By Jennifer Margulis
This article was first published in Mothering magazine.
Helen Neumann remembers running into her parents’ bedroom during a nighttime thunderstorm and climbing into their bed. Four years old, she opened the snaps of her mother’s flowered flannel nightgown and nursed. “I remember it as warmth,” explains Helen, who lives in Iowa City. “The flannel was soft; I felt safe there.”
Although her older sister weaned herself at 11 months, Helen continued to nurse at night until she was about five years old. Now, at age 30, with a baby of her own, Helen is still close to her mother, talking to her on the phone almost every day and visiting frequently. Helen’s daughter, Irene, was born blue and floppy, after more than 40 hours of labor, and was immediately taken to the Neonatal Unit of Mercy Hospital. Still, Helen had the wherewithal to insist on nursing: she picked her tiny newborn up out of the incubator, IV and all, and put her on the breast. Some babies, like Helen Neumann’s sister, wean themselves easily and spontaneously. Other children, like Reed Carr, do not voluntarily stop nursing until they are toddlers. “Reed nursed before he went to sleep and on waking,” says his mother, Catherine Carr, a La Leche League Leader in Hardwick, Massachusetts. “After his last nursing he turned to me, said, ‘Thank you, Mom,’ and that was it.”
Catherine, who had never met anyone who had nursed a baby for longer than a few months, had hoped to be able to nurse for a year. She quickly realized that weaning at a year did not make sense for her children. “At that point they are still babies. I couldn’t imagine stopping. If it was right for them, it was right for me.”
Despite the overwhelmingly positive memories of children who breastfed long enough to remember nursing, American culture has a clear and categorical bias against nursing older children. “If they’re old enough to ask for it, they’re too old to be nursing,” is an oft-repeated adage. It’s as if Americans fear that if a child is cognizant-able to speak and remember-there is something inappropriate, even obscene, about nursing.
Like infants, older children benefit in countless ways from nursing. Women who nurse their children for extended periods cite many advantages to continuing the breastfeeding relationship: Nursing helps create a strong bond between mother and child, provides comfort and nutrition when a child is sick, quickly soothes a frustrated toddler or helps a child regain composure after a fall, makes nap time easier, provides physical contact and psychological comfort, and helps ease sibling rivalry when a new baby is born.
Nursing older children sometimes has unexpected benefits as well. Tracie Yautz, of Harmony, Pennsylvania, nursed her first two children until they were five and her third until he weaned himself at four and a half. In the six weeks after her eldest son, Steven, stopped nursing, his skin broke out in a horrible rash, which they later learned was caused by eczema. Steven had never had a skin problem while he was nursing but was plagued with allergies after he stopped. Kristen Bernard, a homebirth midwife who has attended more than 500 births and who nurses her three-year-old son, Marley, believes that the emotional benefits to nursing past three are fundamental. “I have a very secure boy who is secure in himself and his body,” says Bernard. “I think it’s a very special time that he and I share and that brings him obvious joy and security. He takes a deep sigh and relaxes entirely into his body. It’s a really nice thing. We’re all trying to find that somewhere.”
Bernard believes that prolonged nursing also gives children problem-solving skills and compassion. When Marley’s teeth dug into her nipple in a painful way, she would stop him from nursing and show him the teeth marks. “I’m sorry, Mama! I don’t do it on purpose,” Marley told her. “He made a conscious effort to change his behavior,” Bernard explains. “It taught him to be more self-aware and more careful.”
My oldest daughter nursed in a businesslike manner when she was a newborn. She would drink her fill and then, in less than five minutes, pop unceremoniously off the breast. Because she preferred other forms of cuddling to nursing, I assumed that she would wean herself early. Now three years old, she continues to nurse three or four times a day-in the morning, before nap time, sometimes in the late afternoon, and always before bed.
You can see her love of nursing in the way she plays with her doll. “Sweetie Pie, Sweeeeetie Pie,” she calls out as she picks up the doll from the floor. “‘Sokay. Don’t cry, Sweetie Pie. Do you want nummies on the nursing chair? Okay!” She then very tenderly settles herself and her dolly on the chair and lifts up her shirt, offering her baby doll nummies. She sits quietly for several minutes-unusual for this three-year-old ball of energy-and stares peacefully into the distance.
Despite all of these benefits, most American women who nurse their children for extended periods do so secretly, fearing cultural disapprobation and even legal action. Women who nurse children over three explain that they are discreet about it and rarely, if ever, nurse in public. It is impossible to know how many children are nursed at ages three, four, five, or six, because no comprehensive study on extended breastfeeding has ever been conducted in this country. We do know that few women in the US nurse successfully for any length of time. Although even the mainstream American Academy of Pediatrics now recommends breastfeeding for at least one year, only 14 percent of American babies are currently breastfed that long.[5,6] In 2000, 68.4 percent of mothers initiated breastfeeding and 31.4 percent of mothers were breastfeeding their six-month-old infant.”
