With the holidays quickly approaching, many families are wondering how they will travel comfortably with their breastfeeding sidekick. Grandma and grandpa can’t wait to meet the new baby, aunts and uncles anxiously await your arrival, and cousins are thrilled to have a new buddy. Families with babies of any age might choose not to travel, and a baby is a perfect excuse not to, but if you’re just as excited to see grandpa as he is to see you, don’t let your nursling stop you from boarding that plane. 

Traveling with a breastfed baby can be easier than traveling with a bottle-fed baby because everything you need is contained within one very beautiful and very useful gadget called mom. Whether you plan on packing the car or boarding an airplane, here are some tips that will make your travel a little more convenient this holiday season.

In the Skies

Although most airlines will allow you to carry a child under two on your lap at no additional charge, the Federal Aviation Administration (FAA) recommends all children, no matter the age, have their own seat and be properly restrained with an approved child restraint system.¹ This means you will be unable to nurse on landing or take off, as sometimes suggested to ease pressure in baby’s ears unless you choose not to restrain your child in his seat. Many moms report that it doesn’t bother baby any more than it does mom. However, if it leaves baby uncomfortable, you can always offer the breast once takeoff is complete. Make sure the car seat you choose is approved both for vehicles and airplanes, or you will not be allowed to bring it onto the plane.

If privacy is important to you, choose a seating location that allows for some seclusion. Airplane seats are very close together, so privacy on the plane can be tricky. Window seats or flights during a less busy time of day can be ways to achieve some solitude. If you choose to buckle your baby up in a car seat, some airlines will require the car seat to be in a window seat, making privacy a little more challenging for mom. 

You are not likely to be harassed while breastfeeding on a flight, but it has happened. When your plane is still on the ground before takeoff, the breastfeeding laws that protect you will be the laws present in the state where your flight is originating from. Once you are in the skies, the laws can be murky. Contact the airline before purchasing your tickets to see if they have any policies that protect breastfeeding mothers. 

If the contact was made via email, you can print the email and keep a copy with you in case any issues arise. If the contact was made via telephone, be sure to get the first and last name of the person you are speaking with and make a note of it. Knowing your state’s laws and your airline’s breastfeeding policies will help you prepare for the unfortunate (and hopefully unlikely) event you are hassled.

Getting through the airport with baby can be an ambitious goal, but it doesn’t have to be. Many moms find a soft infant carrier to be handy. It leaves two hands free, one to pull a suitcase and one to hold the hand of an older child if needed. A soft carrier can also provide you with the option of nursing while walking through the airport or waiting in line to board. 

If you are not comfortable nursing in the carrier, practice, or try another brand that might work better for you. Keep in mind some airports may require mom to take baby out of the carrier before going through security, while other airports allow baby to stay attached to mom. Calling your airport beforehand to find out their policy can help you anticipate the stress of getting through security. If you are more comfortable using a stroller to get baby through the airport, you are allowed to push the stroller to the gate and check it there. 

Don’t forget to pack in your carry-on some extra nursing pads, burp rags, diapers, a change of clothes for baby, a new top for you, baby toys, baby wipes, and some healthy snacks. Also, be sure to wear a top that can easily be pulled down or lifted for ease of breastfeeding. While on the flight, remember all the wonderful ways breastfeeding can make life with a baby easier. If baby is hungry, nurse. If baby is thirsty, nurse. If baby is tired, nurse. If baby is scared, nurse. If baby is crying, nurse. If baby is fussy, nurse. If baby is bored, nurse. Nurse! It’s not just for food. The other passengers will be (or should be) thankful. 

On the Road

Traveling by car with a baby can be challenging because everyone must always buckle in while the vehicle is on the road. This means you can’t nurse baby to sleep while your partner continues to decrease the mileage between you and your destination. Fortunately, there are options. Some families find that hitting the road around bedtime allows for baby to sleep during the bulk of their travels. For shorter road trips, consider leaving just before baby is ready for a nap. 

Plan lots of stops that are more than just getting gas and piling back in the car. Take breaks that allow everyone, including baby, to get out of the car, feel the sunshine, stretch their legs, and breathe some fresh air. Don’t forget a diaper check. Nurse at every stop, even if baby is not hungry, topping baby off can give you an extra hour on the road before you must stop again. 

Some babies enjoy the car, and others do not. If you happen to have a baby who finds car rides miserable, you or your partner can sit in the back with baby. This slight inconvenience for the parent who must now be a backseat passenger can be the one thing that enables you to make it to your destination with your sanity still intact. Sometimes babies find the back seat lonely, but they might find the ride more enjoyable with a familiar face to look at. 

