Reasons to keep breastfeeding past 6 months?

[Crazycatlady]

I am breastfeeding my 8 month old DD, morning and evening. She has one bottle of infasoy (confirmed milk protein allergic) for her afternoon milk feed (so I can leaver her during the day) and is well established on solids. She also has infasoy in her cooking.

Today we saw Dr Lack at St Thomas' about her allergies (milk, egg and cod) and when I asked him whether there would be good reason for me to continue with breastfeeding he was fairly nonchalant about it, and also said the increased immunity offered by BFing pretty much disappears past 6 months.

I have been trying to decide whether to keep BFing or whether to stop. I am familiar with the WHO recommendations on BFing, and have also read the kellymom website from top to toe, but I'm not sure I understand WHY Bfing longer term is a better option than formula? Need some assistance from better educated MNers to help me here.

My DD has been very difficult to BF. While I have enjoyed the experience she has always been very distracted and more interested in the world than BFing, so it's hard work, and with having to exclude all dairy and egg from my diet it's hard going on that front too. But I am prepared to continue if there are good reasons to.

What do you think?

I think you need to turn this around - do you have good reasons to stop?
You already know the benefits of why continuing to feed will be helpful to you and your dd... so I think you need to think about whether you want to stop.
The thing is about the breastfeeding relationship is that is has got to be something both you and your baby are happy with.

And I speak as someone who is still feeding a 20mo ds.

Oh it's not true what the Doctor says about the immunity benefit decreases. In fact it's the opposite.
here
check out myth number 3

Thanks for those links Turtle. That Jack Newman piece was particularly interesting.

You know my instinct was that the immunological argument was a sound one, but when the doctor shrugged it off, he's so highly respected that I didn't feel I wanted to challenge him further.

Keep it coming!

I'm stunned that someone who is highly respected in the field of allergies is so unaware of the reasons to continue breastfeeding!!

The immune system of children is not fully mature until the age of about 5 years. Up to this point breastmilk provides them with immune support as well as all of the key nutrients they need for the first 12-18 months.

Ultimately a natural, allergen free food is always going to be better for her than a highly processed substitute. I am surprised that they recommended a soy based formula for her as soy is not considered to be a safe formula base due to the link with phyto-estrogens, and the similarity of soy proteins and cows milk proteins. My youngest DD has cows milk protein intolerance and I was told that soy was no longer recommended as a dairy replacement for young children for these reasons. She is now 3 years old, no longer so sensitive to cows milk, but not grown out of it yet, and still breastfed 2-3 times a day. I was able to reintroduce dairy into my diet when she was about 18 months without her reacting to it, which was a huge relief as I missed cheese like mad! She still has rice milk on cereal and here and there as a drink (ie at nursery) but can tolerate small amounts of cheese, like on pizza, without much of a reaction.

I honestly can't think of any good reason to stop breastfeeding a baby so young, even one that doesn't have food allergies, and I am very disappointed that you were not supported to continue to breastfeed your daughter when it will do her lots of good to continue and leave her vulnerable if you stop!

I'd be tempted to stop if I were you. You've kept it up for eight months which is fantastic, she's well established on solids and your doctor has more or less said there is no real benefit. Unless you are both really enjoying it I'd call it a day and I wouldn't beat myself up about it. FWIW I breast fed both of mine for about 18 months - that was because it was easy and it meant I didn't have to faff about with bottles and sterilising. Also I didn't work so I never had to leave them. I'm not evangelical about it (though I'm sure there will be someone along who is shortly) I think getting it right is finding the balance between what's best for dd (first six months) and what's easiest for you.

Thanks for your thoughts everyone.

Can anyone point me in the direction of any recent studies that quantify the risks of switching to formula post 6-months?

I hear it a lot that the benefits continue to toddlerhood, but have never seen any real evidence of this.

BTW with ref to the soy formula you're absolutely right GreenMonkies for a pre-6 month old, but post 6 months the phyto-oestrogen risks are no longer an issue and the soy formula is a good source of calcium for her since she can't have any dairy.

