Is breastfeeding still important after you’ve reached the six-month milestone? And how long should you continue? The answers may surprise you, as the additional health and developmental benefits of breastfeeding – which solid foods and other milks cannot offer – are often overlooked.
How long should I breastfeed for?
The World Health Organization (WHO) recommends breastfeeding for two years and beyond – and this applies to families around the world, not just in developing countries.1
“It’s important to note the WHO doesn’t set a maximum breastfeeding duration,”2 says Dr Leon Mitoulas, Medela’s Head of Breastfeeding Research. “From an anthropological perspective, breastfeeding for between two-and-a-half and seven years would be optimal.3 However, cultural norms today generally entail weaning at a much younger age.”
The WHO’s recommendations are supported by a recent surge in research into the first 1,000 days of a child’s life – from conception to the second birthday.4 Dr Mitoulas explains: “Scientists have discovered the right nutrition, and other factors, have the most profound impact on growth and long-term health during this time. Evidence unequivocally demonstrates that breastfeeding is uniquely beneficial during that crucial 1,000-day window.
“Breastfeeding can be considered a food, a medicine and a signal all at the same time,”5 he adds. “And these trifold benefits certainly continue beyond two years.”
Food: Nutritional benefits of extended breastfeeding
Once your baby starts eating solids at around six months, you might think your breast milk becomes just a ‘drink’ that complements them. In fact, the opposite is true – your baby will only get a tiny proportion of his calories and nutrients from food when he first starts solids.
“The undisputed best start for babies is exclusive breastfeeding for the first six months. But even after your baby starts eating complementary foods, breast milk provides significant nutrition,” says Dr Mitoulas.
When exclusively breastfeeding, a baby typically consumes 750 to 800 ml (26.4 to 28 fl oz) of milk each day. At nine to 12 months old, he could still take around 500 ml (17.6 fl oz) a day, which provides about half his daily calories. By 18 months, he’ll probably have about 200 ml (7 fl oz) a day, which is about 29% of his calories.6
It’s true that after six months your baby needs other foods for nutrients that he may not get from your breast milk or his own reserves, including iron, zinc and vitamins B and D.1,7 But even in his second year of life, breast milk provides significant amounts of other key nutrients, as Dr Mitoulas explains:
“At this stage, breast milk provides about 43% of a baby’s protein, 60% of his vitamin C, 75% of his vitamin A, 76% of his folate, and 94% of his vitamin B12.”8
Medicine: Health benefits of breastfeeding after six months
Whilst the message to promote exclusive breastfeeding for six months is well known, there is not much information on the role of breastfeeding and human milk beyond six months, once complementary foods have been introduced to an infant’s diet. This is despite organisations such as the WHO recommending the provision of human milk beyond six months.1
Continuing to breastfeed after six months has been shown to lower the chances of some childhood and adult illnesses and, if your baby does get ill, helps him recover more quickly.
Breastfeeding protects your baby from infection and illness, so much so that it’s even considered a form of ‘personalised medicine’, with potential lifelong effects,” says Dr Mitoulas.
For example, breastfeeding for longer than six months has been shown to protect your baby against certain childhood cancers, such as acute lymphocytic leukaemia and Hodgkin’s lymphoma.9 Breastfeeding might also lessen his chances of developing type 2 diabetes,10 although this effect is confounded, or attenuated by factors such as smoking, gestational weight gain, preterm birth and other factors. There are also benefits for your baby in terms of sight 11 , dental problems,12 and obesity.”13
Your breast milk can also reduce your baby’s risk of diarrhoea and sickness,14gastroenteritis, colds and flu, thrush and ear, throat and lung infections.9,15This is especially helpful as he gets older and starts interacting with other children or going into childcare, where germs can be rife.
Breastfeeding can also be a lifesaver, as Dr Mitoulas points out: “The consequences of not breastfeeding between six and 23 months can be dire in low- and middle-income countries, where babies who aren’t breastfed are twice as likely to die from infection as babies who are breastfed, even partly.”16 And breastfeeding is not just about the benefits of your milk, it’s also wonderful for nurturing and calming your baby. Nothing soothes an upset infant or toddler like a nursing session with mum. As your baby grows, a feed helps with everything from teething and vaccinations to the inevitable knocks and scrapes or viruses that occur along the way. For many mums, breastfeeding can feel like a miracle worker.
Signal: Enhanced benefits
The act of being close to your baby, instantly responding to his needs and engaging in lots of eye contact also sends signals between you. Scientists think these could affect many aspects of your child’s development, from appetite to academic performance. The longer you breastfeed, the stronger the positive outcome is likely to be.
Breast milk contains thousands of active molecules,” Dr Mitoulas explains. “These range from enzymes that help digest fats17 and hormones that regulate appetite,18 to immune molecules that promote immune system development.19
Did you know that breast milk is actually alive? Every day your baby drinks millions to billions of living cells20 – there are thousands of them in each millilitre of your milk, including stem cells,”21 he continues. “Each one of these cells has a specific job in terms of keeping your baby healthy, and research is ongoing to discover exactly how these components benefit an infant during long-term breastfeeding.”
One thing that’s already known is that extended breastfeeding has a positive impact on a child’s IQ. Studies show a consistent three-point IQ advantage for children who were breastfed over those who were never breastfed.22
Shouldn’t I switch to follow-on formula after six months?
The health claims on the packaging may look impressive, but there is no better milk for your baby than your own.
No formula milk contains all the antibodies, live cells, growth factors, hormones or helpful bacteria, nor the array of enzymes, amino acids and micronutrients found in breast milk.25 Your milk adjusts to provide your baby with more infection-fighting antibodies and white blood cells when he’s ill26 – something formula simply can’t do. Read Breast milk vs formula: How similar are they? for more information.
Breastfeeding after six months: Benefits for mums
Extended breastfeeding isn’t just brilliant for your baby – it’s also great for you. By continuing breastfeeding beyond six months, you lower your lifelong risk of developing heart disease,27 type 2 diabetes28 and cancers of the breast,29 ovaries30 and uterus.”31 And breastfeeding mums often find their periods don’t return for many months – and possibly for as long as two years.32
“The desire to get back to their pre-pregnancy body weight is a significant one for many mums,” says Dr Mitoulas. “One study showed that a mother’s body mass index (BMI) is 1% lower for every six months of breastfeeding.”24
Not to mention that after six months, breastfeeding is very convenient. Your breasts produce the right amount of milk when they need to and you don’t have to clean equipment or take anything with you when going out. You may also find you’re increasingly only feeding at times that fit your routine, such as before work, after childcare pick-up, and at bedtime. And even if you’re back at work, you can use a breast pump to express milk for your baby so he can continue enjoying the advantages.
With so many potential benefits, it’s perhaps not surprising a growing number of mums are choosing to practise ‘natural-term’ or ‘full-term’ breastfeedingand letting their child decide the right time to stop.