Breastfeeding Beyond the First Year

Category: Breastfeeding
Posted On: Aug 3, 2023
Written By: Kayla Dunavan, BSN, IBCLC

All babies rely on breast milk or formula as their main source of nutrition for the first year of life. However, the benefits of breastfeeding do not disappear after their first birthday, and some of the health-promoting properties of breast milk increase as breastfeeding continues.

The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for about the first six months before introducing nutritious complementary foods. The AAP, among many other organizations, supports continued breastfeeding for two years or beyond, as long as mutually desired. This recommendation was recently updated to support families choosing to breastfeed beyond the first year while recognizing the many benefits of extended breastfeeding for both mother and baby.

Breast milk is constantly evolving to meet the child’s current needs while providing valuable nutrition and protection against illness and disease for the duration of the breastfeeding relationship.

During the second year and beyond, breast milk contains increased fat and energy content, total protein, lactoferrin, lysozyme, and immunoglobulin A. This shift in the concentration of breast milk yields an increase of 60 percent more calories per ounce. One study shows that from 12-23 months of age, 448mL/15oz of breast milk provides:

29 percent of energy requirements
43 percent of protein requirements
36 percent of calcium requirements
75 percent of vitamin A requirements
76 percent of folate requirements
94 percent of vitamin B12 requirements
60 percent of vitamin C requirements

Proper nourishment is essential in building a strong immune system. Nursing toddlers have been found to have fewer incidences of illness along with decreased duration and intensity than those who have weaned.

Antibodies are present in breast milk at any stage, while some of the immune-building properties increase during the second year, as well as at the initiation of the weaning process. Breastfeeding also helps promote strong gut health while preventing allergies and asthma. This strong foundation provides advanced protection from illness and disease throughout the lifespan while supporting the natural progression of immune system maturity.

There is also a direct correlation between cognitive abilities and breastfeeding duration. Children who breastfeed longer have higher verbal and spatial cognitive scores, as well as more grey matter in the brain, which is responsible for sensory processing, muscle control, and conscious thought. Nursing toddlers also tend to be well-adjusted socially, as breastfeeding provides a consistent source of comfort during the gradual transition to childhood.

There are behavioral benefits related to bonding for mothers too – those who breastfeed longer have higher incidence of maternal sensitivity (i.e. responsiveness, emotional tone, flexibility, and ability to read child’s cues) beyond the toddler years.

The breastfeeding mother’s health is remarkably improved as well. There is a decreased risk of multiple types of cancer including breast, ovarian, uterine, and endometrial cancers. For every 12 months of breastfeeding, the risk of breast cancer decreases by 4.3 percent. Extended breastfeeding provides further protection from metabolic syndrome, rheumatoid arthritis, hypertension, osteoporosis, myocardial infarction, diabetes, and weight gain. For some women, breastfeeding past infancy can continue to delay ovulation/menstruation.

Breastfeeding is the biological norm and should be promoted beyond meeting the child’s basic needs during their first year. Children given the opportunity to wean on their own will do so typically between the ages of two and seven. When weaning is individualized based on the needs of the child, they are able to achieve independence at their own pace with an increase in overall security. We should continue to celebrate, encourage and provide support to moms and children who preserve the breastfeeding relationship beyond the first year. Happy National Breastfeeding Month!

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AUTHOR: Kayla Dunavan, BSN, International Board Certified Lactation Consultant (IBCLC), is an LVMC Lactation Consultant. She earned her bachelor of science degree in Child and Family Development, with a minor in psychology, from San Diego State University. Kayla received her certificate in Lactation Consultant Education from the University of California, San Diego Extension. She has worked in a wide variety of hospital and education settings as a lactation consultant.