Nursing is simply not the norm in America. In light of this, research by anthropologists and primatologists that shows that extended nursing is actually the norm among primates is all the more important. World-renowned primatologist Franz de Waal has observed that tandem nursing is common in bonobos, who nurse their young until they are approximately four years old. De Waal writes, “One sees the mother walking bipedally with an infant clinging to her belly and a juvenile riding on her back.” Perhaps even more interesting is the research conducted by Katherine A. Dettwyler, adjunct professor of anthropology and nutrition at Texas A & M University, on both nonhuman primates and on infant nursing practices across a variety of human cultures. Dettwyler writes that nursing a four year old, or even a six year old, is both “normal and natural for humans,” and argues that the “predictions for a natural age of weaning in modern human populations, based on the nonhuman primate patterns, range between 2.5 and 7.0 years of age.”[9,10]
By looking at the weaning patterns in nonhuman primates, Dettwyler identifies several ways to predict when human children would cease to breastfeed if cultural beliefs and expectations were set aside. Citing data from a variety of studies, including one that surveyed 135 primate species, while also pointing out that we share more than 98 percent of our genetic material with gorillas and chimpanzees, Detwyller correlates weaning with the following variables: birth weight, progress toward attaining adult weight, average adult body size, gestation length, and the timing of the eruption of the first molars. Using each of these bases for analysis, Dettwyler shows an array of possible weaning ages in humans, depending on the population, the size of the adults, the rate of growth in each population, and other factors. For example, one primatologist correlated the age of weaning with the eruption of the first molars in 21 different primate species. If human primates were to follow that blueprint, our babies would stop nursing between five and a half and six years of age.
According to Meredith Small, a cultural anthropologist at Cornell University, the cross-cultural data in human populations substantiates Dettwyler’s hominid blueprint. In her book Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent, Small points to human cultures that practice extended nursing and writes, “In all cases, this hominid blueprint of the way babies were fed for 99 percent of human history indicates breast milk as the primary or sole food until two years of age or so, and nursing commonly continuing for several more years.” Small provides evidence for this claim from data from both ancient and contemporary human cultures. Analysis of the remains of American Indian bones from a site near the Missouri River shows definitive evidence that infants were breastfed exclusively for the first year of life and then gradually weaned when they were approximately five years old. The ¡Kung San of South Africa nurse their babies for three to four years. Exclusive and frequent nursing leads to decreased fertility and longer intervals between pregnancies. Once the mother becomes pregnant again, she weans her baby.
Despite the evidence generated from zoological, sociological, and anthropological research that extended nursing is both normal and expected, it is common for medical professionals to discourage breastfeeding after 12 months. There is also a widespread and totally false belief among Americans that breastmilk loses its nutritional value for older children. Cheryl Kissling, a lactation consultant at Mercy Medical Center in Cedar Rapids, Iowa, believes that women stop nursing early because of cultural pressure.
In contrast, breasts are not made into fetishes in most parts of Africa. “Mamas nurse their babies anywhere,” explains Rwandan human rights activist Richard Nsanzabaganwa. “One respects women who stop to nurse their babies-on the bus, at home, or wherever.” Nsanzabaganwa, who nursed until he was five years old, remembers the taste of breastmilk as well as the look on his mother’s face while he nursed. “I am not an expert,” he says, “but I think nursing helps a child both physically and intellectually.” Nsanzabaganwa’s words echo Bernard’s description of how relaxed her child was while nursing. “When I was nursing it was the feeling of totally letting go. You can’t think of anything else, you are completely relaxed.”
As for my two daughters, they will wean when they are ready. They will decide when they want to stop nursing.
1. “When children talk about nursing, they talk about something very warm and special to them. Nursing is their ‘soul food.’ They nurse because it tastes good and feels good and helps them to be happy,” writes Norma Jane Bumgarner in Mothering Your Nursing Toddler (La Leche League International, 1980), 17.
2. There are also many medical reasons to continue the nursing relationship: reduced allergies, higher IQ, protection against diseases (including ear infections and respiratory and gastrointestinal problems), better speech development, possible delayed menstruation in the mother, continued weight loss in the mother, and protection against ovarian and other forms of cancer. See “Not Just for Babies: 10 Good Reasons to Breastfeed Your Toddler,” Mothering, no. 103, November-December 2000, and “Breastfeeding and Attachment Parenting: Extended Breastfeeding Fact Sheet” (http://www.kellymom.com/).
