Pregnant women and expectant families are often bombarded with early breastfeeding information. There is a big push to initiate breastfeeding in the early days. We work to establish a deep latch and robust breastmilk supply. Positions are perfected, and families try out breast pumps with the hope of continuing to exclusively breastfeed over the first 6 months of their baby’s life. But what do you do when the baby starts to grow up? How does breastfeeding change? Should you continue to feed at the breast? For how long should you feed at the breast? What if you are ready for another baby?
In this article, I hope to answer your questions about continuing your breastfeeding journey for as long as you want – as long as it is mutually beneficial for you and your baby. Let’s get the evidence-based information and details out there about toddler nursing, tandem nursing, and help guide modern families with ways breastfeeding can continue to fit into their lives when their baby isn’t so much of a baby anymore.
How long should I continue to breastfeed my baby?
In the last few years, the powers that be (WHO, CDC, ABM, AAP, ACOG, etc.) changed their breastfeeding recommendations. The most updated recommendations from the experts on breastfeeding initiation and duration are to initiate breastfeeding within the first hour of life, exclusively breastfeed for 6 months, and then continue to breastfeed for up to 2 years of age and beyond while introducing nutritious, age-appropriate complementary foods. Here at Modern Guide to Breastfeeding, I encourage families to continue breastfeeding as long as it is mutually beneficial for the breastfeeding dyad, meaning as long as it is good for both mom and baby. Breastfeeding into toddlerhood is a common practice in most countries in the world; however, prolonged breastfeeding is often stigmatized in the US. Breast milk is whole nutrition and the benefits of breastfeeding remain as children grow and develop. The limit does not exist; it is a personal decision for every family.
Toddler Breastfeeding Positions
Once a baby can hold their own weight and use their bodies more purposefully it can certainly impact nursing. Their newfound mobility can send your usually peaceful cross-cradle position out the window. The key is to continue to achieve the deep latch. Do not contort your body to meet the baby's mobility preferences. If they want the milk, they will cooperate with you. It is often nice in this stage to have a specific breastfeeding location, pillow, or routine. Continue to sit comfortably with proper support. Allow your child to come to you, helping to pull them in close. You do not need to be quite as specific or purposeful with your positioning as you might have been before they could support their own head. They can lay in your lap, sit on your leg, lay next to you, facing you. You can experiment with multiple positions. Just make sure you are not permitting damage to your nipples or breasts with a suboptimal latch or pulling of the breast tissue.
Why the Taboo? Breastfeeding Older Children in Public
Unfortunately, there are people out there who judge women who breastfeed past the 1-year mark and people who feel the need to express these opinions or provide unsolicited advice about how you choose to breastfeed and raise your children. Step 1: Ignore them. Haters are gonna hate. Breastfeeding is beneficial for babies past 1 year, and it is normal. Natural weaning typically doesn’t happen until children are older anyway, at least 2 - 3 years old. If you find it too stressful to breastfeed your older child in public, set boundaries for yourself. Find special times in the day or places where you can nurse. Examples would be in the baby’s nursery upon waking, at nap, or before bedtime. Creating a code word for nursing can also be helpful. As your child begins to talk and communicate their needs, they will be able to express their desire to breastfeed. A code word will facilitate this without anyone screaming “boobies” in the middle of the supermarket or pulling up your shirt in public. If you find that you are in public and your child desires nursing and you would like to avoid it or it’s not a good time, distraction is key. Provide some water or a snack, play a game, or sing a song. Validate their feelings and acknowledge their desires, but buy yourself a little time to get to a space in which you are more comfortable with breastfeeding.
Advice on Teeth and Biting
On average, babies will start to teeth or you will see their little baby teeth pop through their gums starting at 6 months of age. However, it can be normal for your baby to not have any teeth at 1 year or get a tooth at only a few months old. Any true teething concerns should be addressed by your pediatrician. Teething can be a stage that also impacts nursing. As you might imagine, having teeth push through can be uncomfortable for babies. They may be more fussy, irritable, wake overnight, seem to regress in their routine, refuse previously preferred foods, drool, put things in their mouth more, or even have a low-grade fever (as previously stated ask peds if you have concerns). These symptoms typically last for a few days. It can be a time when more nursing or closeness to mom is desired. Continue to feed on demand and support their comfort.
Once they have teeth they will sometimes want to try them out. This can involve biting during a nursing session. It is not done in malice – though it might feel like it! They are testing the behavior out. Try not to overreact! Calmly interrupt the nursing session, put the breast away, and tell your baby “no.” Take a break for a few minutes, grab yourself a glass of water, take a deep breath, assess your nipple for damage, and care for any injury to the nipple. Then when everyone is calmed down and feeling better, go back to nursing. If there is significant damage or pain to the affected area, reach out to a lactation consultant, healthcare provider, or follow these recommendations on nipple care.
What is Tandem Nursing?
Tandem nursing is nursing multiple children at the same time. It is common in many countries, and it is evolutionarily normal. It typically comes after continued breastfeeding through pregnancy. In general, breastfeeding during pregnancy is safe and can be continued. It is important to discuss continued breastfeeding with your provider as some pregnancy complications necessitate weaning. It is also important to know that your supply will most likely drop some due to the hormonal changes of pregnancy and that nipple or breast tenderness is common in the first trimester. Make sure that the child you are breastfeeding during your pregnancy is still adequately fed by monitoring your output. Aggressive pumping is not recommended in pregnancy.
During tandem nursing, the newborn or infant should be fed first, and they should be prioritized as far as milk supply goes. The toddler or older nursling can be incorporated into the feeds or provided with time at the breast after the new baby has been fed.
What is Weaning?
Technically, weaning begins with the introduction of any alternative to breastmilk. Complementary foods become more important sources of nutrition and calories with their introduction at 4 - 6 months (you should work with your pediatrician to determine the timing for your baby). The need for breastmilk, and ultimately the breastmilk supply, will start to drop because of this. It typically begins at 7 - 9 months of age with more solid foods and longer stretches of sleep. Naturally, it can continue for years with babies slowly decreasing their breastmilk intake. If you would like to be done breastfeeding and are weaning with purpose, going slow is the key. Start to feed less frequently and for less time. The weaning process should take weeks. If the baby objects, you can try setting boundaries, like only nursing at certain times of the day or for a set length of time (1 song for example). If there is continued objection and you are finding weaning to be impossible, sometimes a breastfeeding vacation is in store and you will need to be away from the baby to cut the last feeds. This can literally be a vacation. You deserve it, Modern Mama. Or it can simply be you staying out of sight for bedtime or other typical nursing times.
Hopefully, this information will help you navigate somewhat uncharted waters here in the U.S., and if desired, successfully continue your nursing journey past your baby’s first birthday. Nursing a toddler or child is somewhat trial and error or figuring out what works best for your family. It is important to remember that it is your own journey and that you should make decisions that work best for your family. Happy nursing, modern families – for as long as you want!
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