At Grandma’s

Pulling up to an unfamiliar house where you don’t have any of your favorite parenting necessities can be intimidating with a new baby. Bring at least one of your most loved soft infant carriers. Choose the one you can comfortably breastfeed in while sitting in the living room with aunts, uncles, cousins, grandpa, and that one guy you only see at family gatherings but can’t remember his name. This way, you won’t feel like you must exit every time baby needs to snuggle up for food or comfort. Of course, nursing baby is also a great “excuse” to leave the crowd and seek quiet time in your own room if needed.

Nighttime can be the most challenging part of traveling. Trying to establish sleep in an unfamiliar place can make the already difficult job of nighttime parenting an achievement that requires courage, strength, and dedication. Be sure to follow a similar routine with baby on your trip as you do at home, and as always, having baby as close to mom as possible is the best way to address baby’s nighttime needs without excessively disrupting sleep. 

There are ways to ensure a smooth transition from sleep at home to sleep at grandma’s house. If you plan on having baby sleep in a crib, make sure the crib is in the same room as you. Baby will be able to hear and smell the familiarity of his mother, which will undoubtedly bring him comfort in his temporary bed. Pack the sheets you use at home while traveling and maintain a similar routine to the one you do at home. If you bathe baby, sing to baby, and then nurse baby to sleep, continue this practice no matter where you stay.

Beware of Holiday Weaning

Holiday weaning is a phenomenon we often see around the busy holidays but can happen anytime throughout the year, traveling or not. Moms get very busy shopping for presents, planning and attending holiday parties, and handing baby over to grandma to say hi. With all your family in town for Christmas, it’s easy to leave baby with Auntie while you head to get groceries for the Christmas party. 

The long lines and traffic can turn a short trip into an all-day outing, leaving Auntie the only option of offering baby the bottle of expressed breastmilk you left behind for an emergency. Meanwhile, you are unable to pump and perhaps get engorged. You get home, but baby already has a full belly of milk and doesn’t want to nurse. You don’t mind because you’re busy putting groceries away anyway. 

Then you start getting the pies ready for dinner and are a bit thankful for being able to do so without the distraction of your baby. The next day begins a similar process. After a few days of this, you are likely to experience a dip in milk supply while baby has become accustomed to the bottle and pacifier she has been receiving over the last few days and may not cue for the breast as much. In some cases, baby will refuse the breast altogether. And so, the term holiday weaning emerged.²

Tips to avoid holiday weaning²

• If you need to run errands, consider bringing baby, especially a younger baby since they seem to be more vulnerable to the disruption in nursing.³ Younger infants are also portable in a comfortable wrap, so don’t forget your soft carrier. Practice nursing baby in the carrier before you head out to run your errands.
• Carry baby in a soft carrier even when at home so baby can stay close and breastfeeding cues don’t go unnoticed. A sling or other soft carrier is a great way to give baby unrestricted access to the breast, therefore protecting the nursing relationship and your milk supply.⁴
• Have those family members who are offering to watch baby run the errands instead.
• Send your partner off to the store, or have your partner bake the pies. You’re a new mom. You have an excellent reason to ask for help.
• Have a potluck-style dinner to save on cooking and prep time.
• Agree to limit gift-giving between family and friends so that you don’t have to spend so much time shopping.
• If limiting gifts is not an option, shop online.

Avoiding holiday weaning is ideal, but if the holiday chaos and traveling stress send you stumbling into the grasp of holiday weaning, don’t worry; you can recover.

Tips to surviving holiday weaning⁵

• Lots of babywearing. I hope you brought that soft infant carrier I’ve mentioned five other times.
• Lots of skin to skin.
• Keep baby close during the night and the day.
• Avoid artificial nipples like pacifiers and bottles.
• Allow all of baby’s sucking needs to be met at the breast.
• If the baby is completely refusing the breast, remember the most important thing is feeding baby and protecting your supply. Pump or hand express your breastmilk and provide it to baby using an alternative feeding method. If a bottle must be used, practice paced bottle feeding.⁶
• Take a bath with baby.
• Offer the breast when baby is asleep or sleepy.
• Remember you are wooing baby to the breast. Keep the interactions comfortable and peaceful. Never force baby.