3. The first comprehensive legislation protecting a woman’s right to breastfeed in public was not enacted until 1993, by the state of Florida. Laws about breastfeeding vary from state to state. Some states have fairly liberal statutes; others, like Idaho, have no provisions protecting women who breastfeed in public against criminal liability. In some cases liability is left up to the discretion of those interpreting the law. In Georgia, for example, women who breastfeed in public cannot be held criminally liable provided they do so in a “discreet and modest way.” According to a 1997 California law, women may breastfeed in public or private without fear of legal prosecution-except in the private home of someone who objects. That a woman’s right to nurse in public or private must be asserted by law indicates that women have been criminally prosecuted for breastfeeding and shows how tenuous the right to nurse is in the US. See “A Current Summary of Breastfeeding Legislation in the US” by Elizabeth N. Baldwin and Kenneth A. Friedman at http://www.lalecheleague.org/.
4. Even the phrase “extended nursing” has no clear definition. It is often used interchangeably to refer to nursing babies past six months or past one year.
5. The AAP recommendation says, “Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first six months after birth. Infants weaned before 12 months of age should not receive cow’s milk feedings but should receive iron-fortified infant formula. Gradual introduction of iron-enriched solid foods in the second half of the first year should complement the breast milk diet. It is recommended that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired.” See “Breastfeeding and Use of Human Milk” in Pediatrics 100, no. 6 (December 1997): 1035-1039.
6. Peggy O’Mara and Jane McConnell, Natural Family Living (New York: Pocket Books, 2000), 49.
7. “Mother’s Survey,” Ross Division, Abbott Laboratories, 2000, 5.
8. Frans de Waal and Frans Lanting, Bonobo: The Forgotten Ape (Berkeley: University of California Press, 1997), 106.
9. Katherine A. Dettwyler, “A Time to Wean: The Hominid Blueprint for the Natural Age of Weaning in Modern Human Populations,” in Breastfeeding: Biocultural Perspectives, Patricia Stuart-Macadam and Katherine A. Dettwyler, eds. (New York: Aldine de Gruyter, 1995).
10. Ibid., 39.
11. Ibid., 50-51, 52, 55.
12. Meredith Small, Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent (New York: Anchor Books, 1999), 186.
13. Ibid. See also N. Tuross and M. Fogel, “Stable Isotope Analysis and Subsistence Pattern of the Sully Site,” in Skeletal Biology on the Great Plains: Migration, Warfare, Health and Subsistence, D. W. Owsley and R. L. Jantz, eds. (Washington, DC, and London: Smithsonian Press, 1994), 283-289, 393.
14. Meredith Small, Our Babies, Ourselves, 82.
FOR MORE INFORMATION
Bauer, G., et al., “Breastfeeding and Cognitive Development of Three-Year-Old Children.” Psychological Reports 68 (1991): 1218.
Brown, Amy Benson, and Kathryn Read McPherson, eds. The Reality of Breastfeeding: Reflections by Contemporary Women. Bergin & Garvey, 1999.
Bumgarner, Norma Jane. Mothering Your Nursing Toddler. La Leche League International, 1980.
Dell, Sharon, et al. “Breastfeeding and Asthma in Young Children: Findings from a Population-Based Study.” Archives of Pediatrics and Adolescent Medicine 155 (Nov 2001): 1261-1265.
Greer, F. R., and R. D. Apple. “Physicians, Formula Companies, and Advertising: A Historical Perspective.” American Journal of Diseases of Children 145 (1991): 282-286.
Hull, V., and M. Simpson, eds. Breastfeeding, Child Health, and Child Spacing: Cross-Cultural Perspectives. Croom Helm, 1985.
Mortensen, E. L., et al. “The Association Between Duration of Breastfeeding and Adult Intelligence.” Journal of American Medical Association 287, no. 18 (May 2002).
Newman, Jack, MD, and Teresa Pitman. The Ultimate Breastfeeding Book of Answers: The Most Comprehensive Problem-Solution Guide to Breastfeeding from the Foremost Expert in North America. Prima Publishing, 2000.
O’Mara, Peggy, and Jane McConnell. Natural Family Living: The Mothering Magazine Guide to Parenting. Pocket Books, 2000.
Rao, M. R., et al. “Effect of Breastfeeding on Cognitive Development of Infants Born Small for Gestational Age.” Acta Paediatrica 91 (March 2002): 267-274.
Sears, Martha, RN, and William Sears, MD. The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from Birth Through Weaning. Little Brown & Co., 2000.
Small, Meredith. Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent. Anchor Books, 1999.
Stuart-Macadam, Patricia, and Katherine A. Dettwyler, eds. Breastfeeding: Biocultural Perspectives. Aldine de Gruyter, 1995.
Taylor, B., and J. Wadsworth. “Breastfeeding and Child Development at Five Years of Age.” Developmental Medicine and Child Neurology 26 (1984): 73-80.
For additional information on prolonged breastfeeding, see the following articles in past issues of Mothering: “Not Just for Babies,” no. 103 and “To Wean or Not to Wean,” no. 97.