I honestly don't know how long I can continue excluding dairy, egg and fish from my diet. That excludes an awful lot more foods than I had ever imagined. It's hard...

Anyone? Tiktok are you about? I'd really appreciate your thoughts here if you have a moment.

Regarding the immunity - there are still some benefits. I am convinced that my DD (who was 11 months at the time) did not catch norovirus from any of my family because she was breastfeeding. My immediate family is just the 4 of us (me, DH, DS had noro) and my extended family that I see regualarly a further 6 (they all got it as well). DD was in constant contact with all these infectious people over the couple of weeks we took to all have it!

I don't think the off chance of noro coming your way is a good enough reason to keep breastfeeding though! Just making the point that there can be a bit of immunity stuff still happening. (I gave up bfeeding both my DCs at 12/13m btw).

A dietician told me that there are 'no benefits to breastfeeding at this age (26 weeks)' and 'it will be easier for you to bottlefeed' she said it in front of my dh too so he wants me to switch to formula because he thinks it is better.
I have been trying to find reasons to continue too (apart from because I want to and because ds has been screaming his head off since we started mix feeding)

for you noodlesoup, and OP if you want to continue and the doctor has put you off.

This is very unscientific, but my 9 month DD has had far fewer illnesses than other babies of a similar age at her nursery and is still breastfed 4-5 times per day. Again unscientific, but I feel that there could be a reduction in the severity of swine flu if she catches it over winter if she is still bfed, particularly if I have it too (inevitable I expect as I catch every cold she gets!)

This for me is a good enough reason, plus I have no reason to stop. She likes it, it's beneficial for her according to bfing info and although she isn't that easy to bf at the moment (biting ) it doesn't cause me any particular problems to continue.

Yep my DH was there to hear all this too, and while he has been extremely supportive of BF I think he is starting to think I should phase it out, at least by Christmas so I can enjoy Christmas food delights... I'm not that bothered really, but he keep mentioning it, strange man!

Crazy,

I totally sympathise on the exclusion diet, I have coeliac disease, so when I went dairy free for DD2 I then had to exclude diary as well as wheat/gluten, the more you have to exclude the harder it is to find anything to eat! You'll find one thing that doesn't have dairy in it, but does have egg, and so on, it makes eating anything "ready made" very difficult.

I'm afraid I don't buy the calcium argument though, DD2 has never had any soya, apart from the odd alpro yoghurt, but gets all her calcium from my {breast} milk and solid foods like green veg and pulses. I went back to work when she was 6 months old, feeding her 3 or 4 times a day (plus night feeds) and expressing twice a day until she was about 18 months old. At this point I stopped expressing and just fed her when we were together, and introduced rice milk for her to drink whilst she was at nursery, which is also fortified with calcium, so we've never needed any formula, and I am a bit that you have been led to believe that your DD would need it, as your breastmilk is far more nutritionally complete and absorbable than formula of any kind.

How often do you do a "challenge" and eat one of the foods she's sensitive to? Now that she's over 6 months and her gut lining is sealing so you may find that she is not going to react to eggs or fish via your milk in the near future, which makes your life easier and makes continuing to breastfeed much more viable as it doesn't restrict you so much.

Why is she only having 3 milk feeds a day? A morning and evening bf and a bottle in the afternoon don't sound like much for an 8 month old, both mine were still big feeders at this age, nursing about 4 - 6 times a day, and once or twice at night, and only eating small amounts of solids. Milk is meant to be their main source of food for the first 12-18 months, and solids are not nutritionally important until they are over a year old. I have to say I found breastfeeding DD2 made life easier in many ways, if we were out longer than planned and she was hungry I could just breastfeed her instead of trying to find suitable foods for her, and so on.

Also, we are only looking at this from a nutritional/immunilogical view-point. Breastfeeding is not just about food. Nothing soothes a teething baby, or eases a bumped knee or lulls an over-tired toddler the way nursing does. I have been monumentally thankful for breastfeeding with both of my girls, it has kept them fed and hydrated through chicken pox and numerous colds etc as well as helped them off to sleep when we are away from home, helped equalise their ears on flights and reconnected us at the end of the working day with a cuddle on the sofa that gives us both a much needed oxytocin fix. It is the most under-rated mothering tool there is, not just antibodies and calories!

noodlesoup,

the dietitian that told you that was talking shit, and should be reported so they can get some retraining.

