is because mothers benefit greatly from prolonged periods of sleep, skin-to-skin contact with their infants, and uninterrupted breastfeeding in the immediate postpartum period to recuperate from childbirth and build up their breast milk supplies. It’s absurd to expect a mother to take her newborn infant out of the house between 3 and 5 days old for an outpatient pediatrician’s appointment, as this interferes with nursing.
To be fair, insurers have room for improvement as well. It is only fair that every 12 months, all insurance providers (private and public) foot the bill for a brand new breast pump and accessories. Medicaid only pays for a replacement breast pump once every five years in some states, including the one I live in.
More support for nursing mothers can be provided by providing clearly labeled public breastfeeding and lactation rooms and areas.
Not all women are able to or choose to breastfeed their infants. Using a bottle to feed your baby is a perfectly acceptable choice. Likewise, it’s important that mothers who choose to breastfeed their children well into toddlerhood (and beyond) feel encouraged in their decision. You can either join a support group for breastfeeding mothers or hire a lactation consultant if you are a parent of a toddler who is still nursing.
Articles you might like: Clinical Studies Show Covid-19 Vaccine is Safe During Pregnancy and Breastfeeding, Navigating Pregnancy and Parenthood in Covid-19 Era, The Facts About The Omicron Variant and it’s Impact on Pregnancy