Wherever you go and however you get there, remember you are the expert in mothering your baby. Trust yourself as a mother and trust your baby. You and baby are a dyad designed to be together, to connect, and to communicate. Follow your instincts, and your holidays are sure to be enjoyable for the whole family, including baby.

References:

1. Child Safety. (n.d.). Retrieved September 28, 2014, from http://www.faa.gov/passengers/fly_children/
2. Cortez Barry, L. (2004, June-July). How to Avert Nursing Strikes during Special Occasions. LEAVEN, Vol. 40 No. 3, 56-56.
3. Ritter, N. (2009). Holiday Weaning. New Beginnings, Vol. 28 No. 3,  30-31.
4. Travel Recommendations For The Nursing Mother. (2010, April 21). Retrieved September 29, 2014, from http://www.cdc.gov/breastfeeding/recommendations/travel_recommendations.htm
5. Brussel, C. (2001, July-August). When Baby Won’t Nurse. New Beginnings, Vol. 18 No. 4, 136-138.
6. Wiessinger, D., West, D., & Pitman, T. (2010). Tear-Sheet Tool Kit. In The womanly art of breastfeeding (8th ed.). New York: Ballantine Books.

You sit down to nurse. You’re tired and looking forward to relaxing with your squishy new baby snuggled comfortably against your chest. You can’t wait to hear those reassuring sounds as he sucks, swallows, and breathes. You are ready. Ready to soak up the warm touch of your baby’s smooth skin, to stroke his back gently with one hand while supporting him with the other. You are ready to feel his tummy move in and out against yours as you enjoy the surge of oxytocin that will pulse through your veins, telling your breasts it’s time to nurture your baby.

You have your water, your snack, and a good book. Baby latches on, you lean back, you relax, and take a deep breath as you comfortably melt into your couch, but as you exhale, you feel like something is not right; maybe you feel homesick or even helpless. You don’t know why or where this is coming from. These negative feelings, ranging from mild to severe, envelope you tightly as you struggle to understand how they could take up residence deep in the pit of your stomach while doing something you enjoy so much, breastfeeding.

A minute passes, baby begins gulping, and you know your milk has let-down. Everything feels right again. In fact, you may even forget about these feelings, but next time you sit down to nurse or even if your milk let-down occurs without a nursling at the breast, you are reminded, yet again, of these passing emotions that you struggle to understand. If this sounds familiar to you, then you might have Dysphoric Milk Ejection Reflex or D-MER.

As a new mother with my first baby, a boy, the description above is my experience. After several months the symptoms improved significantly and pretty much disappeared as we nursed into toddlerhood. By the time I was pregnant with my second baby, I had completely forgotten these poorly understood emotions. Then she was born, and the uncomfortable feelings were knocking at my breastfeeding door again.

Despite laying in my own bed or sitting on my own couch, every time I placed my brand new baby girl to the breast, I felt homesick. It would fill me up with a mild sense of doom I just couldn’t shake. The feelings were brief, so I accepted them and moved on. I began to expect these feelings just as much as I expected to see my baby start gulping. I knew they would visit just before I felt the familiar sensation of a milk release (note: not all women feel a milk ejection reflex) and expected them to leave within a minute or less.

These unexplained poorly understood feelings were consistent and predictable. In fact, they were so predictable. Even when baby wasn’t at the breast, I could tell if I was going to have a let-down because I would suddenly feel that all too frequent ickiness that started in the pit of my stomach and consumed my body like a virus.

Just as it slowly left me with my first baby, it faded with my second. It wasn’t until I stumbled upon an article about D-MER did I know that what I was experiencing had a name or even that it existed beyond my own experience. It was my “a-ha moment!” A physiological reaction to a drop in dopamine!1

What is Dysphoric Milk Ejection Reflex? 

According to D-MER.org “Dysphoric Milk Ejection Reflex is a condition affecting lactating women that is characterized by an abrupt dysphoria, or negative emotions, that occur just before milk release and continuing not more than a few minutes.”2

Most women describe symptoms as lasting less than one minute. It is important to note this is not a psychological response but rather a physiological one.3 Many women with D-MER have been treated for post postpartum depression or other anxiety disorders without success.

Understanding the pathophysiology of D-MER is essential to helping women cope with, and treat, this condition. Since there has not been much research on D-MER it can only be theorized what is happening based on analyzing the symptoms of women who are experiencing this condition and comparing it to what we know about lactation and the milk ejection reflex.