If you want to carry on bf then ditch the formula and go back to exclusive bf, the WHO recommendation that all babies should be bf for at least 2 years is not just aimed at "third world" countries, but for all children.

GM, in answer to your questions:

• No challenges yet for her (since first exposure), first will be 3-4 months from now, followed by further skin-prick testing. I do a challenge via my diet once a month or so, and her eczema still flares (albeit not so badly as when said foods were in my diet on a permanent basis).

• She has 4 milk feeds a day - I BF her morning and evening (7am ish, 6.30pm and 10pm), plus afternoon formula 210 ml. She also has 150ml in her porridge so she's getting a good amount of milk. She doesn't wake for night feeds and hasn't for months so I'm not about to start doing that again! She refuses further BFs if I offer during the day. We are happy with the soy formula given that it is not sweetened the way hydrolised fomulas are, is more calorific than rice or oat milk, and I'm not in a position to BF or express now during the day.

Anyway, we're getting into things that I've already been over and have made decisions about...

I understand that BF is about more than immunological/nutritional superiority, but I'm still looking for scientific evidence of this fact to help me decide our next move. I have googled, but no joy. Still hoping someone here has something...

It's very hard to find research data because there is hardly any out there. However, Dr Jack Newman says this;

But it is said that breastmilk has no value after six months.

Perhaps this is said, but it is patently wrong. That anyone (including paediatricians) can say such a thing only shows how ill-informed so many people in our society are about breastfeeding. Breastmilk is, after all, milk. Even after six months, it still contains protein, fat, and other nutritionally important and appropriate elements which babies and children need. Breastmilk still contains immunologic factors that help protect the baby. In fact, some immune factors in breastmilk that protect the baby against infection are present in greater amounts in the second year of life than in the first. This is, of course as it should be, since children older than a year are generally exposed to more sources of infection. Breastmilk still contains special growth factors that help the immune system to mature, and which help the brain, gut, and other organs to develop and mature.

It has been well shown that children in daycare who are still breastfeeding have far fewer and less severe infections than the children who are not breastfeeding. The mother thus loses less work time if she continues breastfeeding her baby once she is back at her paid work.

It is interesting that formula company marketing pushes the use of formula (a very poor copy of the real thing) for a year, yet implies that breastmilk (from which the poor copy is made) is only worthwhile for 6 months or even less (?the best nutrition for newborns?). Too many health professionals have taken up the refrain.

I have heard that the immunologic factors in breastmilk prevent the baby from developing his own immunity if I breastfeed past six months.

This is untrue; in fact, this is absurd. It is unbelievable how so many people in our society twist around the advantages of breastfeeding and turn them into disadvantages. We give babies immunizations so that they are able to defend themselves against the real infection. Breastmilk also helps the baby to fight off infections. When the baby fights off these infections, he becomes immune. Naturally.

There is also this from LLLi.

And if you want actual research papers there are some out there, but they are not light reading!

www.huliq.com/11/81484/childs-body-composition-linked-breastfeeding-duration

www.jpeds.com/article/PIIS0022347607002624/abstract

iadr.confex.com/iadr/brazil07/preliminaryprogram/abstract_112328.htm

journals.lww.com/jpgn/Fulltext/2006/05000/Breast_feeding_Duration_and_Childhood_Acute.18.aspx

And Brian Palmer has shown that breastfeeding is important in oral/nasal development, with regard to Obstructive Sleep Apnea and this oral/muscle development is related to clarity and development of speech.

But all the science on the internet is not going to convince you to carry on if you really want to stop.

Really good posts GM

I think it is absolutely beyond doubt (as witness previous posts) that there are health benefits to breastfeeding beyond 6 months. The only thing you now have to do is to weigh those benefits against any drawbacks with your current situation.

