Still Going

Before my son was born, I set a goal to breastfeed for at least six months. I always said wanted to set a realistic goal for myself considering my overachieving personality. But, looking back, I think I just plucked that number out of thin air. I simply did not know how long a child should or would breastfeed.

We struggled in the beginning – jaundice, slow to come in milk, and a pediatrician who offered free formula and free excuses as to why it was fine to supplement feed. Once my son made it back to his birth weight, I became steadfast in our journey.

There were more than a few times when we thought about supplementing with formula especially in the first few months when my son was in the throws of nightly cluster feeding. I did not want to do something to harm my son solely based on principle. I was unsure and scared, but I leaned on more experienced resources who I respected to help guide our journey. Luckily, my husband trusted my judgment and supported us along the way. I learned that cluster feeding is completely normal, albeit overwhelming at times. It did not indicate that I was not producing enough milk.

During this time, I learned a great deal about breastfeeding and the benefits to child and mother. I also became more aware of the recommendations in the medical community about the suggested duration for breastfeeding. For example, the World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life. It also recommends starting complementary foods around six months while breastfeeding continues for up to two years of age or beyond.

The Association of American Pediatrics (AAP) takes a similar position. It recommends exclusive breastfeeding for six months, followed by continued breastfeeding while introducing complementary foods and continuing breastfeeding for one year or longer as mutually desired by mother and child.

On this topic, I listened to a Progressive Parenting podcast titled “Extended Breastfeeding” hosted by Gena Kirby. In this episode she interviewed Kathleen Kendall-Tacket, PhD, IBCLC, FAPA. I really enjoyed this podcast. Ms. Kirby and Ms. Tacket discussed a variety of fascinating topics, but one relevant here included the AAP guideline cited above.

Ms. Tacket conducted a study about weaning ages in a sample of women in the United States who practiced ‘extended breastfeeding’. In the study, extended breastfeeding was defined as breastfeeding for six months or longer. For context, a contemporary definition refers to breastfeeding beyond a year. The study found that the average age for weaning was between two and a half years to three years, and ranged from one month to seven and a third years. See Sugarman, M., & Kendall-Tackett, K.A. (1995). Weaning ages in a sample of American women who practice extended breastfeeding. Clinical Pediatrics, 34(12), 642-647.

Ms. Tacket said the article written about the study was controversial at the time, especially considering the low rates and duration of breastfeeding in the United States in the mid-1990s. Medical professionals and health organizations, with the support of the government, sought to change this climate. They could not deny the research on the health, psychological and social benefits of breastfeeding. In 1997, the AAP cited Ms. Tacket’s study, among others, when it updated its policy on breastfeeding to that listed above.

Ms. Tacket disclosed that though it was perceived by many in the medical field as an advancement, some people were disappointed that the AAP did not align its policy with that of the WHO recommendation of a minimum of two years. The justification for the policy was based on the rates and duration of breastfeeding at that time. The AAP wanted the policy to help increase the rate and duration of breastfeeding and was concerned that setting the policy at a minimum of two years, a large departure from reality at that time, would discourage rather than encourage women in the United States.

For us, breastfeeding finally was going pretty smoothly at six months. We saw no reason to stop. We have now passed the one year mark too. My son eats solid foods well, though like any toddler he has good days and bad days. I rest easier knowing that he still gets his nutritional needs met through breastfeeding on those off days. It also supports his emotional needs and helps sooth and comfort him when he gets scared, hurts himself, is overwhelmed, or just because. It provides him with a sense of safety and familiarity in a sometimes overwhelming world.

We don’t have a set goal anymore. I suppose we see the WHO recommendation out there in the distance, but we understand that a bright line does not exist – not for us. Our breastfeeding relationship will continue to evolve as my son gets older. Over the past year, we learned to trust in what works best for our family and we intend to keep going until my son wants to wean. That time will come. Until then, we will enjoy this time, these moments – this life together.

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