Article on extended breastfeeding by Sarah Buckley, M.D.

(An edited version of this article was published in the Courier Mail, Brisbane Australia July 5, 1998.)

My first-born, Emma, was 14 months old. I had enrolled in a course, and, with the feeling of my life opening up again, had begun to wean. It was at that time, a junction between two worlds, that I read a book called Mothering Your Nursing Toddler. Starting with the assumption that extended breastfeeding is satisfying for both mother and child, the author, Norma Jane Bumgarner writes of the security, confidence and self-esteem that we give our children when we allow them to nurse, and wean, according to their own schedule. She certainly convinced me, and Emma and I went on to nurse happily for three more years.

Re-reading the book six years later, her message seems less radical. My three keen nurslings have, to me, well proven the benefits of an extended breastfeeding relationship, with a physical resilience and emotional independence that comes, I believe, from the access to loving arms and the secure base that breastfeeding provides. Over the years I have also learned about the more tangible advantages of extended nursing, which is becoming more commonplace, as women rediscover the pleasures of devoted mothering in their children's early years.

While breastfeeding is well accepted in our culture, with around 80% of babies starting out on the breast, rates drop off quickly, with 50% still feeding at 1 month and 24% at 6 months. Breastfeeding a toddler can attract the sort of disapproval that any breastfeeding mother was subjected to a generation ago, leading some mothers to become "closet nursers". In contrast, mothers in most traditional cultures breastfeed their babies into at least the second year, as did most mothers in Western Europe until this century. Even in medieval times, the dangers of early weaning were understood, and sickly infants, twins and males were breastfed longer than the usual one to two years. The trend towards mothers working away from the home, the cult of the childrearing "expert", and the advice that a mother's own milk is less suitable for her baby than a scientific formula, have all contributed to the decline of extended breastfeeding.

There is increasingly strong evidence supporting extended breastfeeding. Katherine A. Dettwyler, Associate Professor of Anthropology and Nutrition at Texas A&M University has recently summarised the research on breastfeeding beyond 6 months, in a soon to be published paper, She notes that "In every case, regardless of the outcome health variable, the longer the child was breastfed, the better the health outcome, with the children breastfed for 18-24+ months having the lowest risk." Professor Dettwyler lists the areas that have been studied so far, including: dental malocclusion, gastrointestinal disease, Sudden Infant Death Syndrome, ear infections, childhood cancer and childhood diabetes. New studies published this year support her conclusions that breastfeeding is associated with higher IQ and school achievements in later childhood, with the benefit probably increasing with duration of nursing. Professor Dettwyler estimates, from anthropological data, that the natural age for weaning is between 4 and 6 years.

Extended breastfeeding also has physical benefits for mothers, partly through the release of hormones in her body as she nurses. Prolactin, sometimes known as the mothering hormone, has been shown to have a relaxing effect on the mother and to enhance the desire for contact with her baby. Oxytocin, which is responsible for the let-down reflex during breastfeeding, has been called the love hormone because of its relationship to orgasm, birth, breastfeeding and bonding. Both of these hormones are thought to contribute to the slow return of fertility among breastfeeding women.

Breastfeeding also triggers the release of endorphins, the body's natural opiates in the brain of both mother and baby, underlining the pleasurable aspects for both partners in this amazing and rewarding relationship. Whether you're making a conscious decision to extend your nursing relationship or simply haven't felt the need to wean yet, you'll get support and information from your local Nursing Mothers Group. There are also many resources on the Internet; start with

http://www.prairianet.org/community/health/laleche/bfresources.html

Happy Mothering Week

REFERENCES

Dettwyler, Katherine A, A Time to Wean: the hominid blueprint for the natural age of weaning in modern human populations. Page 43. In Breastfeeding; Biocultural Perspectives, Eds Patricia Stuart-Macadam and Katherine A Dettwyler, Aldine de Gruyter, 1995.

Filds, Valerie. The Culture and Biology of Breastfeeding: an historical review of Western Europe. P115. Breastfeeding; Biocultural Perspectives, Eds Patricia Stuart-Macadam and Katherine A Dettwyler, Aldine de Gruyter, 1995.

Lawrence, Ruth. Breastfeeding: a Guide for the Medical Profession. St Louis. C.V.Mosby. Quoted in Patricia Stuart-Macadam, Biocultural Perspectives on Breastfeeding, P 8. In Breastfeeding; Biocultural Perspectives, Eds Patricia Stuart-Macadam and Katherine A Dettwyler, Aldine de Gruyter, 1995.

Sobrinho, L. The Psychogenic effects of Prolactin. Acta Endocrinologica 1993 129, 1; 38-40

Wilson, AC, Forsyth, Js et al. Relation ot infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study. British Medical Journal 3 Jan 1998 316 21-25.

Horwood, LJ: Fergusson, DM Breastfeeding and later cognitive and academic outcomes. Pediatrics Jan 1998 v101 no 1

Sarah J Buckley MD
www.sarahjbuckley.com