Tuesday, August 17, 2010

Child-Led Weaning

Recently, during this year's World Breastfeeding Week, I participated in the Big Latch On. I heard the final count of nursing mamas latched on at 10:30 for one minute was 518, so we didn't break the record but it was still a great time! Here are a couple of articles written about it.

In my post about the Latch On, I mentioned seeing a nursling there who was about three years old. Seeing this little girl got me thinking a lot about child-led weaning (and extended/full-term breastfeeding). Extended or full-term breastfeeding refers to breastfeeding past what is considered the "typical" age of weaning in developed countries (certainly not past a year!) and child-led weaning refers to allowing a child to wean from the breast at his or her own pace. (The Natural Child Project has a great article about child-led weaning.) The weaning process begins as soon as solid foods are introduced, and the child-led weaning method allows for a more gradual progression from being exclusively breastfed to being completely finished nursing (because it happens over a longer period of time).

The World Health Organization recommends exclusive breastfeeding "up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond." The American Academy of Pediatrics (AAP) and the The American Academy of Family Physicians (AAFP) both recommend that all babies be exclusively breastfed for six months and continue breastfeeding (with appropriate complementary foods) for at least one year. The AAFP position paper on breastfeeding makes it clear that “breastfeeding at least until the second year of a child's life is not considered 'extended' breastfeeding. Rather, breastfeeding until the bare minimum age of two years is the norm and anything less brings about detrimental consequences.” The position paper says about nursing beyond infancy (emphasis mine):
"...[B]reastfeeding should ideally continue beyond infancy, but this is not the cultural norm in the United States and requires ongoing support and encouragement.... Family physicians should be knowledgeable regarding the ongoing benefits to the child of extended breastfeeding, including continued immune protection, better social adjustment, and having a sustainable food source in times of emergency.... There is no evidence that extended breastfeeding is harmful to mother or child. Breastfeeding during a subsequent pregnancy is not unusual. If the pregnancy is normal and the mother is healthy, breastfeeding during pregnancy is the woman's personal decision. If the child is younger than two years, the child is at increased risk of illness if weaned. Breastfeeding the nursing child after delivery of the next child (tandem nursing) may help provide a smooth transition psychologically for the older child."
The AAFP paper also mentions some very interesting research I'd read before, done by Katherine Dettwyler, PhD, an anthropoligist from Texas A&M University, entitled A Natural Age of Weaning. Her research "looked at the various "life-history" variables (such as length of gestation, birth weight, growth rate, age at sexual maturity, age at eruption of teeth, life span, etc.) in non-human primates and then looked at how these variables correlate with age at weaning in these animals." She did the research because she was curious as to when human children would naturally wean if we didn't have cultural norms and societal pressures influencing our weaning decisions. She found that the "minimum predicted age for a natural age of weaning in humans is 2.5 years, with a maximum of 7.0 years."

Isn't that incredible!? And here we are with in the United States with embarrassingly low breastfeeding rates. According to a study published in Pediatrics, "While nearly 75 percent of all U.S. mothers initiate breastfeeding, only 32 percent are breastfeeding exclusively at three months. Just 12 percent of U.S. infants meet the medical recommendation to breastfeed exclusively for six months. Only 22 percent are breastfeeding at all at one year."

I think that in Western culture, as prudish as we are about breastfeeding in the first place, we forget that there are other benefits to nursing besides simply its nutritional value. Breast milk does continue to provide excellent nutritional benefits (and health benefits for both mom and baby that are proportional to the duration of breastfeeding). But nursing is about more than just food: it is a comfort measure, a way to reconnect after time apart, and an invaluable parenting tool.

Some of my favorite bloggers write a lot about full-term nursing. Dionna at Code Name: Mama has a beautiful series of posts on The Joys of Breastfeeding Past Infancy. In one of my favorites of the series, Lauren at Hobo Mama reminds us that we don't start out nursing a toddler, rather we start nursing our newborn babies and then "breastfeed day by day, not a year’s leap at a time". I also love this post Lori wrote about conversations she has with her nursling, challenging the idea that if they can walk and talk (and ask for it) they're too old to still be nursing.

I plan to practice child-led weaning, not just because breastfeeding is a public health issue, but because intuitively, it seems like the gentlest way for me to parent my child through this early part of his life. But more than that, I plan to do whatever works best for us as a family in each moment. I know better than to make definite decisions about the future without having flexibility and realizing that my child is an individual with his own needs, wants and ideas. I think it is particularly important to remain flexible when it comes to parenting decisions, whether they be about nursing, sleep, diapering, whatever. We do what works until it stops working, and then we figure out what works next!

6 comments:

  1. Lovely post Amy, and thanks for your great and helpful comments on my blog today too!

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  2. Thanks, Melodie! And you're very welcome...I couldn't help myself!

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  3. I love this compilation of facts on extended nursing. I want to put this in my Sunday Surf next week. I don't remember having read that quote before about how tandem nursing can provide "a smooth transition psychologically" — coming from the AAFP, that's a pretty strong recommendation! Love it.

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  4. That would be great, Lauren! I'm glad you enjoyed my post.

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