A couple months ago, I worked in a different location with coworkers I don’t know well, and a woman saw me carrying my freshly pumped milk to the employee kitchen to refrigerate.

“How old is your baby?” she asked.

“Thirteen months,” I responded with a smile.

“Oh!”, she exclaimed. “And you’re still breastfeeding?”

“Mmm hmm,” still smiling, waiting to see where this was going to go.

“Why?”

“Well, because it’s still healthy for him and we both like it. The experts recommend breastfeeding for at least a year, so that’s what I’m doing.” (Of course, you know I have many more reasons, and I am breastfeeding well over 1 year, but I wanted to keep it simple and friendly)

“Yeah, but once you get to a certain age. . .’  she left her sentence unfinished as she shook her head disapprovingly. ‘I breastfed for 3 months and then we were done.” And then my coworker joined us and changed the subject.

I didn’t want to push the issue, but I was thinking, “Once you get to a certain age, what?” Do you think I am wasting my time because breast milk is no longer a healthful food? I’m spoiling my child by giving him something comforting that you associate with newborns and young infants? I’m sexually traumatizing him by exposing him to my breast and letting him suck on it? Inhibiting his independence by providing something that he can only get from me, his mother?

This woman’s reaction is nothing new. I’ve heard all those objections to “extended breastfeeding” before, in various forms. (in case you are wondering, all are unfounded: studies have shown there are no negative effects on the breastfeeding child’s development.) The mothers-to-be in my prenatal breastfeeding classes often express surprise, disgust, and amusement when I suggest the health benefits of breastfeeding for a year or more. This has led to comments about how inappropriate it is to nurse a child who can walk, talk, and ask for the breast.

In a previous post, I listed some of the good reasons to breastfeed longer than a year, and why my baby and I are not weaning yet. We continue to reap great health benefits from it. I know it’s best to keep breastfeeding, so why do I end up feeling defensive when questioned about it? And why is our society so disapproving of such a good thing? Even though I am surrounded by breastfeeding advocates and fellow breastfeeding mothers, I am constantly reminded that our society thinks we’re a little weird.

So what’s “normal” for breastfeeding and weaning? Many of the things that we take for granted as “normal” in our lives to us are rooted in our local culture, and not universal human norms. Here are a few reasons why breastfeeding beyond babyhood is perfectly normal.

Most human cultures breastfeed way longer than we do

The worldwide average duration of breastfeeding is far longer than our norms in the U.S. Less than 25% of babies in the US are breastfed until one year; less than 10% are breastfed to 18 months. In comparison, in developing countries, over 50% of children aged 20-23 months are still breastfeeding. During the months I spent in Central America, I saw mothers everywhere nursing their babies, toddlers, and preschool-aged children, and it was so normal, nobody even seemed to notice.

All the other mammals breastfeed their offspring longer

. . .based on weaning age in relation to key developmental milestones, that is. Several years ago, I had the privilege of hearing Katherine Dettwyler, PhD, speak at a seminar. Her research, from a biological and anthropological perspective, concludes that the natural biological weaning age of human children is 2 .5 – 6 years. A short summary is found here. Her comparisons of human milestones to those of other mammals in relation to weaning age is fascinating, and it makes sense.

Extended breastfeeding is more common than most people think

There are a lot of “closet nursers” out there. I’ve known many moms who breastfeed far longer than a year, but who limit it to home and don’t talk about it in public simply because of the negativity they have been met with. A common piece of advice to mothers is to teach the child a “code word” for breastfeeding, so that the child doesn’t blurt out “Boobie, Mommy!!” while in line at the grocery store.

Breastfeeding beyond the first year (or whatever length of time) may not be for everyone, and I don’t think we need to convert all mothers into extended breastfeeders. But I bet more moms would discover how much they enjoy nursing during toddler years if they gave it a chance, if they didn’t feel pressure from family, coworkers, and society to wean at a certain age.  And I hope for a society that can learn to accept and support mothers who continue to breastfeed without questioning her parenting abilities.

Welcome, Readers of February’s Carnival of Breastfeeding! After you read this, check out the other great posts on the theme of “Overcoming Breastfeeding Challenges” linked at the bottom of this post.

I’ve spent more than enough time dwelling on all the things I did wrong after my son was born, as you can read in my earlier post, When breastfeeding begins badly, and what I should have done about it. Here’s what I’ve learned from my experience, and in the work I’ve done with breastfeeding moms since then:

1. Many (but not all) breastfeeding problems can be prevented.
2. Nearly any breastfeeding problem can be overcome with help from an International Board Certified Lactation Consultant (IBCLC),  enough support at home, and determination.

