I wish I had a nickel for every time a parent has talked about the idea of “breastfeeding beyond 6 months.” Many recite the “6 months of exclusive breastfeeding” recommendation from expert groups, most notably, the World Health Organization and the American Academy of Pediatrics. But after those first six months, the conversation seems to be full of questions or erroneous assumptions. Here are some of the nuts and bolts of this whole concept.
Why is breastfeeding beyond 6 months important?
Some people assume that the nutrition in human milk is somehow inferior after 6 months. That’s just not true.
People also assume that the mother’s milk is just about nutrition, and that’s untrue, too. There’s a clear message of high concentrations of immunoglobulins in colostrum during the first few days of life. That’s true! However, some assume that the immunoglobulins gradually fade away until they completely disappear at 6 months. That’s patently false.
Immunoglobulins and other protective factors continue to be in mother’s milk throughout lactation. Therefore, breastfeeding beyond 6 months is important.
Think about this just a little. As babies become more mobile, they get into germy things. They’re around other kids who have germs. Hence, it’s ideal to have mother’s milk as a remote immune system after 6 months. (And everyone who wants to keep their baby out of the doctor’s office should remember that!)
Should infants be exclusively breastfed after 6 months?
The short answer? No.
I’ve explained that the day the baby is 184 days old is not necessarily the exact moment to introduce baby foods. Nevertheless, somewhere around 6 months, it’s important to offer the baby soft, semi-soft, or solid food consumed. (The fancy word is “complementary” food, but I often just say “baby food” or even “table food.”)
From a nutritional standpoint, it’s important to offer these foods primarily because the infant’s extra iron stores are fairly well depleted by about 6 months. Foods that contain iron are especially important.
How much milk do babies need after 6 months?
Well, it depends on the infant, and it depends on how much baby food they are consuming. It also depends on how far “after 6 months” we are talking. Babies need more food energy (“calories”) at 8 months or 12 months than they need at 6 months. That’s an official recommendation, but it also just makes good sense.
So to answer the question related to the needed amount of milk, let’s first look at percentages related to food sources recommended by the World Health Organization (WHO) as of April 1, 2020:
“Breast-milk is also an important source of energy and nutrients in children aged 6–23 months. It can provide half or more of a child’s energy needs between the ages of 6 and 12 months, and one third of energy needs between 12 and 24 months. Breast-milk is also a critical source of energy and nutrients during illness and reduces mortality among children who are malnourished.”
That quote addresses percentages of milk in relation to total intake. To calculate how much milk babies need, we need to know the total number of calories they need in a day.
Despite a vigorous search on this, I cannot see that the WHO specifies the total amount of calories needed when breastfeeding beyond 6 months. And, I’m eager to point out that the WHO emphasizes that at 6 months, it’s not about nutrition or food energy. As I’ve explained earlier, it’s about food exploration.
So, let’s look at “beyond” 6 months.
The total nutritional needs for American infants are defined by the American Academy of Pediatrics for the breastfed baby who is 8-12 months old as:
Now that your baby is eating solid foods, planning meals takes a little more thought. At this age, your baby needs between 750 and 900 calories each day, about 400 to 500 of which should come from your milk or from formula (approximately 24 oz. [720 mL] a day)
For babies who are breastfeeding beyond 6 months, that totally aligns with the WHO’s recommendation that half or more of the infant’s intake should be from the mother’s milk. And, after lactation is fully established; nearly every mother I can think of produces about 25-30 ounces of milk in a day.
When is the decision made about breastfeeding beyond 6 months?
Honestly, I never raise this “decision” question to parents during pregnancy, or even in the early part of lactation. If they have their eye on the “6 months” thing, that’s great. But I am fearful that forcing them to verbally commit to a timeline can lead to a downhill conversation.
If they give me the “6 months” number, I applaud them, and promise to support them. As the breastfeeding journey progresses, we can have a broader conversation.
Truth is? I’m more interested in helping them enjoy breastfeeding. If they enjoy it, they won’t want to stop!
What about baby-led weaning?
There’s a ton of evidence to support why infant-led or child-led weaning works. And along with that, let me give a pitch for why I’m in favor of not using a spoon.
Don’t older babies bite when breastfeeding?
Well, they certainly can. But once again, most parents don’t understand that concept, or how to minimize the possibility of biting. Here, I’ve given my top tips for how to avoid biting after the baby has teeth.
Isn’t breastfeeding beyond 6 months just a nuisance?
I suppose it depends on how you view “nuisance.” I could argue that bottle-feeding or formula-feeding is a nuisance! Shucks, I could tell you that after I write this post, I’m going home to cook dinner, and that’s a nuisance! It all depends on how you look at it.
Certainly, after about 3-4 months, this wiggly, squirmy, distracted little person is often, exposing the mother’s breast. Is that a nuisance? Is it just playful? Or so awful that you want to avoid it at all costs? Or totally unimportant? Again, it depends on how you look at it.
Breastfeeding in public isn’t all that “difficult” but finding a place to do so can be taxing. (There are even apps for mom-friendly places!)
Worse still, breastfeeding beyond 6 months often brings criticism from others. I encourage women to stand their ground on this issue, or any other! I’ve also given 7 tips to deal with the criticism.
Are you breastfeeding beyond 6 months? Did you decide early on or take it day by day? Share your thought in the comments below!
As a career RN and IBCLC. I was blessed to work with breastfeeding moms every day. What a rewarding 45-1/2 years. It was a privilege to support moms and babies in initiating and continuing breastfeeding for as long as it was mutually working for them. I chose to breastfeed my first child for six months and my second for 27 months. Working in a supportive environment allowed me to pump milk on my breaks. Our team of IBCLCs , supported employees throughout the hospital, in meeting their breastfeeding goals.
Patti, good for you! Good for you! And good for your children and society in general. This is such a great testimony of how a supportive environment and supportive colleagues can make such a difference. Thank you for sharing such a good story.
Marie,
Thank you for replying to my post. I was blessed to have the opportunity to be paid well doing what I loved. I worked at both Beverly and Salem Hospital ( Mass.). I worked with wonderful, compassionate,well educated RN, IBCLCs. We staffed seven day inpatient coverage, to OB, SCN, and pedi.. I got to attend the annual ILCAconference every other year ( all expenses covered) . Education was valued. I finally retired but I have wonderful memories. Staff RNs who had taken the CLC course are now
going on to be IBCLC’s. I donot know if you knew Pat Ganda. She mentored the rest of us after passing the exam in 1985 in DC. In these tumultuous times, breastfeeding is more important than ever. Thankyou for all you do.
Patti
Patti, agree; definitely always good to count your blessings!
I am an RN working in a labour/maternity unit now. I had my 1st child at a young age; was working in a postnatal unit straight out of varsity and looking back now was really inexperienced. I breastfed him for 6mnths with great difficulty, ‘colic’, and all the interventions of friends and family. My 2nd son was a calm happy baby and I fed him for 9mnths, of which most was after returning to work, not expressing but breastfeeds at night. I cannot believe how inexperienced I was! I also cannot believe how much info, that isn’t accurate, new mom’s have to sift through to make an informed decision. Thank you for an informative blog.
Diane, “sift through” jumped right out at me. You nailed it! From the moment she starts getting care, we send her home with a wheelbarrow full of information. Later, she goes hunting around the Internet, and doesn’t know what’s right, what’s wrong, what’s irrelevant, and what is age-appropriate. I consider myself a curator of information. Mothers (or anyone else) shouldn’t have to “sift through” all of this stuff in order to feed their babies. It’s not always easy to deliver a new post twice a week, so thank you for acknowledging that my blog is helping!