Breastfeeding a Toddler
There is no lack of “opinions” about the breastfeeding of a toddler. “If he’s old enough to ask for it, he’s too old.” “If he’s got teeth, it’s nature’s way of saying, it’s time to stop.” And not rarely: “Breastfeed a 1 year old? That’s disgusting.” And even health professionals get into the act. Here from a French child psychiatrist, as quoted in Le Soir, a French language Belgian newspaper, on November 29, 2003: “One does not share the breast: to extend breastfeeding past 7 months is without doubt sexual abuse”.
How do people who say this develop such notions? Breastfeeding into toddlerhood has been the norm in much of the world until very recently.
Here are some quotes on breastfeeding a child older than a baby, from various works of literature
-“On Lammas-eve at night shall she be fourteen;
That shall she, marry: I remember it well.
“’Tis since the earthquake now eleven years;
And she was wean’d, I never shall forget it,
Of all the days of the year, upon that day;”
William Shakespeare. Romeo and Juliet. Act I, Scene 3 (Juliet was 3 years old when she was weaned). Yes, and look how she turned out! 🙂
-“And have you any children?”
“I’ve had four; I’ve two living—a boy and a girl. I weaned her last carnival.”
“How old is she?”
“Why, two years old.”
“Why did you nurse her so long?”
“It’s our custom; for three fasts…”
Leo Tolstoy. Anna Karenina
“Only seldom was a whimper heard from one of the four children, all of whom, from the six-month-old infant to the six-year-old Amanda, were fed from Louise’s breast.
“Never again, never in the future that dawned later on, were we so sated. We were suckled and suckled. Always superabundance was flowing into us. Never any question of enough is enough or let’s not overdo it. Never were we given a pacifier and told to be reasonable. It was always suckling time.
“There must be reasons why we men are so hipped on breasts as if we’d all been weaned too soon.”
Günter Grass. The Flounder
Why does it even matter to those who say such things as “If he’s old enough to ask for it…”?
What business is it of theirs? Despite what people might say, accusing me of shaming mothers who don’t breastfeed (I don’t), haranguing mothers at the mall about bottle feeding their babies (I don’t), telling our patients at the International Breastfeeding Centre that formula is poison (I don’t), why can’t people just shut up about a mother who breastfeeds a toddler?
Here are my thoughts on why it matters to so many people.
First of all, because in our society breasts are perceived as sexual playthings only. And, of course, the breast does have an erotic purpose. But so does the mouth; so, should we cover our mouths in public because the mouth has an erotic purpose as well? We accept that the mouth is for eating and the mouth has this sexual side. But we can’t seem to accept that the breast is not only sexual.
As a result, we accept, grudgingly, that a baby breastfeeds, but a toddler? That’s a little too disturbing. That’s like having sex with children. And that’s where the comments in the first paragraph come from, the disgust at the notion of having sex with children.
Freud helped propagate the idea that breastfeeding a toddler is somehow not right. Freud believed that children go through several stages, starting from 0 to 1 year with the oral stage, followed by the anal stage. He believed, without any real proof, that you cannot be in two different stages at the same time, and it is a sign of “misdevelopment” if a child is still showing signs of being in the oral stage after a year. In other words, still breastfeeding. Psychiatrists are aware of this because they study Freud, but the rest of us have basically forgotten about this declaration of Freud’s while at the same time believing it.
Well, it’s okay to breastfeed after a year, it’s fine to breastfeed until the child can ask for it and even discuss how much he or she loves it, it’s not disgusting. The only disgusting part of this is the reactions of too many people who find breastfeeding a toddler disgusting.
Many doctors (and nutritionists) believe there is nothing in breastmilk after a year (some say 6 months)
If there is nothing in breastmilk after a year, then what’s the point of breastfeeding? Here is where the mother is blamed. “She’s doing it only for herself”, for keeping her toddler a baby, and incredibly, for some sort of sexual pleasure.
The thing is, that breastfeeding is so much more than breastmilk. It is a relationship, a close, intimate physical and emotional relationship between two people who are generally in love with each other.