I did it.  Here’s my story about how we fixed our breastfeeding problems.

But wait. It’s really important for me to write a disclaimer here. Every mother-baby couple is unique. What was recommended for me might not work for you. I share my story not to give advice, but to let you know that if things are going badly, there is still hope! Don’t give up; get help. If you’re having problems, don’t put off seeing a lactation consultant. The sooner you get help, the easier it will be.

Our breastfeeding problems, in a nutshell

My son nursed very poorly for his first few days of life. Then, I developed serious postpartum complications and my doctor advised me to stop breastfeeding for a week (I  “pumped and dumped” to keep the milk coming) while on medications. When I tried to resume nursing after a week of the bottle, my baby would arch his back, cry, and push away when I offered the breast. We went on for what felt like ages like this, while I was heavily supplementing my baby with formula and crying at nearly each nursing attempt.

There was no single, quick fix, but rather a succession of measures prescribed over a period of several weeks by the lactation consultants I saw. Here are the steps we took, under professional guidance.

Get the baby on the breast ASAP. Even though that meant using a nipple shield.

I was adamantly opposed to nipple shields at first, but I learned that sometimes, these are just the right tool. Not only was he barely latching, but my nipples were bleeding from the failed attempts. Taking the breast with a nipple shield is infinitely better than no breastfeeding at all. So we got my son onto the breast, while I pumped after feedings for his supplements to try to build my milk supply. But this wasn’t enough- after awhile my milk still wasn’t increasing and he wouldn’t take the breast well without the nipple shield. Back to see the lactation consultant.

Get a really, really deep latch.

The lactation consultant said I was doing a pretty good job of bringing him onto the breast, but his latch could be even better. She showed me what she called “the deep latch technique” that helped my baby take more breast in his mouth than I thought possible. Having him on so far was more comfortable for me, and it helped him draw out more milk.

But my baby didn’t like how it felt. The breast reaches farther back into the throat than a bottle, and he wasn’t used to it. I had to hold him forcefully to prevent him from pulling  his head backward and weakening the latch.

So we finger-fed. After breastfeeding, instead of giving a bottle of supplemental milk, I would bring him to my mother or husband for a finger-fed supplement while I pumped. They would stick their index finger waaaay back in his throat while injecting supplemental milk into the corner of his mouth with a special syringe. When he sucked the finger, they would release milk. When he paused, the milk flow stopped.  He gagged at first. This was hard to do, (my husband says this is a huge understatement!) but it helped him learn to accept the breast.

But he sucked lazily at the breast, perhaps because he knew more milk would be coming after the breast to fill him up. And because I still wasn’t making enough milk.

Make more milk.

My milk supply was low from the very beginning, for a number of reasons. At 5 weeks, the lactation consultant’s scale told us that he only took 1.9 oz from both sides after 45 minutes of nursing.  I took herbal supplements to increase milk supply and pumped with a hospital-grade breast pump after feedings to stimulate milk production. By 6 weeks, I had enough milk that we stopped the supplemental formula. His supplements after nursing were nothing but pumped breast milk.

But by 8 weeks, he still wasn’t nursing efficiently enough to get a full feeding at the breast. The lactation consultant taught me how to use a supplemental nursing system (SNS), a contraption that delivers supplemental milk through a tiny tube at the breast while the baby nurses. It speeds up the flow of milk,  making him suck more vigorously, which in turn stimulates more milk production.

Happily ever after

So there you have it. I gradually increased the number of un-supplemented breast feedings until he was off all supplements and taking nothing but the breast at the age of 4 months. At 6 months, I went back to work, pumping milk for his bottles, and nursing while home, and now at 14 months we’re still breastfeeding mornings, nights, and weekends. My son loves to nurse, asking for “nuh-nuh”, although he’s so busy playing and his tummy gets filled with solid food, so it’s not as often anymore.

Was it worth it? Yes. Many, many times, I nearly gave up. It was really hard. I couldn’t have done it without help from family and encouragement from my pro-breastfeeding friends. But this is what motivated me to stick with it. Knowing that my baby would be as healthy as possible. That once we got the hang of it, nursing at the breast would be so easy; ready anytime, anywhere with no preparation or cleanup. That I would have this special way to comfort and soothe him throughout his infancy and beyond.

