Why I Breastfeed My Four-Year-Old

Breastfeeding recommendation

That is the catchy title of a recent article published in the British newspaper The Daily Telegraph that tells the story of Vickie Krevatin, who breastfeeds her four-year-old son Jessy because, she says, it alleviates his symptoms of attention deficit hyperactivity disorder (ADHD). You may remember Lynn Stuckey, who in 2000 went to the TV show “Good Morning America” to explain why she breastfed her older son. In her case, The Illinois state’s attorney’s office and the Department of Children and Family Services claimed that breast-feeding a first-grader was “sexual molestation”, but a family court judge disagreed. When her son was 8 years-old, he still nursed occasionally, even when she was not certain she was producing milk (story).

The American Academy of Pediatrics recommends breastfeeding exclusively for the first six months, then gradually introducing solid foods while continuing to breastfeed for at least six more months (to age 1) and after that for as long as mother and baby both want to. The World Health Organization recommends breastfeeding for at least two years.

Breastfeeding is one of the most effective ways to ensure child health and survival. “If every child was breastfed within an hour of birth, given only breast milk for their first six months of life, and continued breastfeeding up to the age of two years, about 800 000 child lives would be saved every year”, state Professor Robert Black and colleagues in a study published in the journal The Lancet. Listen to an interview with Professor Black here.

And yet, according to the U.S. Surgeon General, only 74.0 percent of American infants born in 2006 were ever breastfed. The goal is to increase that number to 81.9 percent by the year 2020. This requires effective strategies to overcome the numerous barriers to breastfeeding:

  1. Lack of Knowledge

A study reported that only 36 percent of women thought that breastfeeding would protect the baby against diarrhea. Another national survey found that only a quarter of the U.S. public agreed that feeding a baby with infant formula instead of breast milk increases the chances the baby will get sick.

  1. Social Norms

In the U.S., bottle feeding is viewed by many as the “normal” way to feed infants. Certain cultural beliefs and practices also contribute to what women consider to be normal feeding practices although some of these practices are not recommended today. The mistaken belief that, for babies, “big is healthy,” can lead to both formula feeding and inappropriate early introduction of solid foods.

  1. Poor Family and Social Support

Women with friends who have breastfed successfully are more likely to choose to breastfeed. On the other hand, negative attitudes of family and friends can pose a barrier to breastfeeding.

  1. Embarrassment

A study found that only 43 percent of adults believe that women should have the right to breastfeed in public places. Restaurant and shopping center managers have reported that they would either discourage breastfeeding anywhere in their facilities or would suggest that breastfeeding mothers move to an area that was more secluded.

  1. Lactation Problems

Frequently cited problems with breastfeeding include sore nipples, engorged breasts, mastitis, leaking milk, pain, and failure to latch on by the infant. One national study on feeding practice found that about 50 percent of mothers cited insufficient milk supply as their reason for stopping breastfeeding.

  1. Employment and Child Care

Women often face inflexibility in their work hours and locations and a lack of privacy for breastfeeding or expressing milk, have no place to store expressed breast milk, are unable to find child care facilities at or near the workplace, face fears over job insecurity, and have limited maternity leave benefits. The Patient Protection and Affordable Care Act requires employers to provide unpaid, reasonable break time for an employee to express breast milk for a year after her child’s birth. More information can be found here.

  1. Barriers Related to Health Services

Studies have identified major deficits relevant to breastfeeding in hospital policies and clinical practices, including a low priority given to support for breastfeeding and education about it, inappropriate routines and provision of care, fragmented care, and inadequate hospital facilities for women who are breastfeeding.

So, for how long should you breastfeed? Most experts agree that you should breastfeed at least the first six months, then gradually introduce solid foods while continuing to breastfeed for at least six more months (to age 1) and up to eighteen more months (to age 2). Breastfeeding beyond age 2 may be advisable on a case-by-case basis but is rare.

Diego Wyszynski
Dr. Diego Wyszynski is the Founder and CEO of Pregistry. He is an expert on the effects of medications and vaccines in pregnancy and lactation and an accomplished writer, having published 3 books with Oxford University Press and more than 70 articles in medical journals. In 2017, he was selected a TEDMED Research Scholar. Diego attended the University of Buenos Aires School of Medicine and Johns Hopkins School of Public Health.

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