There’s so much controversy over breastfeeding that a lot of attention in the media is focused on debating whether it’s breastfeeders or formula-feeders that are put under more pressure. The simplest answer is that both are under different kinds of pressure that they don’t want. The underlying issue we should be debating is enabling women to have the choice to breastfeed or not according to their own judgement. To do that we need a society that is accepting and supportive of both. We’re a long way from that. As breastfeeding rates are so low in Western society, the topic of extended breastfeeding is one that you don’t really raise outside of breastfeeding-friendly circles unless you’re willing to argue your way through some very strong opinions.
WHO recommends mothers worldwide to exclusively breastfeed infants for the child’s first six months to achieve optimal growth, development and health. Thereafter, they should be given nutritious complementary foods and continue breastfeeding up to the age of two years or beyond. – World Health Organisation website
Even the phrase ‘extended breastfeeding’ sounds like something that must be abnormal. It means breastfeeding past the age of 12 months (or 24 months in some cultures). The WHO recommends breastfeeding to the age of 2 or beyond. Full-term breastfeeding is a less commonly used phrase, but is a far more accurate term based on this. There are plenty of extended breastfeeders around Ireland, probably a lot more than you realise unless you’re one yourself. Because most are minding their own business and feeding their children quietly and unobtrusively. Unfortunately that doesn’t help to normalise breastfeeding, and particularly full-term breastfeeding in our society. Who has time to look after their baby and deal with trolls though?
Before I became a mother I was ignorant and uneducated about breastfeeding. I knew it was the most natural way to feed my baby, but I wasn’t sure if it was something that I would naturally feel comfortable doing. My expectations were that I would give it a try for six weeks and maybe I’d do a full six months. Where the idea of six months came from, I didn’t really know. Most likely from growing up in a society where formula companies are banned from directly advertising their formula until babies are past six months of age. At that point they’re free to blind us with the dubious science behind various ‘follow on’ milks we don’t need, subtly implying that if you’re still breastfeeding you should move on to formula now. I wasn’t actually aware that breastfeeding rates were so low in Ireland. Or any of the reasons why. I hadn’t heard the term ‘extended breastfeeding’ and if I had, I certainly would not have planned to do it myself.
I started out breastfeeding my first newborn with some assistance in the hospital. I had little confidence in what I was doing and was still recuperating from the birth. Less than 12 hours after I left the hospital I was being told that I must use formula to top up and get a breast pump as soon as possible. Instinct led me to abandon the poor advice from the midwife, but it couldn’t show me how to feed my baby easily and without pain. I pushed through just a bit longer, taking it one day at a time, and reached my six week goal. Albeit with an oversupply problem thanks to the unnecessary pumping early on which meant I only fed with muslins ready to catch all the milk that my baby had learnt to let leak out. I tried a lactation consultant. I went to the local HSE breastfeeding group. I still found myself in tears many nights at the thought of the next feed. My baby woke every hour looking to feed again on cuts and bruises that I struggled to heal.
My siblings and I had all been breastfed for at least a year. Things have changed since my babyhood though, and I found that my mother didn’t really understand the difficulties of breastfeeding when it’s not the norm anymore. It’s no longer something you ‘just do’ because now women don’t often have a wide network of experienced people around to show them how. She was the second person to encourage me to use formula – this time to stop my baby waking during the night ‘because he was hungry’. An attempt to help, but not the kind of support I needed. I had no close friends who had breastfed their children. In fact I don’t even recall ever seeing a baby being breastfed until I had my newborn and was suddenly socialising in a world of mothers and babies instead of male-dominated offices. Yet three months in and I abruptly found myself the only one still breastfeeding in my favourite mum & baby class. It felt like we were on our own. Days passed and we kept going. Mostly due to sheer stubbornness and a desire not to quit before all the struggling reaped some benefits. Like the times we could travel easily without bottles or sterilisers or tins of powder. Nothing required but the choice to continue breastfeeding… and a wad of muslins.
Later we moved house and I found my (first) Cuidiú village. At this point nap times clashed with breastfeeding support classes. We were muddling along reasonably well aside from his propensity to bite while teething, which he usually was. Yet the regular coffee mornings in the presence of breastfeeding and bottle-feeding Mums and babies did the job of slowly normalising breastfeeding for us. There were women using SNAs or shields. There were others tandem-feeding. There were plenty who had formula-fed from the start, chose to do a mix, or had ended their breastfeeding journeys early by choice or necessity. In an open environment where all choices were valid, I learned a lot that I wished I’d known in the early days. My baby was never the oldest ‘still breastfeeding’. It was thanks to this village that my goal moved from six months… to one year… to whenever my toddler would wean himself… He showed no interest in doing so. I gently encouraged him to wean where possible. He resisted firmly. Little by little more days and months went past. We were still breastfeeding, and that was our normal.
Gradually though, the number of feeds did drop. Except at night. There were so many sleepless nights. They continued all the way past his second birthday before his teeth were fully down and suddenly, just like that, he night-weaned himself. No drama. His stretches of sleep grew longer and he wasn’t looking for milk when he woke. Sadly for us, he did still wake virtually every night and does to this day. The sleep-inducing effect of breast milk was something we did miss for getting him back to sleep faster. Now we were down to nap time and bedtime feeds. Bedtime was cut surprisingly easily by reducing his feeds and moving them to before bedtime stories. The length of feeds dropped quickly to literally a count of ten on each side. He had access to water if he was thirsty after that. Then a change of bedtime story broke the routine enough that he forgot all about the token bedtime feed.
The last feed to go was the nap time one. This was a real battle with a child who was always insanely difficult to put down to sleep. In the end a sore blister meant I couldn’t feed him on one side. When he accepted this without much trauma I applied the same ban on the other. That was it. We were done! He asked a couple of times and was told everything was still broken. He wasn’t too bothered and stopped asking within a week. At nap time I happily drove around until my cranky toddler finally fell asleep for that awkward phase just before daytime naps were no more. I can’t even remember the ‘last time’ we breastfed. It had been a gradual process with no hormonal imbalances or excess milk to pump. No regrets either, I was more than done. 2 years and approximately 3 months. Far longer than the initial six week attempt I’d committed myself to. From a modest start, our breastfeeding journey had slowly taken us all the way into extended breastfeeding territory.
Statistics are scarce when it comes to breastfeeding past the first few months. The number of women still breastfeeding at six weeks is shockingly low in Ireland. By six months virtually no one seems to be breastfeeding anymore and although I know so many extended breastfeeders through Cuidiú and La Leche, we’re very much a minority. I’ve written before about the lack of decent support for new mothers who want to breastfeed. Now that funding has been cut for the ‘baby friendly’ hospital initiative there is even less support. I’m pro-choice when it comes to breastfeeding. Everyone should choose what’s best for them. But they should have that choice, with support for whatever they do. For now the ‘extended breastfeeder’ remains an endangered species. The less full-term breastfeeders there are out in public – whether that’s for six months or a few years – the less normalised breastfeeding in general becomes, and the harder it is to find peer support when you need it.
World Breastfeeding Week draws to a close today as I sit here in Canada instead of Ireland, feeding my second child. It has been a vastly different breastfeeding experience with the support of my lovely homebirth midwife and two Cuidiú villages. Once again we are on the brink of continuing on to extended breastfeeding with no expectations of when he should or will wean. One day at a time until our journey is done. I can only hope that my own children will become parents in a world where this is not unusual and the art of breastfeeding is flourishing once again. In that world they can easily find the support they want whether they choose the same path or not.