Extended and Tandem Breastfeeding

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As some of you may have gathered from previous posts (or know, if you know me in "real life"), we practice extended breastfeeding (beyond age 1) and child-led weaning. Bekah, 22 months, is still breastfeeding. We believe that children will wean when they are ready to do so, and should not be forced or even heavily encouraged to do so. Since we also have Daniel, who is of course nursing, we are doing what is called "tandem nursing," which is when two children of different ages are both breastfeeding at the same time.

There are many benefits to both practices -- extended nursing and tandem nursing. I'll start with a few here:

*Emotional Benefits: Kids have an emotional need to be close to their mothers, and some fulfill this by nursing. It's often observed that even non-nursing kids will snuggle against their mothers' breasts and seem to draw comfort there. Some older babies and toddlers will attempt to latch onto their mothers even if they didn't nurse. It seems to be biologically programmed for children to nurse and seek comfort that way.

*Discipline/tantrum benefits: There is no better way to get a toddler over a tantrum than to nurse. A toddler having a tantrum is completely out of control and totally overemotional. Nursing calms them and brings them back to equilibrium. Bekah can be crying constantly, unable to talk to me and out of control (and no amount of cuddling with either of us will help), but she'll nurse for five minutes and be completely fine again.

*Nutritional benefits: Toddlers are notoriously picky eaters. Even the ones who aren't picky are often too busy to eat sometimes and don't always get a good variety. If they are nursing, they are getting the proper balance of nutrients and fat and whatever else they eat is fine. That is, if they have days where they don't eat well, it isn't really a concern (obviously toddlers should be eating a varied diet of solids, assuming no medical issues). The content of the milk actually changes as the toddlers age, so it is perfect for them always!

*Bonding benefits: Sharing nursing times with siblings can be a very bonding experience. Siblings have been known to curl around each other, hold hands, stare at each other, etc. The older sibling doesn't need to feel pushed away, like only mommy and baby have that special time; the older sibling is included too.

*Health benefits for mom: Two years or more of breastfeeding, lifetime (not necessarily consecutively) has been shown to reduce the rates of breast and ovarian cancer and provide many other health benefits. Breastfeeding also helps moms to lose pregnancy weight.

There are many other benefits but those are just some major ones.

According to the CDC, in the U.S., 17% of babies are breastfed at 1 year, and almost 6% are still breastfeeding at 18 months (in 2003). Data past this age was not available (70% start initially, for reference). In a study that looked at parents who practice attachment parenting in particular (as we do), 83% were breastfeeding at 1 year, 66% at 2 years, and 44% at 3 years (this doesn't surprise me, as among my friends, you are "weird" if you wean your kid before age 2). So, clearly a subset of the population nurses their kids quite a long time!

I began breastfeeding with the intention of making it to one year -- which sometimes seemed very, very far away. At that time I read about extended nursing and tandem nursing but I just didn't think I could do it. However, what I didn't understand then was that I wouldn't be nursing "a toddler," but I would be nursing MY toddler! Once Bekah was a year, neither of us was at all ready to stop, and I was already pregnant with Daniel. We kept going, and have decided on baby-led weaning (which I'll discuss in a moment). Of course, with Daniel's arrival, we began tandem nursing. He is 5 months now and our nursing relationship is smooth. I feed Daniel (he is still exclusively breastfed; we will start baby-led solids when he is older) every 2 -3 hours, and Bekah nurses typically 3 - 4 times per day (morning, before nap, before bed, if she wakes at night or if she is upset during the day).

Child- or baby-led weaning means that the child chooses when to stop nursing, with no pressure from the parents. This doesn't mean there is NO communication about nursing, of course. Many toddlers start doing acrobatics while nursing (they enjoy standing on their heads, sitting facing you, twisting and turning, etc.) and asking to nurse by pulling up your shirt. At this point, toddlers are taught nursing manners: they are not allowed to nurse if they do any acrobatics, and they need to find a more appropriate way to ask to nurse (such as saying "milk" or another keyword, or signing "milk"). It's best, of course, if the keyword is neutral, not like "boobie!" because your child WILL yell it out in public sometimes. :) After age 1, nursing is really a give-and-take relationship. The mother can feel free to tell the child to wait if they are out, or she is busy, and can offer a substitute for nursing (cuddles, a story, a snack, etc.). If a child bites or doesn't mind his/her nursing manners, s/he may be asked to stop immediately. There is no concern about him/her getting "enough milk" as a toddler (barring allergies or health concerns, of course), so nursing sessions are primarily about comfort.