The theory that fits all the pieces together best is that an abnormal dopamine drop occurs with the milk ejection reflex, causing a brief dopamine deficit. We know dopamine regulates prolactin by blocking its release. Therefore dopamine must drop for prolactin to rise, which is an essential part of lactation.

What we don’t know is when and for how long dopamine drops. It is theorized that this known and normal drop in dopamine occurs just before the milk ejection reflex. For women experiencing D-MER it is thought that dopamine drops to inappropriately low levels, thus causing the known symptoms of said condition.4

Women with D-MER may experience widely varying degrees of dysphoria. Some women may feel a little homesick, while others, in very rare instances, may experience suicidal thoughts or feelings of self-harm.

One thing that remains consistent from one mother to the next is that the symptoms will come and go quickly and are always associated with the milk ejection reflex whether baby is at the breast, mom is pumping, or mom experiences a spontaneous milk ejection reflex without physical stimulation.5 

According to the Australian Breastfeeding Association, the most commonly reported symptoms are hollow feelings in the stomach, anxiety, sadness, dread, introspectiveness, nervousness, anxiousness, emotional upset, angst, irritability, hopelessness, and something in the pit of the stomach.5 For most women, symptoms will last for about three months, while others might experience a longer duration. Less commonly for some women, symptoms of D-MER will last throughout the entire breastfeeding relationship.6

Not having D-MER with a first child is not a guarantee a breastfeeding mother won’t have it with a subsequent child; women with D-MER may experience it with every child or with just one.6 Women who are experiencing D-MER without knowing what it is may find the symptoms, even mild ones, quite difficult to manage. Not understanding what is happening can leave a mother disconcerted or distressed and could lead to premature weaning.

Since D-MER is rare and not widely understood, it can often go undiagnosed. For this reason, education both to women and healthcare professionals is critical. Many women who have suffered from D-MER find education to be the only treatment necessary, especially in mild to moderate cases. Simply labeling and understanding what she is experiencing is often enough to manage the brief dysphoria a mother feels with each milk ejection reflex.

For severe cases where the mother is at risk of weaning even after education has been offered, certain medications can effectively treat D-MER.7 Since anything that increases dopamine will help mitigate symptoms of D-MER, lifestyle choices should not be ignored when considering a treatment plan; everything from diet to physical activity could theoretically help a mom with this condition.7

All women who suspect they are experiencing D-MER should seek help from a trusted medical professional familiar with this condition.

Link to published article can be found here.

References:

1. Depression or other negative emotions upon milk let-down (D-MER), Viewed 9 April, 2015 <http://kellymom.com/bf/concerns/mother/d-mer/&gt;
2. Defining D-MER: What It Is, Viewed 9 April, 2015  <http://www.d-mer.org/Home_Page.html&gt;
3. Heise AM, Wiessinger D. Dysphoric milk ejection reflex: A case report. Int Breastfeed J. 2011 Jun 6;6(1):6.
4. D-MER (Dysphoric Milk Ejection Reflex): What is it? by Alia Macrina Heise, from Breastfeeding Today, Issue 4 (November 2010), pp. 18-20.
5. Dysphoric Milk Ejection Reflex (D-MER), Viewed 9 April, 2015 <https://www.breastfeeding.asn.au/bfinfo/dysphoric-milk-ejection-reflex-d-mer&gt;
6. Cox S, (2010), A case of dysphoric milk ejection reflex (D-MER), Breastfeeding Rev, 18(1):16–18.
7. Management of D-MER, Viewed 9 April, 2015  <http://www.d-mer.org/Management_of_D-MER.html&gt;

When a mother brings her baby to the breast, many things happen concurrently with breastfeeding. Skin-to-skin contact occurs every time the baby sucks at the breast, which helps warm the baby up and stabilize the heart and respiratory rates.¹ Oxytocin is released, decreasing mom’s chance of hemorrhage immediately after birth and increasing bonding as mom and baby get to know each other.^2,3 Bringing baby to the breast also gives mom and baby a chance to recalibrate from a stimulating new life. These steps together form an engaging dance between mom and child, a dance that comforts, warms, and protects baby. Among all the steps of this dance, there is one that is only available to baby during the first few days of life, although present since mid-pregnancy. It is consumed briefly and only in small amounts, but its impact is vast. Colostrum.

