Wednesday, March 23, 2011

When Milk Turns to Water

Yes, I'm "still" nursing Zon at 29 months. 

Whether you have nursed a child or not, and nursed past infancy or not, you most likely can still recall a few myths, such as:

After 6 months, your milk turns to water.
Nursing a toddler is sexual.
You can’t nurse them too long or they’ll be dependent.

Nursing past 6 months or 1 year is actually the norm for the rest of the world. It has only been in the past half century, primarily in America, that we stopped providing adequate nourishment for our toddlers and young children.

This article provides an excellent summary with cited research on why “extended” nursing is normal and healthy:

And now, here is a guest post on the topic by Dr Thomas:

”I think if you nurse for a year, someone should throw a party for you.  The best I've been able to do is give out shirts. (  I've given out more shirts than I can count now and I have a (now not-so-current) recognition list of "one year" dyads on my website. (

So, with all these moms in my practice reaching the one-year goal, I decided to do something to recognize those mothers who continued to breastfeed to 18 months.  Those wonderful moms, who took the shirt and congratulations at a year said, "No thank you" when I offered at 18 months. They didn't want people to know.  They nursed past one year, but they didn't want public acknowledgement. They were "closet" nursers and ok with it.  

The one-year visit is also an opportunity to talk about the benefits of continuing to nurse after a year.  I'm going to try not to call it "extended breastfeeding" since that reveals a cultural bias that exists where I live, but maybe not where you live. Worldwide, nursing two to four years is simply normal, not extended.

And before cultural biases interrupt the discussion, the AAP policy statement on "Breastfeeding and the Use of Human Milk" says that there is, “…no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer."

So what happens at a year? Well, according to popular belief, as your beautiful breastfed child is sleeping the evening before their first birthday, their world gets rocked: the next day, they will discover that milk serves no purpose. We have found a cow that makes better milk than mom.

How do you make a non-verbal one year old understand that? They are counting on that same warmth, expression of love and wonderful nutrition that they got the day before. What's magic about that 366th day of their life?

Now really, I know that doesn't make sense and the one year old is probably confused, but I know some wonderful women who believe that even if they are continuing to nurse, that the child still needs supplemental cow's milk "to get enough nutrients."  

I may live in America's Dairyland where we wear cheeseheads in public, but cow's milk is for cows.  And since I'm usually having this conversation at a well visit, with the child right there, I can do a reasonable job of convincing the family that my physical exam suggests that their child is not a cow.

The infection fighting properties of milk are still present; lysozyme, lactoferrin and secretory IgA are present in stable amounts. There are smaller levels of protein, calcium and long chain fatty acids when compared to the milk of a 3 month old, but we're aren't talking about a 3 month old, who is only getting milk. Our toddler is getting complementary foods.  And we know that moms who nurse longer lower their risk of breast cancer.

I get it.  Many people, including most healthcare providers, don't understand why you'd want to nurse for more than a year.  But they aren't the ones trying to calm a screaming 15 month old.  I'm just saying- if I had to pick between the crying kid I need to distract and make happy somehow and the crying child who I can nurse and calm and get to smile in about 5 minutes, I'm picking the latter.

Someday, I'll be able to do something for my friends, those wonderful closet nursers, and I'll know we're making progress in my little slice of the world. Maybe then we can convince the rest of our country that nursing a toddler is normal.”

Jenny Thomas, MD, IBCLC, FAAP, FABM


  1. Awesome Pediatrician! I may have to drive to WI. ;)

  2. I remember nursing my son on the bus when he was almost 2 years old, nobody even looked at us. I can't believe any woman would feel the need to hide nursing a baby. I love seeing older babies and toddlers nursing because it is NORMAL~

  3. Here's the link for easy sharing:

    Thanks for the guest post spot! Jenny Thomas

  4. I remember my step MIL commenting that it was time to wean my youngest when her turned about a year old. I said, that I would do that but I think he would be jealous that his older brother (who was 2.5 years old at the time) was getting Booby and he wasn't. The stunned look on her face as she said, "Oh you're still nursing [the toddler]?" was priceless.

    Now they are over three and 19 months old and still going strong.