Many children go through a nursing "lull" around a year old. They lose interest because they are so focused on learning to walk, talk, etc. Some babies will actually self-wean at this point, and refuse to nurse anymore at all. Others will pick up more again after they've achieved their developmental milestone. Once they pick up, many toddlers need to nurse very often (3 - 6 times per day) throughout their second year. Between 2 and 3, many toddlers slow down again and several wean. Some children continue to nurse through their third and fourth years, and some as long as school age, although this is rare. Children who DO nurse past their third year often only nurse if they are sick, upset, etc. and this may be as infrequent as once a month. It is typically not a daily or multiple times a day thing anymore past the third year. There are always exceptions, but it is typical to nurse infrequently at an older age.

In a lot of cases, children nurse so infrequently at an older age that a parent will not notice they have weaned until they look back and realize it's been several weeks since the child's last nursing session. After a few months of not nursing, children will forget how to latch. Children also often lose the ability to latch around age 7 or so. A very good resource on the natural weaning age and how weaning occurs is Kathy Dettwyler's work (she is an anthropologist who has thoroughly studied the subject). I won't go into it in too much more detail because her work is really great, and that link is only a couple pages long, so click it to learn more.

A lot of people have misconceptions about extended and tandem nursing, which I'll try to clear up here:

*Older children nurse as often as babies -- Nope! Many older children only nurse once a day, or even just a couple times a week. Some nurse even less frequently than this.

*Older children will nurse during school; their mother will have to come at lunch time or recess -- Sorry! Most children over age 2 or 3 nurse only at home, and again, probably not very often. Their mothers certainly don't go to school to nurse them.

*Children need to stop nursing to learn to eat "proper" food and drink from a cup -- Not true! Most children learn to use a cup and eat adult food between 6 and 12 months, just like their non-nursing peers, and after age 1 get most of their food from solids and cups. Nursing doesn't mean they don't learn to get nutrition from other sources. After age 1, nursing is mainly (though not entirely) for comfort.

*Children will NEVER wean without their parents' encouragement -- Ever heard of a nursing teenager? It just doesn't happen. When a child outgrows the need to nurse, they will stop. This varies by child; some are actually under a year, while some are 7 or 8. But they will ALL eventually stop with no encouragement.

*Breastmilk doesn't provide any nutritional benefit after 1 year -- False. The milk changes as the child changes and is always perfect. It continues to provide the proper balance of fat and calories, as well as other nutrients, to fill in what the child may not be getting during their picky eating phases.

*Moms practice extended breastfeeding more for their own benefit; they don't want to let their babies grow up -- No way. Children nurse because THEY want to. They can't be forced to do so. Many mothers even grow weary of nursing after awhile, but remain committed to child-led weaning, even if they put some restrictions on nursing (i.e. "only before bed and upon waking"). The entire practice is geared towards meeting a child's needs, not an adult's.

*Nursing will teach children to seek food for comfort -- Nope. A person who uses food as comfort does so in lieu of a more appropriate source, like a friend or spouse or even writing in a journal. Nursing is a time of cuddling with mommy, having mommy's full attention, an intimate moment. The food is secondary, and a distant second at that. Mommy's attention is what matters most. Eventually, when the child weans, he will seek hugs and cuddles and closeness with his mother, not a separate source of food. Nursing a child just isn't the same as saying "Here, eat this piece of candy and stop crying."

*Breastmilk/feeding doesn't provide any other benefit after 1 year -- Sure it does! The many immune benefits continue for as long as nursing does (although the benefits have not been studied beyond age 2). Comfort continues, too. Nursing is a great parenting tool, because it can end tantrums quickly and make sick children feel better. In fact, sometimes breastmilk is the only food a sick child can tolerate.

*Children need to learn to seek comfort away from the breast in order to mature -- Yes, but it's not that simple. Children who are nursing do seek comfort in other ways, too. A child doesn't nurse EVERY time he is upset. Perhaps he needs to sometimes, but other times is satisfied with a kiss, a hug, a cuddle. Nursing is only ONE way that a child seeks comfort, and sometimes it is the most effective way. For example, if a child is devastated, beyond control, nursing can restore equilibrium in a matter of minutes instead of needing an hour to calm down. Children don't need to give up nursing to learn that comfort can be had in other ways too.

*Children who nurse past 1 are dependent and babyish -- Nope! Have you ever met one? Most children who are nursing are VERY confident and independent. They know that their need for cuddling and loving are being met, so they feel quite assured. They often enjoy new people and experiences because they are securely attached to their parents. It is children who are NOT securely attached who have issues with dependence because their needs are not being met.

Extended and tandem nursing is not for everyone, but it is a really great experience. Mothers feel very close to and in tune with their children, and their children feel securely attached to their mothers and very confident. I couldn't parent without it.

How do you feel about extended and tandem nursing? Have you ever done it? Do you have any other myths you'd like cleared up, or questions you'd like to ask?