Again, my story is not a formula to solve the problem of breast refusal. There are a number of approaches to coaxing a bottle-drinking or supplemented baby onto exclusively nursing at the breast. Read a great article about that here. And if it’s just not working, a lactation consultant may have a solution.

Did you have difficulties in breastfeeding? How did you overcome them? What motivated you to persevere?

Other Carnival of Breastfeeding Posts:

Breastfeeding 1-2-3: The importance of a babymoon

The Motherwear Breastfeeding Blog: Which obstacles have you overcome to breastfeed?

Hobo Mama: Supplemental feeding techniques for a breastfed baby (some of the same techniques I used!)

Whozat: A rough start

Maman A Droit: Clueless!

Jessica Montalino: Motherhood: Week 7 and our breastfeeding experience

Breastfeeding Moms Unite: I’ll be brief: How to overcome breastfeeding challenges

Living Peacefully with Children: When nursing takes longer

Good Enough Mum: Tounge tied and twisted

Mama’s Herb Garden: Nine things your nipples wish you knew about them

Hello, readers! I do realize it has been 20 days since my last post. There’s more coming, I promise. But first, I want to give you a personal update.

When I started this blog, I was working part-time while mothering my 8-month-old baby, but now I work full-time.  I’m not complaining: although it’s financially necessary, (my husband is a full-time graduate student) I truly enjoy the work I do. But the work schedule leaves me with an hour and a half every weekday evening with my son before his bedtime. It’s not enough. As soon as he’s in bed, I’m preparing lunches, laundering or packing cloth diapers, washing breast pump pieces, and packing everything up for the next day.

One post per week is challenging for me. I wish I could write faster, spend more time blogging, and post more. I’d love to interact more with the blogs I enjoy and admire. To answer the great questions some friends and readers have emailed me (sorry guys, I haven’t forgotten, especially about those milk-supply and pumping questions). I just haven’t found a way to do it all without cutting into my sleep or family time.

I’ve just had a burst of encouragement from three sources: a friend/fellow blogger who I admire recently told me she wished I posted more often; a company contacted me to do a review/giveaway of their product, and I just discovered links to some posts I have written on message boards and discussions. So I’m inspired to spend a little more time here and to let you know that The Milk is still flowing. . .

My son’s first birthday is right around the corner, and a few people have asked me The Question.

“So, how long are you going to breastfeed?”

My response changes every time, because the truth is, I have no idea.

One year old is the age at which babies can safely digest whole cow’s milk, so non-breastfed babies may transition off formula. It’s also the age when many babies are weaned from the breast. The American Academy of Pediatrics recommends at least 1 year of breastfeeding.  But there is a wealth of evidence that toddlers continue to benefit from breastfeeding beyond one year.

Here’s why I’m not weaning at one year:

• Breast milk continues to give my baby protection against illness. The American Academy of Family Physicians position paper on breastfeeding states “If the child is younger than two years, the child is at increased risk of illness if weaned”.
• I’m not ready for another baby yet. The hormones of breastfeeding supress fertility, and so far, I have no signs of ovulation. At some point, it’ll come back whether I wean or not, but I’ll take as long as I can get.
• The longer I breastfeed, the more I’ll lower my future risk for breast, uterine, and ovarian cancer.
• I’m thinner now than I was before pregnancy, despite eating more and exercising less, because of breastfeeding.
• My son loves nursing and he is comforted by it. He now asks to nurse in the morning and when I get home from work. He looks sweetly at me and holds up his hand, making the “milk” sign that I taught him. I love cuddling with him and how he melts in my arms when the milk starts flowing.
• Twice now, he’s been sick and refused to eat or drink anything. But he still wanted to nurse. A LOT. I’m sure it was because he felt miserable and wanted comfort, not because he was hungry. It was such a relief to have a way of keeping him hydrated and nourished. I like having this emergency food supply for him.

For more on these reasons (and more) for breastfeeding beyond a year, check out Kellymom.com’s resources about breastfeeding after the first year, with several articles and fact sheets; and Dr. Jack Newman’s article Breastfeed a Toddler – Why on Earth? addressing the normalcy and benefits of extended breastfeeding.

So how long will I breastfeed? All I know for sure is that neither of us are ready to wean yet. I hope to breastfeed at least another year. Ask me again when he turns two!

How long did you (or will you) breastfeed? How did you decide when to wean?