Low in fat but high in protein and immunoglobulins, colostrum is extremely easy to digest and acts as a laxative. The laxative effect of colostrum is essential for an infant working on passing his first stool, meconium. The passage of meconium and subsequent early stooling will assist with the removal of excess bilirubin before being reabsorbed back into the bloodstream. Since jaundice is the product of elevated bilirubin concentrations in the blood, infants who do not pass meconium quickly are at greater risk of jaundice due to the reabsorption of bilirubin present in the infant’s stool.⁴ Colostrum gets to work immediately by assisting baby’s very first bowel movement!

Baby’s gut is permeable during the early days to weeks of life, leaving your baby at greater risk to allergens and pathogens passing through the loose junctions between gut cells.^5,6,7 Once these allergens escape the gastrointestinal tract and enter baby’s bloodstream, sensitization can occur, leading to serious food allergies or other illnesses.⁵ Present in breastmilk are various types of human growth factors, including epidermal growth factor, nerve growth factor, insulinlike growth factor, and somatomedin C, with epidermal growth factor having the highest concentrations in colostrum.⁷ These growth factors work to seal the loose junctions in the gut, so baby isn’t as vulnerable to his new microbial environment.^5,7

Sealing baby’s gut isn’t the only way colostrum helps to ensure the health of a brand-new infant whose immune system is relatively immature.⁸ While in utero baby receives immunoglobulin G or IgG via mom’s placenta. IgG is useful but works only in baby’s circulatory system.⁹ Another immunoglobulin, secretory Immunoglobulin A, or sIgA, is highly concentrated in colostrum and works where baby is most likely to experience pathogenic insult, the mucous membranes of the throat, lungs, and intestines.⁹ Colostrum has 13 grams per liter of this valuable immunoglobulin, while mature milk has 1 to 3 grams per liter. That’s a big difference!^10,11 Even with this drop in concentration, it is important to note that overall daily production levels of sIgA remain consistent for the duration of breastfeeding. However, as your colostrum transitions to mature milk, the sIgA concentrations are diluted with other essential nutrients baby needs to grow.^10,11 Considering that baby’s immature immune system is experiencing the world of pathogens for the first time, it makes sense why sIgA concentrations are so high initially—small amounts of milk for a small tummy but large amounts of immunoglobulins for a large world.

Even in amounts small enough to be measured in teaspoons, colostrum is just what baby needs to fill up his little tummy. A baby’s stomach is quite small during the first day of life, about the size of a shooter marble; this means no more than a few drops to one teaspoon (5 mls) is all baby needs to be satiated.^12,13 As a new baby contentedly suckles at the breast, he enjoys a feast that fills up his tiny tummy with the exact volume and content he needs. Although 5 milliliters may not seem like a meal to mom, it is undoubtedly a complete meal for baby on his first day of life. Due to the rigid nature of the newborn stomach, consuming more than the small amount a mother’s body makes will result in regurgitation as baby gets rid of what his inflexible stomach cannot accommodate.¹⁴ So while mom blows raspberries on that smooshy belly, she can know that, like puzzle pieces, her colostrum and baby’s stomach are a perfect match!

With this knowledge of infant anatomy, one can understand the importance of a low volume but nutrient-dense food for infants during the first few days of life; it also gives a clear reason for all those short but frequent feeds baby asks for. Frequent feeding, along with infant growth, relax the stomach, and by the end of the first-week baby will enjoy larger meals of 1.5 to 2 ounces.^12,13,14 By one month, there is quite a bit more variation. Some babies will continue to enjoy just one-and-a-half ounces per feed, while others will take four-and-a-half ounces.^12,13,15 This means if a baby prefers meals on the smaller side of normal mom is likely to receive requests from baby to feed more often. Some mothers report feeding their babies every hour. These early weeks can seem like a lifetime. The days are long, but the year is so very short, and soon enough mom will be the one bugging her toddler to come sit down and eat.

As milk transitions from colostrum to mature milk, mom will likely notice some changes in her breasts and her baby. Baby’s sucking pattern will evolve to include more gulping. Mom’s breasts may begin to leak or feel fuller.¹⁶ Some mothers report no noticeable changes in their breasts while others report discomfort and engorgement, but the most notable changes will be in baby’s bowel movements. During the first day or two baby’s stools will be a thick, greenish-black meconium. The few days that follow, the stools will become less black and green to yellow as mom’s breasts fill with mature milk. The entire process of milk transitioning from colostrum to mature milk usually takes three to four days, with the visual changes in baby’s stool taking about one week.^4,17

Like a couple learning the tango, mom and baby need each other to engage in their dance. A woman’s body is designed to feed her baby, and her baby is designed to receive food from her. This dance starts on the first day as mom’s colostrum helps baby acclimate to life outside the womb and continues throughout the breastfeeding relationship. Sometimes it will be graceful, and sometimes they will stumble. Each step pieced together, each partner giving and taking. At the end, there is a dance filled with conversations without words and beautiful nuances that contribute to baby’s physical and emotional development. From the time mom and baby take their first steps as a breastfeeding dyad to the very last nursing session, they are dancing with endless purpose.

