I Don't Want to Wean!
What Does Extended Nursing Really Mean?
By Ann Calandro, RNC, IBCLC

Fill in the blank: Breastfeeding is great up until the age of _____________.

What comes to mind when you hear the words "extended nursing"? Extended beyond what? What is the average age of weaning in the culture where you live? How long is the longest you would consider nursing your baby? Have you ever thought about it?
Breastfeeding is a natural feeding choice. In the United States, some mothers begin breastfeeding, planning to continue for six weeks or six months or one year. As the babies reach those ages, weaning begins. Other mothers begin breastfeeding with similar plans, but those plans alter as their babies grow. Perhaps these moms realize how important the breastfeeding relationship is to them and their babies, or they may find parenting easier with breastfeeding. In the end, these moms may decide to "extend" their plans a bit.

A Historical Perspective

Contemplating the birth of my first child back in 1976, I planned to breastfeed her for six weeks. I'm not sure what made me plan to breastfeed for six weeks, but I believe several factors were involved in my decision. First, my mother had breastfed me for six weeks. I remembered as a child when she smilingly told me how important it was to "give your baby a good start." She also told me sadly that her milk dried up after six weeks. I assumed mine would too. (My mother was a heavy smoker, and it is now known that heavy smoking may affect the quantity of milk.)
Second, I was going back to work in six weeks. The formula samples and information I had received both at the hospital and in the mail had encouraged me to believe – in subtle and not so subtle ways – that it would soon be a necessary part of my baby's life. I was surrounded by slick baby magazines that assumed I would soon need those colorful bottles, nipples, pacifiers and cans of formula. Most everyone I knew was bottle-feeding. My personal culture had set me up for weaning my baby at six weeks.
When I gave birth and began nursing, I wasn't thinking much beyond those first six weeks. When I went back to work, I left her with bottles of formula. I decided I would nurse her part time when I was at home for a short while.
My baby gagged on formula. She disliked the feel of bottle nipples. She preferred me. She would politely wait until I got home from work to eat and eat and eat. I decided to wait before weaning her. Breastfeeding was too important.
As the months passed, breastfeeding turned into nursing and became a relaxed and joyous part of our lives. I couldn't imagine not nursing her. We nursed for six months, then 10 months. We nursed into toddlerhood. We nursed through my next pregnancy and after her sister was born. She weaned with a little encouragement from me just after she turned 4 years old.
My other three children also nursed well beyond my original, cultural expectation of weaning. Shocking? It sure would have been to me back in early 1976. As a pediatric nurse caring for very ill babies, I wasn't exposed to breastfed babies. However, motherhood changed me. I put aside my preconceived notions and began to follow my instincts. I became involved in La Leche League, and my group of peers believed in child-led weaning. (I felt in my heart that this was right for me and my children, too. I am no longer a nursing mother, but I am still fascinated with the history of nursing and eagerly read about breastfeeding patterns in other cultures. You might be surprised to know that the average worldwide age of weaning is about 4 years of age.)

A Cultural Perspective

In the United States, we are all American but we are not all the same. Each mother brings with her into motherhood her own cultural beliefs and plans. Many of us are affected by the opinions of our spouses, our mothers and our friends. We are also affected by advertising. From early pregnancy, mothers are bombarded by "friendly" formula companies who send free coupons and samples to expectant and new mothers. When signing up for baby clubs, mothers who are planning to breastfeed are placed on the target list of infant formula companies. Carefully mailed formula encouragers arrive before Baby's birth, in the take-home bag from the hospital and again when the baby is around 6 weeks old.
A multi-million dollar industry with a tremendous advertising budget would like to recruit you and your baby to buy their product! Why do you think one of the formula companies gives out a booklet about breastfeeding in the first two months? By the way, each time a formula company sends advertising and gifts to mothers, this company is in violation of the International Code of Marketing of Infant Formula, which the United States has voluntarily agreed to withhold.

