Myth vs. Reality - The WHO Breastfeeding Recommendation

I was recently reminded of a myth that I have heard several times in various forms over the past few years. It goes something like this:

Myth:

The World Health Organization recommendation that breastfeeding should continue for two or more years only applies to the developing world.

Reality:

On the contrary, the WHO recommendation says nothing about their recommendation being for one population and not another. In fact, their recommendation about breastfeeding duration specifically mentions that it is targeted at all mothers worldwide: “WHO recommends mothers worldwide to exclusively breastfeed infants for the child's first six months to achieve optimal growth, development and health. Thereafter, they should be given nutritious complementary foods and continue breastfeeding up to the age of two years or beyond.”

Still, some would argue that the wording isn’t specific enough to say that the recommendation applies to the West.

The American Association of Family Physicians state that the WHO guidelines do apply to babies in the USA, and that “If the child is younger than two years, the child is at increased risk of illness if weaned.” They also point out that, “It has been estimated that a natural weaning age for humans is between two and seven years.”

Recent research is showing more and more about the benefits for children and mothers of continuing to breastfeed into toddlerhood. Toddlers who are breastfed continue to receive protection against infection from their mothers’ milk. Other research has shown improved cognitive and social abilities among children who were breastfed beyond infancy. The nutritional benefits of breastmilk also continue into toddlerhood, and research published in the journal Pediatrics found that breastmilk continues to change to meet the changing needs of the older nursling:

"Human milk expressed by mothers who have been lactating for >1 year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods. During prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant."

So how long should I breastfeed?

This is your decision! My hope for all mothers is that they will have accurate information and the support that they need to breastfeed for as long as they want to. Every mother’s breastfeeding situation is unique. Her physical, mental and emotional well-being is unique. A mother's decision to wean or to continue to breastfeed is very personal and is her own.

Influences in our Western culture encourage many mothers to wean before they or their babies feel ready. Other influences may give mothers the impression they should continue to breastfeed, even if they are not enjoying it and may even be resenting it. Neither of these situations is optimal, and they become worse if mothers end up making these important decisions based on common myths, rather than evidence based information.

Deciding whether to continue breastfeeding or to wean a baby or toddler can be very difficult. Whatever you choose, please do your research and then trust yourself and move forward confidently in the knowledge that you are doing your best for your child and for yourself.

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