Link to published article can be found here.

References:

1. Moore ER et al. (2012). Early skin-to-skin contact for mothers and their healthy newborn infants (Review). Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003519.pub3/pdf on March 26, 2015.
2. Uvnas-Moberg K. Neuroendocrinology of the mother-child interaction. Trends In Endocrinology And Metabolism: TEM 1996 May;7(4):126-31.
3. Ross HE, Young LJ. Oxytocin and the neural mechanisms regulating social cognition and affiliative behavior. Front Neuroendocrinol 2009 October;30(4):534-47.

• Fisher, Denise. “Breastmilk: Composition and Function.” Educational handout. Health e-learning. n.d. Online.

• Mohrbacher, Nancy and Kathleen Kendall-Tackett. Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers. Oakland: New Harbinger Publications, Inc, 2010. Print.

• Vukavić T. Timing of the gut closure.  J Pediatr Gastroenterol Nutr. 1984 Nov;3(5):700-3.

• Jack Newman, MD, FRCPC 2011, How Breast Milk Protects Newborns, Viewed 1 June, 2015

<http://kellymom.com/pregnancy/bf-prep/how_breastmilk_protects_newborns/>

• Huggins, K. The Nursing Mother’s Guide to Weaning. Boston, MA: Harvard Common Press, 2007.

• 2006, What is Colostrum? How does it benefit my baby?, Viewed 7 June, 2015 <http://www.lalecheleague.org/faq/colostrum.html>

1. Picciano MF (2001) Nutrient Composition of Human Milk

1. Slusser W et al. (1997) Breastfeeding update 1: immunology, nutrition, and advocacy

1. Scammon RE et al. (1920) Observations on the capacity of the stomach in the first ten days of postnatal life

1. Kent JC et al. (2006) Volume and frequency of breastfeedings and fat content of breast milk throughout the day

1. Zangen S et al. (2001) Rapid maturation of gastric relaxation in newborn infants.

1. Saint L et al. (1984) The yield and nutrient content of colostrum and milk of women from giving birth to 1 month post-partum

1. 2011, When Will My Milk Come In, Viewed 1 June, 2015

<http://kellymom.com/bf/concerns/mother/when-will-my-milk-come-in/>

1. “Is my breastfed baby getting enough?” Educational handout. La Leche League International. September 2008. Print.

Four and a half years ago, I was told by a dear friend it was disgusting I was still nursing my eighteen-month-old son. I was relatively new to the world of mothering and was unsure how to handle such negative comments about my breastfeeding relationship. It cut deep. The implication my son could do anything disgusting at the tender age of one-and-a-half left me feeling protective over his integrity. 

Now I have more experience, and with more experience comes more confidence. I’m writing this in hopes of normalizing the act of breastfeeding, so hopefully one day no one will have to have their relationship with their child brought to trial. I know this is not the article that will change the world but it may plant a seed and I like gardening. Let us explore some of the more common myths about mothering your nursing child. Whether you are “still” breastfeeding or have never breastfed.

Myth: A nursing child will never learn how to be independent. They are clingy, whiny, and demanding.  

Independence is something we value immensely in our culture starting as early as babyhood. Of course we all want our children to experience a healthy level of independence, but the idea of how we encourage that independence is up for debate. Many purported experts suggest parents ignore their baby’s cries to promote independent sleep, which is not biologically normal for an infant, nor is ignoring your child biologically normal for a parent. We often hear the silly argument that you will spoil your baby if you hold them too much. 

New mothers are told not to give in to their infant’s “demands,” forcing women to oppose their instincts and follow through with erroneous advice. Under the pressure of our culture’s desire to push independence, infancy and its associated needs are treated as though it damages the elusive independence we love. With less than 50% of women still breastfeeding at six months1, it is no surprise that breastfeeding into early childhood is seen as something only for babies and may compromise a child’s independence. 