A Medical Perspective

What guidance does an American woman get from her health care providers? The American Academy of Pediatrics encourages mothers to breastfeed exclusively for six months, and thereafter, breastfeed along with other foods for at least a year, and then, for as long as the baby and mother mutually choose. (The American Academy of Family Practitioners agrees.) The American Dietetic Association recommends breastfeeding for at least one year. The World Health Organization encourages breastfeeding for at least two years.

A Biological Perspective

Anthropologists and biologists study other mammals to find out how long normal nursing extends. It is easy to do because other mammals all breastfeed by instinct and breastfeed until just the right moment for weaning. They are not influenced by the neighbors, advertising or going back to work. Their internal clocks tell them when it is time. Their weaning depends on how fast their babies mature and are able to care for themselves.

Studying humans doesn't help, because humans sometimes don't breastfeed at all. Some humans may breastfeed for days or weeks, and others may breastfeed for years. Katherine A. Dettwyler, an anthropologist, has studied the weaning patterns of other large primates and has theorized that an accurate rule of thumb for weaning would be when Baby quadruples its birth weight (7 X 4=28 months) or has lived six times its gestation age (6 X 9=54 months).
Dettwyler "does advocate that medical professionals and paraprofessionals, family members, friends, acquaintances and even strangers recognize that human children, like their nonhuman primate relatives are designed to expect all the benefits of breast milk and breastfeeding for a minimum of two and a half years. The information that three or four years of breastfeeding, or even longer, is both normal and appropriate for human infants should be disseminated to heath care professionals and parents alike."

Is it still healthy for the child to breastfeed for extended periods? Yes. Breast milk continues to offer immunological properties to the child along with superior nutrition. Although it is not designed to be the sole food for children beyond the first six months or so, breast milk continues to add nutrition, vitamins and calories along with health benefits.
Nursing an older child is very different from nursing a baby. Older children nurse infrequently, usually only when going to sleep at night.
Mothers, too, benefit from extended nursing. A recent study indicated that longer nursing decreases the mother's chances of developing breast cancer.

The Inevitable

As a lactation consultant, I am frequently asked weaning questions. I work in South Carolina, an area where bottle-feeding is the norm. Sometimes mothers call me wanting information about the best way to wean their babies. I always encourage gradual weaning to make the transition easier for both Mother and Baby. I also explore with each mother her reason for weaning.
I have heard many, many reasons for weaning. Sometimes it is due to pressure from a partner who "has had enough of this nursing stuff." Sometimes, it is due to a medical professional advising weaning due to a medication or a treatment. (This can be unnecessary. It is always best to get a second opinion in this case.) Other times, Mother is asking about weaning but really doesn't want to wean. She just wants to know her options. (I usually recommend that she read How Weaning Happens, by Diane Bengson. This book is very useful to mothers who are beginning to consider this step.)

"Ideally, the way weaning happens for you and your child will provide a satisfying conclusion to a rewarding breastfeeding relationship," Bengson says. "It can be like a surprising, revealing end to a good novel. Some mothers say weaning is like a joyous, but tearful 'bon voyage' at the beginning of a new adventure. Weaning signals the end of the breastfeeding relationship, but also a step taken in trust that the mother-child relationship remains close and significant for both of you."
Sometimes babies wean themselves before their mothers are ready. Sometimes mothers wean before babies are ready. Sometimes weaning is like a dance; a beautiful gentle waltz, moving slower and slower until it gradually ends. Sometimes weeks pass before Mother realizes the dance is over. She doesn't even remember when the music stopped.

Want to see more?
· Child-led Weaning: The Way Nature Intended
· Nursing Beyond 1 Year
· Tandem Nursing in Today's World
· Talk about it!


About the Author: Ann Calandro is an iParenting expert panelist and an International Board Certified Lactation Consultant.

I Don't Want to Wean! What Does Extended Nursing Really Mean?