In spite of there being a ton of proof that breastmilk still contains, protein, fat, carbohydrate after a year and after 3 years and even longer, many doctors and nutritionists persist in this idea that breastmilk contains nothing after a certain time after birth. Furthermore, after a year, breastmilk still contains the long chained polyunsaturated fatty acids that the formula companies like to imply they invented. The antibodies and multiple other immune factors that help resist infection are still there, some in greater quantities than during the first few months after birth. The various trophic factors (factors which stimulate the development of various organ systems) are still present in the breastmilk. Trophic factors present in breastmilk aid in the maturation of the brain, the gut, and the immune system, as well as other systems. Breastmilk always contains stem cells, alpha lactalbumin which, when exposed to stomach acid, changes into HAMLET (human alpha lactalbumin made lethal to tumour cells), and so much more.
How do doctors conclude that there is nothing in breastmilk after a year? I can only guess, but I think one guess has a solid basis in fact.
It is not rare for some older babies and toddlers to spend long periods on the breast and yet not gain weight. This occurs, usually, because the mother has had a significant decrease in her milk supply. The baby is sucking on the breast and not getting very much milk. Most health professionals do not know how to look at a baby at the breast and know if the baby is getting milk or not. They believe that if the baby is latched on and making sucking movements, he must be getting milk. So, they assume there is nothing in breastmilk after a year or any arbitrary period of time after birth. But this is untrue. In the first video, the baby is receiving lots of milk. You can tell because of the pause in the chin as he opens his mouth to the maximum. Each suck is open-pause-close. That pause says “I just got a mouth full of milk”. The longer the pause, the more milk the baby received.
In this second video, even though the baby is latched on and sucking, the baby is hardly getting any milk. There is no pause in the chin.
In some cases, the baby spends long periods of time at the breast, is not getting much milk, is not gaining weight, perhaps even losing weight, and yet, refuses to eat food. How can that be? How can a baby who is obviously not getting enough milk to gain weight or is obviously losing weight, why would that baby refuse food? Hungry people, babies included, gobble up food.
I believe that the mother’s milk supply has decreased to the point where these babies are, in fact, on a low calorie diet. It’s not that there is nothing in breastmilk; it’s that the baby is not getting breastmilk, at least not very much of it. So, they develop ketosis, a situation that several fad diets try to induce in the dieter. Don’t eat much, you develop ketones in your blood and you don’t feel hungry.
Why do the babies stay on the breast for long periods if they are ketotic? Because breastfeeding is more than nutrients and calories. Breastfeeding gives the baby security, comfort and, yes, love. So they stay on the breast and suck and suck and don’t get much in the way of nutrients, but they do get comfort.
Most pediatricians will tell the mother she must stop breastfeeding and the baby will start to eat. In fact, that’s not necessarily true. Yes, some will, but not all, so it’s dangerous because they may become dangerously dehydrated. They may then be hospitalized for nasogastric feedings and then they will start to eat food as well once they get a lot of calories. But hospital is not necessarily a safe place for a malnourished baby/toddler. And this approach ends the breastfeeding and that is a significant price to pay. And it’s not necessary to hospitalize the child or stop breastfeeding.
What can be done is to increase the baby’s intake of breastmilk at the breast? When they get more milk from the breast, the ketosis decreases and disappears and they start to feel hungry and start to eat food as well as continuing breastfeeding. This is the better solution. We frequently use domperidone in this situation and it works. The mother’s milk increases, the baby gets more milk, the ketosis goes away, and the baby starts eating food as well as breastfeeds.
It should be pointed out that even if everything is going well with the breastfeeding, doctors will frequently tell mothers to stop breastfeeding because “there are no further benefits for the baby”. This of course says volumes about that doctor’s understanding of breastfeeding in general but also breastfeeding the toddler.
And a few quotes from the World Health Organization:
“Breast-milk is also an important source of energy and nutrients in children aged 6–23 months.”
“Breast-milk is also a critical source of energy and nutrients during illness.”
“Longer durations of breastfeeding also contribute to the health and well-being of mothers: it reduces the risk of ovarian and breast cancer and helps space pregnancies”
Need breastfeeding help? Make an appointment with the International Breastfeeding Centre.
Copyright: Jack Newman, MD, FRCPC, 2017, 2018