One thing every mother to a toddler has in common is they likely hear “mommy” 1,440 times per day (guess how many minutes are in a day) followed by an emotional plea if that “mommy” did not elicit an immediate response. Breastfed toddlers are not clingy, whiny, dependent, and demanding, but rather toddlers are clingy whiny, dependent, and demanding. Take the breastfeeding out of the equation, and you still have all the whine, but with one less tool to comfort the child. 

Diane Bengson, Author of “How Weaning Happens,” says, “Toddlers have many needs that linger from babyhood, including the need to cuddle, the need to be comforted, and the need for help when falling asleep. These needs are all naturally met through nursing, and it is a wise mother who recognizes and honors her child’s need to be dependent. Trusting the child in this way builds self-confidence needed for later independence.” 2 Becoming independent is a milestone, just like crawling or walking. Children will hit it when their developmental ability is ready. As with any other milestone, one of the best ways to encourage it is to provide a safe environment for the child to explore comfortably. A child feels safest when their needs are met, including their need for dependancy.3  

Myth: Immunities from breastfeeding are no longer valuable or needed past the age of one. I’ve also heard this one with six months as the cutoff.

Simply put, that’s like saying after the age of eight, eating vegetables is no longer healthy. Let’s jump right into the research. A toddler’s immune system is only sixty percent developed at the age of one,4 but don’t worry about your little one’s developing immune system; nature has it all worked out for us. 

As your nursing toddler gets older and therefore takes less milk, the immunities in breastmilk increase in concentration, so breastmilk still plays a vital role in protecting the young immune system.5 And it works! Breastfeeding children between sixteen and thirty months have been shown to require less medical care due to illness than their non-breastfeeding peers,6 and we continue to see this trend. 

In another study, looking at three-year-old nurslings, the same results were seen.7 The importance of protecting these young immune systems with mama’s milk is critical. It can mean life or death, especially in developing countries. In Guinea-Bissau, children between the age of one to three years old, who were no longer receiving breastmilk, had a mortality rate that was three-and-a-half times higher than their nursing counterparts.8

Myth: If they are old enough to ask for it, they are too old to get it.

Even very young babies ask to breastfeed. Turning their head toward the breast, bringing their hands to their mouth, rooting, and finally crying are all ways a baby will ask. A child whose language skills are good enough to say “milkies” is asking just the same as a baby who cries for the breast.9 

This sentiment comes from a culture that doesn’t fully understand breastfeeding; not only does it indicate a lack of knowledge about the existence of hunger cues, but it also suggests breastfeeding is only about the milk. Nursing a child offers nutrition, yes, but nutrition is a small fraction of what else the breast offers. 

The subtle nuances between mother and child during a nursing session are pieces of interactions that teach trust, safety, commitment, and respect. The baby’s need for warmth, comfort, safety, sucking, and nourishment are all met at the breast, and it does not stop when the child is old enough to use words instead of cues. If one understands the depth of a nursing relationship, one understands the bizarre notion that asking for the breast is somehow a sign the child should not get the breast. If a child asks for a hug, should the mother refuse? A kiss?

Myth: A nursing child will not learn personal boundaries and could become socially awkward.

For a baby, the breast is as close to being in the womb as possible; the warmth of skin to skin, the sound of mom’s beating heart, the comfort of sucking, the nutrition, and the familiar smell of mom are all part of the comforting package. It creates a baby’s natural habitat and allows the baby to feel safe like he did in the womb.10 

Comfort at the breast continues into childhood. As the breastfeeding relationship matures, it changes, but the breast remains a safe place. Consequently, toddlers will often seek the breast when they’re scared, hurt, or overstimulated. We all learn best in a safe environment, so what safer place to teach personal boundaries than at the breast. 

Breastfeeding in mother’s arms is often where a baby will experience his first bits of gentle discipline; earlier in the breastfeeding relationship, this may mean mom not allowing baby to bite. As baby gets older, he will learn boundaries when mom requests that he not tug at her shirt when asking for milk or pull on her hair. For some (okay, most), playing with the other nipple is off-limits. Pulling at mom’s hair may be discouraged, but standing up may be permitted. Every nursing dyad will have different boundaries for their relationship, but one thing for sure is that boundaries will always be present, and therefore taught.

We have seen that children who breastfeed longer than a year tend to adjust better socially than their peers who were not. One study that focused on children who were nursed past one year found a significant link between the length of the breastfeeding relationship and how teachers and parents rated the children at six to eight years of age in terms of social adjustment. 

The children who experienced access to the breast the longest were consistently recognized to be better socially adjusted.11 The authors do recognize the study was not controlled for certain mothering behaviors exhibited by breastfeeding mothers versus their bottle-feeding counterparts. But does it matter? Does it matter if this positive outcome is due to the act of breastfeeding, the nourishment of human milk, or the behaviors typical of women who mother through breastfeeding? Either way, breastfeeding played a role.

Myth: breastfeeding into childhood is not normal.

Our culture is a bit mixed up. We see manufactured infant feeding apparatuses as normal, while the biological norm for all mammals is considered abnormal. The public often thinks of breastfeeding as a private act. Ask any mom who breastfeeds under a cover, away in a room, car, or bathroom what her experience is with breastfeeding in public. 

Many women report that family members or even strangers have expressed that breastfeeding should be kept away from the sensitive eyes of teenagers and lurking men. Apparently, they are incapable of seeing the breast as multifunctional. If you are unsure of this, go to any breastfeeding article in mainstream media and read the comments. It’s all backward. 

Since the biologically normal way to feed a baby has slipped behind closed doors and under blankets, we don’t see moms nursing babies, and we rarely see them nursing toddlers. What else are we in society to conclude, but that it doesn’t happen, and if it doesn’t happen, it isn’t normal; not true.

Research done by Katherine A. Dettwyler shows the human infant was designed to breastfeed well into childhood and that it is normal for a child not to wean as late as seven years of age, with a range of 2.5 to seven years.12 The American Academy of Pediatrics recommends that breastfeeding continues for as long as “mutually desired by mother and child.” 13 The American Academy of Family Physicians agrees and has a similar statement of their own.14 The World Health Organization and UNICEF recommend breastfeeding to a minimum age of two years old.15

This last myth, “breastfeeding into childhood is not normal,” I believe is what led my friend to question my breastfeeding practices. After regaining my composure, I replied that baby and I enjoy the relationship and so continue to do so. My supportive and knowledgeable husband quickly shared that it is good for his son and his wife. 

A few days later, I received a call from my friend. In his shock of hearing about my breastfeeding experience, he began asking other moms about their breastfeeding relationships and discovered many were nursing well into childhood. With his newfound knowledge, he called to apologize. I guess I planted a seed.

References:

1. Breastfeeding Report Card: United States / 2013 – 2013breastfeedingreportcard.pdf
2. NEW BEGINNINGS, Vol. 23 No. 3, May-June 2006, pp. 100-105.
3. Baldwin, EN. Extended Breastfeeding and the Law. Mothering. 1993 (Spring);66:88.
4. Huggins, K. The Nursing Mother’s Guide to Weaning. Boston, MA: Harvard Common Press, 2007.
5. Goldman, A. S. et al. Immunologic components in human milk during the second year of lactation. Acta F’aediatr Scand 1983; 722:133-34.
6. Gulick, E. The effects of breastfeeding on toddler health. Pediatr Nurs 1986; 12:51-54
7. van den Bogard, C. et al. The relationship between breast-feeding and early childhood morbidity in a general population. Family Med 1991; 23:510-15.
8. Molbak, K. et al. Prolonged breastfeeding, diarrhoeal disease, and survival of children in Guinea-Bissau. BMJ 1994; 308:1403-06.
9. Wiessinger D, West D, Pitman T. “The Womanly Art of Breastfeeding” New York: Ballantine Books, 2010, p.453
10. Dr Nils Bergman 2004, Kangaroo Mother Care, Viewed 16 March, 2014 <http://www.kangaroomothercare.com/olanders.aspx&gt;
11. Ferguson, D. M. et al. Breastfeeding and subsequent social adjustment in six- to eight-year-old children. J Child Psychol Psychiatr Allied Discip 1987; 28:378-86.
12. Dettwyler KA.”A Time to Wean” from Breastfeeding: Biocultural Perspectives (Stuart-Macadam, P. and Dettwyler, K., ed.), New York: Walter de Gruyter, Inc., 1995, p. 305-345.
13. American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics. Feb 2005;115(2): 496-50.
14. American Academy of Family Physicians. AAFP Policy Statement on Breastfeeding. 2001.
15. World Health Organization. Global strategy on infant and young child feeding (Document A55/15). 16 April 2002.
16. (Gulick 1986). The Breastfeeding Answer Book, Third Revised Edition, pp. 202 (Van den Bogaard 1991) The Breastfeeding Answer Book, Third Revised Edition, pp. 202 molbak 1994 The Breastfeeding Answer Book, Third Revised Edition, pp. 202