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Extended breastfeeding: myths, facts, and the stigma and shame

If you have a moment, I would like to tell you about my personal experience with extended breastfeeding. The following is part my own account (so, no judgment, shame, or issue if you are doing/did it differently!) as well as some information about the truth of extended breastfeeding.

I am three years and seven months into breastfeeding my third and last baby. I never weaned my babies, they ended their breastfeeding journeys on their own time. My first directly nursed for 13 months but received my pumped milk stash through 15 months. My second directly nursed past her second birthday. My third child is still going. I don’t have plans to stop her but the relationship is evolving as she becomes more her own person each day.

I describe breastfeeding my children as a relationship because they are people. Children are people. Just as I respected the decisions of my older two to end their breastfeeding relationships with me (as if you could force an unwilling two-year-old to nurse?), I also respect my third daughter’s decision to continue ours at this time.

But recently, I shared a few videos for #worldbreastfeedingweek2023 that showed me feeding my three year old. And the comments came in HOT on social media. I was kind of shocked, to be honest. Then after a week of steady berating, I was no longer shocked. I realized that some of what people said was true (yes, there are a lot of sickos on the internet). But most of what people said was SO FALSE it was scary. So I decided to use these comments to bust some of the myths, and to unpack some of the stigma that leads so many who do choose to breastfeed “into the beyond” to do so very privately.

“Your child is too old to be breastfeeding.”

Let’s start with the most common and basic one: “Beyond 6 months/a year is just too long.” I received some variation of this comment too many times to count. But here are the facts:

The Academy of American Pediatrics (AAP), The World Health Organization (WHO), The American Academy of Family Physicians (AAFP), and The American College of Obstetrics and Gynecologists (ACOG) are all consistent with their recommendations or support in continuing to breastfeed for at least 1 year. Research says that the health of moms and babies is optimal when breastfeeding continues for at least 2 years. These major health organizations are in consensus that breastfeeding past two years of age is not only not “too old” but that it supports the health of both parties.

The benefits of extended breastfeeding have been demonstrated in the literature, as I discuss in this blog post.

“There’s no nutritional value in that milk.”

The idea that breastmilk lacks nutritional value after a certain period is a myth. The body cannot tell time. It makes milk as long as, and sometimes for a long time after for some people, milk is being removed from the breast. The nutritional composition changes over time, and the breastfeeding parent’s body changes the composition of all of the milk’s factors (nutritional and immunological)

based on the exact needs of the child at any given time. Research has shown that breast milk retains its nutritional quality for the entire duration of breastfeeding. For example, one study looked at samples of human milk from the second post-partum year. They found that these samples, compared to those found in milk banks which generally accept milk from newer post-partum donors, contained significantly higher concentrations of total protein, lactoferrin, lysozyme and Immunoglobulin A, but significantly lower concentrations of zinc, calcium, iron and oligosaccharides. (Lactoferrin - a protein in milk that helps iron absorb in the digestive tract. Lysozyme - immune-supporting protein. Immunoglobulin A - an antibody protein that is part of the immune system. Oligosaccharide - a type of carbohydrate.)

Several comments seemed to mistakenly suggest that breastfeeding older children was taking the place of a balanced diet of solids foods, which is not recommended, and likely not practiced.

“That kid is going to be bullied!”

Critics of extended breastfeeding claim children will be psychologically damaged, socially stunted, or that it is somehow abusive.

The AAFP states that there is no evidence that extended breastfeeding is detrimental to the physical, psychological, or emotional health of the child in any way.

The Academy of American Pediatrics (AAP) concurs that there is “no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer” and explains that breastfeeding has “significant health and developmental benefits for the child.”

Ironically, most of the folks that seemed ‘concerned’ my child was going to be bullied were bullying ME on my page. 🙃 And it’s true that social stigma is cited as a barrier to extended breastfeeding in increasing majorities of women as they feed for longer. This study reported that for mothers breastfeeding in an unsupportive culture, “29 percent cited social stigma [as a negative consequence of] breastfeeding past six months, 44 percent for breastfeeding past 12 months, and 61 percent for breastfeeding past 24 months”. Another study observed that “Mothers manage the stigmatization of these breastfeeding practices through secrecy and avoidance of health professionals and others who might judge them, often leading to social isolation." This is unacceptable. By increasing education around breastfeeding, healthcare providers and others can change their perceptions to avoid making others feel judged and isolated.

ICYMI: Check out the reel and caption for info on the benefits of extended breastfeeding!

“Clearly this is about some sick need the mother has…”

Probably the most taboo and disturbing myth around extended breastfeeding is that the child is fulfilling a sexual desire or need on the part of the breastfeeding parent. While there is undoubtedly those who fetishize breastfeeding (because there’s probably a fetish for just about everything), breastfeeding is NOT a sexual act. The association between breastfeeding and sex is undoubtedly due to the hypersexualization of the breasts (and the female body in general). The association between sex and the breast likely makes folks who have avoidant attitudes toward sex and sexuality uncomfortable, and therefore compels them to negatively view public breastfeeding especially, as well as extended breastfeeding. In a study, authors found that a lack of knowledge about breastfeeding increased the negative emotions toward it in general. Lack of familiarity or experience with breastfeeding is likely a major component of the misunderstanding and association between breastfeeding and sex. Several commenters insinuated connections between extended breastfeeding and pedophilia and incest, more completely inappropriate associations, likely due to the misunderstanding or ignorance of the primary function of the breast as an organ that makes food, versus a sexual ornament.

“I’m fine with breastfeeding, but why do you feel the need to share it? It seems like you need attention.”

I personally do not need attention. But in sharing this, it became clear that what DOES need attention is the subject of extended breastfeeding. Breastfeeding rates are still declining significantly in the US over the first year. The breastfeeding report card from 2022 showed that while a wonderful 83% of parents initiated breastfeeding in 2019, by one year, the percentage of children receiving any breast milk dropped to 36%. The report card also notes that “​​many families do not breastfeed for as long as they intend to3 and breastfeeding disparities by race and ethnicity persist.” (I would be remiss if I did not acknowledge herein that I have privilege as white, middle class woman who is self-employed, which in large part allows me more opportunities and more proximity to my child in order to continue breastfeeding.) Parents need support in order to continue breastfeeding to whatever extent they desire. Policies that support families and access to ongoing support within the communities are helpful to parents seeking to continue breastfeeding. In addition to supportive policy, breastfeeding parents need social support, leadership, and examples. When people demonstrate things publicly, it serves to normalize and educate, which reduces stigma and taboo, initiates discussion, and engenders support.

“What we don’t understand, we fear. What we fear, we judge as evil. What we judge as evil, we attempt to control. And what we cannot control…we attack.” - Unknown source

Stigma and taboo often arise from misunderstanding. Hopefully by learning and understanding the benefits of and the reasons why parents might choose to breastfeed beyond the first year, we can encourage those who want to do it to keep going. We can encourage those who are doing it but are doing it secretly out of fear or negative experiences to share their feeding journeys, and shed more light on the importance of extended nursing. By sharing and feeding publicly, we can begin to change the perceptions around breastfeeding and normalize extended breastfeeding.


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