I gave up bf'in ds at about this age because the "breast-safe" medication I was taken was having horrible side effects, and I needed to switch to a version that did not make me ill and did not make me incapable of caring for ds.

So that seemed big enough to weigh against the immune and other benefits to ds.

Only you can judge if being able to come off the exclusion diet is big enough for you.

A meta analysis of the breastfeeding and cancer risk questioned whether the BFing link was truly causal and concluded

"Even if causal, the public health importance of these associations may be small. Our estimates suggest that increasing breast-feeding from 50% to 100% would prevent at most 5% of cases of childhood acute leukemia or lymphoma"
www.ncbi.nlm.nih.gov/pubmed/15986434

The WHO are obviously not going to bring out individual recommendations for different countries, so they have a catch-all guideline which rightly says, BF for a minimum of a year. It goes without saying that the difference in health outcomes between a baby in the UK who is formula fed and one in a developing country that is formula fed are (literally) a world apart.

BFing decreases the risk of diahorrhea. In the developing worldl, a dose of the runs is fatal, and that's why its more important (in mortality/population studies) there than here.

I'm not saying its not important here, obviously it is, but I think that post 8-9 months the advantages become more slender.

But that said yes, undoubtredly BF decreases allergies, decreases respiratory infections and decreases gastrointestinal upset.

By 8-9 months babies can make and secrete their own antibodies, but due to their age and therefore lack of exposure to bacteria etc, their immunological repertoire is still limited, which means they can still benefit from the antibodies which the mother gives in her breast milk. Hence that extra immunological protection is conferred as long as they are still BFing. But in the developed world that is unlikely to be the difference between life and death IMHO.

I'm really not down on extended BFing - I support it, and I am sure Tiktok will come along and shoot my arguments down in flames any second

While I have my head above the parapet however, I do have one question. I really cant BF more than sporadically any more for various reasons. (one being I don't really want to) however I feel extremely "MEH" that according to govt guidelines, I seem to have no option other than formula until she is a year old. My understanding is that the main reason for avoiding cow's milk was a) allergy and b) iron bioavailability. Well there are no signs of allergy to any dairy (and she's had plenty) and so I was wondering whether I could give her cows milk plus vitamin/iron supplements as necessary instead of formula. If any knows I'd be grateful for info.

I read on a thread on here previously that one of the continued benefits is that if your baby gets a virus then through bf it will give the virus to you, your body starts making antibodies to that particular virus which are then fed back to the baby through bf - this is obviously not possible with formula and may be relevant this winter with swine flu/other viruses around which you may not already have immunity from so your ds won't have already had any antibodies from you to fight them.

I'm afraid I can't remember where the rersearch for this came from but maybe someone else on here can help!

Thanks everyone - you have given me lots to think about and read about, particularly GM thank you! Will have a proper read before deciding what to do.

So well expressed GreenMonkies!
I also despair at the strange attitudes toward breastfeeding our young!
Why do we believe the milk of another mammal or a bean could be better for our human babies?
Its well documented that milk should form the bulk of an infants diet for the first 12 months and doesn't it just make sense that its human milk?
As already mentioned when babies are ill even vomitting they tolerate breast milk so do we really need more proof?
I do sympathise with diet restrictions CrazyCatLady maybe some more reliable research re allergies and breastfeeding would be helpful
Good luck!

Oh for goodness sake! What is the allergist on? She's allergic to milk protein - surely in that case breastmilk is the the best nutrition possible for her? Far better than soya - so many milk allergic children go on to develop soya allergy. Bfing her is the best thing you could possibly have done for your dd, CCLady.

Quite apart from the nutrional aspects, IMO bfing an older baby is so much more pleasurable than bfing a younger baby. It's much more relaxed, because the child is no longer as dependant on you for all her nutrition and comfort. It becomes a two-sided relationship, not just a matter of responding to a demand. Eventually the dristraction doesn't matter, because you both learn to feed when it feels right.

It's so difficult to describe!

It's funny and delightful when they start talking to your breasts, and when you realise that they have their own way of requesting a feed. When a feed turns into a cuddle, or vice-versa, and you can enjoy a special closeness with your child.