Breastfeeding is still hugely beneficial to both mother and baby beyond 12 months of age, unfortunately most advice and support for breastfeeding mainly refers to infancy, leaving mums unsure about their breastfeeding journey into toddlerhood, especially when they and their child are not ready to wean. Most babies naturally continue to breastfeed beyond 12 months of age, with completed weaning usually occuring between 2-7 years of age.
Breastfeeding beyond 12 months will continue to support a child’s immune system. For as long as you feed your child they will continue to receive hormones, antibodies, white blood cells, immunoglobulin A, G and M, human milk oligosaccharides (which help to develop a child’s microbiome and support gut function and gut health), free fatty acids, and nucleotides to support their immune system. These protective factors can actually increase during the second year of breastfeeding and during a gradual wean.
There is no age at which breastmilk is considered to become nutritionally insignificant for a child. Breastmilk continues to be a source of nutrition, and can provide 29% of daily energy and 43% of protein requirements for a toddler, and also a good source of vitamins and minerals meeting 75% of vitamin A and 60% of vitamin C requirements, and also a source of essential fatty acids.
Breast feeding will continue to support a child’s emotional and social development. There is a large body of evidence for a positive association between breastfeeding and cognitive development later in life
Breastfeeding for 12 months or more also benefits mothers and has been shown to reduce the risk of breast cancer, ovarian cancer, high blood pressure, heart disease and diabetes.
So that being said, what does breastfeeding a toddler look like, how often do we feed them, when do we feed them, and will it affect their intake of solids?
How often do I breastfeed?
The WHO recommends that toddler's continue to breastfeed frequentley and on-demand until 2 years of age or beyond.
Toddlers will want to breastfeed for many reasons; including for comfort, for connection, for nutrition, to aid sleep and for immunity.
Each mother child feeding relationship is unique, there is not a one size fits all approach. Some 12-18 month old toddlers still want to feed 5 x day and as they get older the frequency begins to drop. Others are content to feed 3 x per day, whilst others like to feed through the day and night.
Breastfeeding a toddler can look different one day to the next, depending on sleep, emotions, growth, solid intake and appetite. It is okay to follow your child’s cues for breastfeeding.
When do I breastfeed?
Beyond 12 months usually solid foods come first and breastfeeds come after, although this will depend on wake times and meal-times.
Toddlers typically breastfeed around 3-4 x a day (somedays may be more than others)
It may be helpful to make sure that breastfeeding is spaced out 1-1.5 hours away from a meal.
It is okay for your toddler to demand breastfeed as long as there are regular nutritious meals and snacks provided with 4- 5 opportunites to eat throughout the day.
Routine Example 12-18 months (2 x naps)
6.30/7am Breastfeed
8am Breakfast
9.00am Breastfeed
9.15am -10.30am First Nap
10.30 am Morning Tea
12.30 Lunch
1.30pm Breastfeed
2pm - 3.30pm Second Nap
3.30pm Afternoon tea
5.30pm dinner
7pm Breastfeed before bed
Routine Example ~ 18 months (1 x nap):
7am Breastfeed
8.00 am Breakfast
9.30am morning tea
11.30pm Lunch
Breastfeed before their nap (nap 12-2 ish)
2.30 Afternoon tea
5.00pm dinner
7pm Breastfeed before bed
It can be common for health professionals to recommend weaning for toddlers who are not eating well. However, there is no evidence to support this recommendation. Research does show that in situations where breastfed toddlers have an increased risk of malnutrition, this appears to be due to inadequate nutrition from solid foods or reverse causality (the mother is more likely to continue breastfeeding a child who is ill or growing poorly). In one study of 250 toddlers in Kenya, solid food intake increased after weaning, but not enough to replace all the fat, vitamin A, and niacin that the child had been getting via breastfeeding (Onyango 2002).
Some toddlers may still wake at night to breastfeed, this is very normal. Toddlers nutritionally do not to feed overnight to meet their requirements, however if night waking and feeding back to sleep is working for you then this is okay. If night waking to feed is frequent and this is causing stress, then night weaning and using other strategies to re-settle your toddler is also fine.
As your toddler grows, they become more active and independent and they begin to eat more, they naturally start to reduce their number of breastfeeds.
Do I need to give cow’s milk as a drink if i am breastfeeding?
No, cow’s milk as a drink is not necessary if you are breastfeeding (or even if not breastfeeding).
Many mums are told that they must introduce cow’s milk as a drink at 12 months of age, however this is not necessary.
Breastmilk is an excellent source of fat and protein and will also contribute to a toddler's overall calcium intake, but not all of their calcium needs. Beyond 12 months with continued breastfeeding, it is recommended to include a varied diet for toddlers with foods rich in calcium to meet additional calcium requirements, such as greek yoghurt, sardines, cheese, white beans, tofu and chia seeds.
Breast feeding your toddler and childcare
Your child care provider should support you to continue to breastfeed your toddler. It is against the law for a childcare provider to ask you to stop breatfeeding or to refuse to feed your toddler expressed breastmilk, they must also let you breastfeed or express milk on the premises. Your right to breastfeed is protected under the ACT Discrimination Act 1991.
Breast feeding your toddler and work
Discuss your needs with your employer, if you wish to express during the day your employer will need to provide you with a private space to do so (not a toilet cubicle) and a fridge to store the expressed milk in.
You may wish to adjust your breastfeeding regime to accomodate work by breastfeeding before work and after work. This may take some adjustment to begin with if you find that you are going long periods without breastfeeding (some pumping may be required).
It is okay to set boundaries when breastfeeding a toddler
Toddlers will want to breastfeed for many reasons; including for comfort, for connection, for nutrition, to aid sleep and for immunity. There may be times when you are unable to breastfeed, you don't feel like breastfeeding or it may be close to a meal time.
Setting boundaries is a loving way to support your child to learn about their needs and also supports your needs as well.
It is okay to say 'I see you want a breastfeed, we are about to have dinner, would you like a hug and a drink of water'
Funny things toddler's do when they breastfeed
Breastfeeding toddlers can be really funny as they can be so unpredictable.
They may let you know they want a breastfeed by pulling or lifting up your top at the most inconvenient time
They may push their hand in your mouth or put fingers up your nose
They will pronanly grab your other bood whilst they are feeding (cause one bood is not enough), watch out for the nipple cripple
They may perform a gymnastics routine whilst still attached to your nipple - or you may get a foot in your face
X Anna