Extended breastfeeding: Is it for you and your toddler?

You see, while many people are supportive of extended breastfeeding, others are not.

There are many myths about the practice that tend to fuel opposition and make people feel uncomfortable or even angry about it — even though extended breastfeeding is another way parents can support their children's growth and development after being born.

The World Health Organisation (WHO) recommends that newborns be breastfed within their first hour into the world and exclusively for the first six months.

WHO also recommends introducing solids at around six months while continuing breastfeeding until the child is two years of age or beyond.

Keep reading to discover how you can embark on a successful extended breastfeeding journey and the benefits for you and your tot.

What is extended breastfeeding

Extended breastfeeding is the practice of breastfeeding past the age of 12 months. Some healthcare providers recommend that babies be weaned at this point, as they have established a good latch and have a strong sucking reflex.

But extended breastfeeding is perfectly healthy for both mother and child, so feel free to follow these recommendations if your child is ready for weaning.

Reasons for extended breastfeeding

Mothers breastfeed beyond the first year due to several reasons:

• Mother-and-child bonding time
• Emotional confidence for both mother and child
• Personal preference to breastfeed the child for a certain period
• To provide the best source of milk for the child
• Convenience
• The child has low immunity
• A child is not ready to wean

Benefits of extended breastfeeding

For mothers:

• Reduces the risks of breast and ovarian cancer, type II diabetes, and postpartum depression
• It helps to keep weight in check, together with a balanced diet and exercise
• It provides a natural method of birth control (98 per cent protection in the first six months after birth), although it's still possible to get pregnant
• A way to reinforce the bond with their baby
• Mothers who breastfed beyond one year were less likely to develop hypertension, diabetes, hyperlipidemia, or cardiovascular diseases (CVD) when post-menopausal

For toddlers:

• Second-year breastmilk continues to provide an excellent source of nutrients, including protein, fat, calcium and vitamins, in addition to calories, natural antibodies, and enzymes, which cannot be replicated by science and technology
• It enhances their immunity, so toddlers get sick less often and recover faster if they do fall ill
• Provides a familiar sense of comfort and security when the child is unwell
• Toddlers tend to develop fewer behavioural problems, including restlessness, anxiousness and clinginess; where the latter is often associated with extended breastfeeding

Duration of breastfeeding sessions for toddlers

Breastfeeding mothers would know that these sessions vary with individual children. The flow of the breastmilk and the child's personality (whether he's a fast chomper or one who likes to take it slow and easy) contribute to the duration of nursing sessions.

As they reach toddlerhood, children tend to be more active and distracted during the day, so mothers should expect shorter sessions than when they were younger.

At times, the toddler might want a quick 'drive-through' — goes to the mother for a quick suckle and returns to what he was doing.

Frequency of breastfeeding for toddlers

Breastfeeding frequency tends to become less for a toddler than for a newborn. Breastfeeding is more a source of comfort, warmth and security than sustenance for a toddler.

Some toddlers may nurse erratically throughout the day — once in the morning when they wake, a quick nurse during mid-day and, perhaps, nursing to sleep. Some toddlers may go through frequent night wakings to nurse, not because they are hungry, but more for assurance that mama is around.

If your toddler has started childcare (18 months onwards), you may discover that he might want to nurse right after coming home. This is a normal sign — your child simply wants to "connect" with you after being away for some time.

When your toddler is unwell, angry, frustrated or scared, it is completely normal that he comes looking for you to nurse for that extra emotional comfort.

Breastfeeding and a toddler's diet

Contrary to belief, after the first year, breastmilk continues to provide a wealth of nutrients such as proteins, fats, vitamins and natural antibodies that cannot be replicated via other sources.

While breastfeeding should be complementary to a toddler's diet, a mother should note the number of solids the toddler consumes and ensure that the bulk of his diet is primarily solids.

During a child's second year (12 to 23 months), 448ml of breastmilk provides:

• 29 per cent of energy requirements
• 43 per cent of protein requirements
• 36 per cent of calcium requirements
• 75 per cent of vitamin A requirements
• 76 per cent of folate requirements
• 94 per cent of vitamin B12 requirements
• 60 per cent of vitamin C requirements

Breastfeeding and a mother's diet

The components of breastmilk change and transition to accommodate a toddler's needs, so a mother should not neglect her health.

Breastfeeding burns 300 to 500 calories daily, so nursing mothers must ensure a healthy and balanced diet and keep themselves in the pink of health, too!

Here's an overview of what a breastfeeding mum should be eating to support her breastfeeding needs:

• Iron-rich foods like dark green leafy vegetables such as spinach, kale, broccoli, red meat, iron-fortified cereals, bread and pasta
• Calcium-rich foods like milk, tofu, cheese, yoghurt, soybeans, sardines, turnips and enriched bread and grains
• Protein-rich foods like lean meat, eggs, dairy, beans, lentils and seafood (if your child is not allergic to them)
• Omega-3 fatty acids from salmon, fish supplements, nuts and seeds
• Whole grains
• Fruits and vegetables
• Soups
• Water

There are also certain foods to avoid during nursing, especially if your toddler reacts to them, including alcohol and seafood.

Suppose your concern is to boost breastmilk supply. In that case, breastfeeding mums look to these nutrient-rich foods to help increase milk production — for example, fennel tea, fenugreek, and alfalfa, which are available at our local supermarkets.

