Everybody knows that breastfeeding is recommended (i.e. “breast is best”) when the baby is small. I have a nit to pick with that terminology, as do many breastfeeding advocates these days. Because breast is not best, breast is normal, standard, the benchmark – and formula is substandard. This means that by offering your child formula, you are exposing them to increased risks of a number of illnesses, not just while they babies, but all the way down to their adulthood, that they would not normally be exposed to. Yes, the increase of risk is slight and not inevitable, so no, offering your baby formula is not irresponsible, or a death sentence, etc. However, it is not the same. What I’m advocating is being familiar with the facts before you make your decision. Formula making companies spend billions on advertising to convince the world that formula is harmless and pretty much the equivalent of breastfeeding, when in fact this is far from the truth. At the very least, not even formula makers dispute that “breast is best” in the first 6 months of life.
But not many people know that there are many advantages to continuing to breastfeed your child well beyond 6 months. In fact, the WHO (World Health Organization) and UNICEF both recommend breastfeeding to continue until 2 years of age – and beyond if mother and child both desire it.
Because quite the contrary to many myths about long-term breastfeeding, breastmilk continues to bestow the same benefits on children after 6 months of age that it did before 6 months of age. In other words, it continues to be the most easily digested, and most complete food your child can have, including personalized immune protection conferred from the mother’s body to the child. Increasingly beyond 6 months of age, breastmilk may not be enough (not because the amount of it decreases, but because the child’s appetite and nutritional needs increase), so it needs to be supplemented – gradually – so that by 1 year of age, ideally the child gets 50% of his or her calories from breastmilk, and the other 50% of his or her calories from a balanced diet.
In the second year of life, between the ages of 12 and 24 months, half a liter of breastmilk provides
- 29% of energy requirements
- 43% of protein requirements
- 36% of calcium requirements
- 75% of vitamin A requirements
- 76% of folate requirements
- 94% of vitamin B12 requirements
- 60% of vitamin C requirements
Dewey KG. Nutrition, Growth, and Complementary Feeding of the Breastfed Infant. Pediatric Clinics of North American. February 2001;48(1).
As you can see, breastmilk continues to provide significant nutritional benefits for the child well after the first birthday. In fact, many children in their second year continue to consume a good deal of formula or other milk product, which means that so as long as a child insists on having milk/formula for breakfast or at bedtime, it would be natural for that child to breastfeed.
Perhaps even more important than the nutritional benefits are the immune benefits of continued breastfeeding. When a child breastfeeds, he or she gets personalized immune protection from the mother. The child brings home a virus or a bacteria from daycare, the playground or the mall, which is spread immediately by close contact to the mother, whose more mature immune system begins making antibodies and other immune factors as a response. These living immune cells are passed in the breastmilk to the child who thus gets direct immune protection from the mother’s body even to illnesses that his or her less mature immune system may not have been able to handle by itself. (Reference: Goldman AS, Goldblum RM, Garza C. Immunologic components in human milk during the second year of lactation. Acta Paediatr Scand. 1983 May;72(3):461-2.)
It is thus no surprise that studies have found that nursing toddlers are sick less often than their weaned peers.
For more information about nursing beyond the first year of life: