AAP recommends breastfeeding for at least 2 years. Here’s how to actually make that happen

Soft breasts and an empty freezer signaled the end of breastfeeding for my firstborn. He was 10 months old—and I was 5 weeks pregnant—when I realized I wasn’t going to be able to continue nursing him or give him breast milk in a bottle like I had planned. It was heartbreaking, but unfortunately, pretty common.

It turns out, the majority of breastfeeding moms have to stop breastfeeding their babies before they’re ready. A 2013 study in Pediatrics found that 60% of mothers who stopped breastfeeding did so earlier than they wanted to. The four most common reasons they stopped include: difficulties with lactation, infant nutrition and weight, illness or need to take medicine, and the effort associated with pumping milk.

According to an August 2022 study by Aeroflow Breastpumps, 63% of new moms believe that increased access to breastfeeding resources would have allowed them to breastfeed longer. Additionally, 50% of new moms who are no longer breastfeeding quit due to preventable breastfeeding complications. Returning to work was the main reason 24% quit breastfeeding. This survey is especially challenging during a time of a nationwide formula shortage, which is inspiring 38% of new moms to breastfeed for longer.

Related: Here’s why I personally feel validated by the extended breastfeeding guidelines

Extended breastfeeding is a term used for breastfeeding that happens after 12 months of age. In June 2022, the American Academy of Pediatrics (AAP) updated their breastfeeding guidelines to recommend exclusive breastfeeding for 6 months, followed by extended breastfeeding up to age 2, if the mother and baby both want to. Age-appropriate foods should be introduced as well at around 6 months old.

This recommendation can feel daunting to mothers, especially since 2 out of 3 infants are not exclusively breastfed for the first six months, according to the World Health Organization. The CDC’s 2022 Breastfeeding Report Card showed that 83.2% of infants born in 2019 started out receiving at least some breast milk. By 6 months old, that number dropped, with 55.8% of infants receiving any breast milk and 24.9% exclusively receiving breastmilk. At 12 months, only 35.9% of babies were receiving any breast milk.

Ending your breastfeeding journey can be gutting, especially if you weren’t ready for it. Keep reading for some tips on reaching your extended breastfeeding goals with your little one.

Understand your toddler has different needs

Newborn babies’ breastmilk requirements are very different from a baby at 6 months old, and a toddler at age 2, and beyond. Where you might nurse a newborn 10 to 12 times a day, you might nurse an 18-month old just 1 to 3 times a day. Know that as kids age, extended breastfeeding is less about fulfilling their nutritional requirements and more about bonding with your child—and passing on immunity, too.

“Most moms don’t set out to breastfeed for an extended time. Rather, one day they look down and realize their baby is not quite a baby anymore, and they are okay with that,” Amy Peterson, BS, IBCLC, lactation consultant for Evenflo Feeding and Forbes Health Advisory Board Member, tells Motherly.

Related: Does breastfeeding protect against RSV? Yes, studies show

She adds, “As babies grow into toddlers, keep in mind that nutritional needs are largely met with food and drink. Breastfeeding still provides nutrients and immunities, but the reason for breastfeeding often changes from food to comfort. Breastfeeding can solve almost any problem: fix a boo-boo, calm a tantrum, soothe to sleep, provide closeness at night. Extended breastfeeding becomes a wonderful parenting tool.”

This is so true—I’ve even used breastfeeding as a way to ease my kids’ pain and fear from getting routine childhood vaccinations.

However, even though your toddler will also be eating and drinking other things, your breast milk is still full of nutritional value. “Breast milk remains nutritious during extended breastfeeding,” Peterson says. “Amazingly, immunities in breast milk increase as the quantity of breast milk decreases. This is a wonderful benefit as toddlers touch and perhaps lick(!) everything in their environment.”

Don’t cut out nighttime feedings

Ashley Georgakopoulos, IBCLC, Motif Medical Lactation Director, recommends not cutting out nighttime feedings or pumping sessions. “This is a time where lactation hormones are surging, and can help maintain supply for the long haul,” she tells Motherly. 

Embrace change if you get pregnant again

It can be hard to focus on your extended breastfeeding goals if you are pregnant.

“Getting pregnant will inevitably impact milk supply,” says Peterson. “Hormones shift during pregnancy, and breast milk dwindles back to colostrum. You cannot increase your supply by breastfeeding more often, power pumping or taking supplements.”

This happened to me, and it is very disheartening. Peterson said that toddlers may naturally wean, although many may want to breastfeed again once baby is born.

“Many toddlers become sad when milk is no longer available. At the same time, many mothers report their nipples become uncomfortable with the stimulation of breastfeeding, so limited time at the breast may be welcome,” she says.

To be fair, it isn’t impossible to continue breastfeeding while pregnant. “Some toddlers will persevere and continue to latch onto the breast until the new baby arrives,” Peterson says, “but many will naturally wean. It is very common for toddlers to show an interest in breastfeeding again once the new baby arrives and milk is flowing.”

Communicate your needs

Extended breastfeeding is a team effort, and Georgakopoulos recommends asking for help.

“Communicate your needs, such as pumping breaks and time with your baby/toddler away from distractions,” she says.

“I cannot emphasize support enough, both from the medical professionals to people in your life and surrounding community,” Georgakopoulos adds. “From the beginning, having the ability to focus on learning breastfeeding, hunger cues, lifestyle adjustments and troubleshooting issues if they arise, will set you up for the rest of the experience.”  You’ll need that strong foundation to be able to sustain breastfeeding and pumping for however long you want.

Related: Ice for mastitis? New breastfeeding guidelines changes everything we thought we knew

Ignore the stigma

Extended breastfeeding has a negative stigma in the U.S., including from some healthcare professionals. A 2019 study in Health Communication found that the majority of healthcare students responded with negative emotions and neutral responses to extended breastfeeding, with the main reason because it would be burdensome to the mother.

If breastfeeding doesn’t get a lot of support in the healthcare community, it does seem to be more supported on social media groups. A 2020 study in the British Journal of Health Psychology found that women involved in extended breastfeeding Facebook groups had greater breastfeeding success and breastfed longer due in part to the normalization of extended breastfeeding and a supportive online community.

And don’t forget: you don’t need anyone else’s approval if it feels right for you and your baby. “Both mom and nursing baby benefit greatly [from extended breastfeeding],” says Georgakopoulos. “Mom has reduced risk of female-related cancers, breast and ovarian, the longer she nurses, and the immune system in baby takes roughly 2 years to mature and is drastically helped by breastfeeding or receiving breast milk.”

Related: Exclusively pumping is still breastfeeding, mama—here are 5 ways to make it easier

Reach out for help

You don’t have to do this alone!

“Breastfeeding USA and La Leche League International are two organizations that provide support for breastfeeding families,” according to Peterson, who also recommends moms reach out to local breastfeeding helpers for one-on-one support.

Georgakopoulous adds, “Mom-to-mom support is priceless, and a huge part of breastfeeding is learning from others but also being able to talk through everything. Search for support from groups like La Lèche League chapters and WIC Breastfeeding groups.”

Having a supportive partner or friend can also help.

Related: What not to say to the mother who’s struggling with breastfeeding

Advocate for better policies that support extended breastfeeding

The CDC’s 2022 Breastfeeding Report Card highlighted several indicators that can help mothers reach their breastfeeding goals. These included supportive maternity care practices, state-paid family and medical leave laws, and early care and education (ECE) policies.

Help yourself—and countless other new mamas—by advocating for these policies at the local, state, and federal levels.

Sources

Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am. 2013 Feb;60(1):49-74. doi:10.1016/j.pcl.2012.10.002

Black R, McLaughlin M, Giles M. Women’s experience of social media breastfeeding support and its impact on extended breastfeeding success: A social cognitive perspective. Br J Health Psychol. 2020 Sep;25(3):754-771. doi: 10.1111/bjhp.12451

Odom EC, Li R, Scanlon KS, Perrine CG, Grummer-Strawn L. Reasons for earlier than desired cessation of breastfeeding. Pediatrics. 2013 Mar;131(3):e726-32. doi:10.1542/peds.2012-1295

Zhuang J, Hitt R, Goldbort J, Gonzalez M, Rodriguez A. Too Old to Be Breastfed? Examination of Pre-Healthcare Professionals’ Beliefs About, and Emotional and Behavioral Responses toward Extended Breastfeeding. Health Commun. 2020 May;35(6):707-715. doi:10.1080/10410236.2019.1584739