Breastfeeding mums can also consider supplements to support their diet and nutritional needs. These are readily available at our local pharmacies and drugstores.

However, do look for product advice that states that they are suitable for breastfeeding and lactating mothers.

Is traditional chinese medicine (TCM) safe during breastfeeding?

As advised by the Health Science Authority (HSA), breastfeeding mums are advised to use caution when it comes to TCM.

Seek advice from TCM physicians on recommended herbs that are safe for breastfeeding and on TCM health supplements meant to replenish your qi-blood.

Soups such as Eight Treasures Soup (Ba Zhen), All-Nourishing Decoction (Shi Quan), and Mutton Soup with Angelica Roots are good for replenishing qi-blood.

Common concerns about extended breastfeeding

Will breastfeeding the past year make it harder to wean my child?

Many mothers hear that breastfeeding becomes a habit when it is prolonged, and thus makes it even harder to stop when the mother wants to.

Like any other stage of breastfeeding, weaning can be child-led or mother-led. The former allows the child to be developmentally ready and goes off the breast on his own, while the latter has the mother take the lead to initiate weaning.

Some researchers feel that letting your child take the lead is more natural, allowing the child to be ready for the change. The decision belongs to both the mother and toddler.

How do I tackle an active toddler during breastfeeding?

If your child is capable of all sorts of nursing acrobatics, rejoice that you are not alone!

Here are some simple tips to help keep breastfeeding a less frantic one with an active toddler:

• Set rules such as only nursing at home or in the nursing room if your child loves flashing you in public or the sessions get too much attention when outside.
• Use a nursing cover to help protect your modesty and choose a quiet corner (if no nursing rooms are around) in the restaurant or cafe.
• Some mothers set a routine or designated times for nursing to help manage things.
• Teach your toddler a code word he could use should he wish to nurse when you are out. For example, he may say "neh neh" or "milk milk," so you can anticipate his needs instead of clawing at your blouse when he wants to be nursed.
• Take along your child's fave toy or wear a nursing necklace to distract him during nursing.
• Babywear your toddler and nurse on the go if your child dislikes sitting still when outside.
• Express your breast milk and offer your child the bottle when you are out, and keep direct latching at home or indoors only.

My relatives tell me that prolonging breastfeeding for my son would pervert him. Is this true?

This is a myth. There is nothing sexual about breastfeeding. Our breasts are biologically designed to feed our offspring. The average age for child-led weaning is two to seven years old.

If a child needs to be fed, they do, regardless of gender. Kids of both sexes have the same need for milk.

Should a boy be denied the health benefits of breastmilk because society has deemed it 'inappropriate'? To help, it would be good to teach kids from both genders to ask for milk appropriately when they are older.

Is it possible to breastfeed my toddler while I'm pregnant?

Be prepared for your milk supply to dip due to hormonal changes. There's an effect on your milk supply as your body starts redirecting resources toward the growing foetus, and pregnancy may also affect the taste of your breast milk.

However, alert your gynaecologist about your extended breastfeeding journey with the elder child.

Should the pregnancy be unstable, the gynaecologist may advise you to wean your toddler off breastfeeding as a form of foetal and maternal health protection. Always check with your gynaecologist in the event of pregnancy.

For healthy pregnancies, many local mums have continued breastfeeding throughout their pregnancy and sometimes even in tandem after the baby is out.

This depends on several factors, including your health, your foetus' condition and how your body adjusts to the changes.

Breastfeeding mums who are pregnant should also ensure that their health takes priority by maintaining a healthy diet and taking prenatal supplements as advised by their gynaecologist.

Many pregnant mums experience an aversion to breastfeeding, which is entirely normal. Sore nipples and pain during nursing are common occurrences, making breastfeeding during pregnancy a whole set of challenges once again.

During pregnancy, the toddler may wean himself for several reasons, including a change of taste in breastmilk and knowing that mummy is in pain during nursing.

When you do decide to wean your toddler

Singapore lactation nurse Jophia Bok advises that gentle and gradual weaning is the way to go. She suggests these steps to make weaning your toddler less stressful for both mum and child:

Limit breastfeeding to once a day.

Reduce the breastfeeding time, e.g., from 25 minutes to 10 minutes.

Delay the breastfeeding time. For example, Jophia's kids only breastfeed for about five to ten minutes before they sleep at night. Some nights when she knows they are tired or in good spirits to sleep, she delays going into their bedroom while winding down on their bed. After a while, when the room is quiet, she peeps in and finds them sleeping on their own.

Remember: patience is key when it comes to weaning. Tell yourself to remain calm if your child starts reacting negatively with tantrums or meltdowns. Do not blow your top, as your child is also trying to understand and transition with the change.

Extended breastfeeding disadvantages

Extended breastfeeding has many benefits for both mom and baby but also some disadvantages.

The most common disadvantage is that extended breastfeeding can be difficult to maintain. You might start with the best intentions, but before you know it, your baby is eating solid foods, and you're struggling to figure out how to keep up your supply.

You may miss out on bonding with a new baby. If you have another child, you'll probably want to spend more time with them than you did with your older child when they were an infant.

As your baby grows up, it may start developing teeth or other physical characteristics that make it harder for them to latch onto your nipple — which can hurt!

You should also be aware that if your baby hasn't started eating solid foods yet, they won't be getting any nutritional value from nursing (which could be dangerous).

This article was first published in theAsianparent.

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