Midwives have existed since the
beginning of humanity. Why, then, is it so difficult to find a midwife in America?
What events occured between the mid 1800's until the present day which nearly made
midwifery extinct in America? And why are more families now looking into homebirth as a
refuge from hospital care?
Nursing Past A Year
My wife is breastfeeding our seven-month-old twin boys. We were planning on weaning them at 12 months, but if that is not long enough, let me know. Also, I would be interested in seeing the statistics regarding IQ, sickness, and other bad effects of not breast feeding.
Joe Harris, staffer in Washington State Senator Pam Roach's office
The American Academy of Pediatrics came out with a wonderful policy statement in support of breastfeeding in Dec, 1997. (If you'd like the full text, it's available online, Pediatrics Dec 1997, vol 100, no 6, 1035-1039). It's far better, clearer, more specific than any wholly American document so far, but it leaves the public with the impression that breastfeeding is important for the first year, and far less so after that. It also implies that weaning will start before the end of the first year, yet a baby's body "expects" to be mostly
milk-fed for at least the first year. So at the very least, consider *starting* weaning at about a year, not *finishing* it by a year, and expect a majority of calories to come from human milk throughout that first year.
The World Health Organization recommends breastfeeding "for well into the second year and for longer if possible." There are reasons for this. As the World Health Organization puts it, "Babies get ill frequently as they learn to crawl, walk and play. A child who is ill needs breastmilk."
An anthropological study recently looked at "weaning markers" in other higher primates and compared them with those same "markers" in humans - age at certain tooth eruptions, comparison to adult body length andweight, comparison to gestation length, to birth weight, and so on.
The author came up with a probable physiological "weaning window" for humans with a low end at about 2 1/2 years and an upper end of about 7 years. Those figures seem to fit very, very well with how breastfeeding operates in unpressured societies.
That same anthropologist proposed this analogy: Suppose you have an oil well in your back yard. Like all oil wells, its yield is highest in the first year. You get a check for $100,000 dollars. Great! So now do you cap the well? The next year you get a check for only $10,000. Do you cap the well? The next year you get a check for $1,000. Do you cap the well? The next year you get a check for $100.
Do you cap the well? Her point was, the well will *always* yield a benefit. But there may come a time when, for you, the noise of the pump or some other reason makes you decide on balance that you'll cap it. Or, if you decide *not* to cap it, there comes a time when it just peters out on its own without any effort on your part.
Breastfeeding works something like that. Its nutritional and
immunological importance wanes over time. But there's never, never a time when it's not a good food or a good source of antiinfectives. And, of course, this analogy doesn't address the emotional value, the place breastfeeding has in the mother-child relationship.
If your wife decides she wants to wean actively at a year, she can feel good about the normal start she's given your children. If she doesn't want to, here's some of what the future holds:
In studies comparing "cognitive development" (the PC version of "smarts"), the correlation between duration of breastfeeding and high performance extends as far as it's been studied. In other words, the school-age child who nursed for 6 months outperforms the bottle-fed child, but the one who nursed for a year outperforms the one who nursed for 6 months, and the one who nursed for 2 years outperforms the one who nursed for a year. I think it's been carried to about 2 years, with no studies yet that look at longer nursing durations.
Normal jaw development seems to require a good year of nursing, minimum. That won't guarantee they won't need braces, but it sure reduces the likelihood.
A child's immune system is pretty mature by about age 6, as is his digestive system. It makes sense to back up those systems for as long as it fits your family. Same with bones: it appears that we're genetically geared to be building bones out of breastmilk for a number of years. Cow milk isn't assimilated in the same way, so the longer you build those bones from breastmilk, the better off they probably are. There hasn't yet been a study showing reduced fractures in the elderly with increased dairy early on; indeed, this culture has a bigger problem with osteoporosis than most, even though our dairy consumption is the highest in the world. I think it makes simple good sense to go with human milk for human children.
Your wife might be interested in a book called "Mothering Your Nursing Toddler" by Norma Jane Bumgarner. It talks about what it's like nursing at various ages, how to wean if you want to, what happens if you don't. Another good book is "The Nursing Mother's Guide to Weaning" by Kathleen Huggins, which covers the same topics but isn't specifically about children past a year.
If your wife hasn't been to a La Leche League meeting she might enjoy it. I know one mother of twins who came to her first meeting because she was going home for the holidays and "needed a booster" before she dealt with nay-saying relatives. When you're doing such a maverick thing as nursing past a year in this country, it can be a huge lift to
surround yourself with people facing your same issues.
Bottom line: children wean. It's not something we have to do for them. We *can* do it if we choose, and we can do it any time the burden outweighs the joy, but there's never a time when breastmilk is no longer a complete food for them, and there's never a time when breastfeeding is anything but completely normal, no matter what our particular culture says.
Maybe I should end by telling you about my own two weaning experiences. My first son weaned abruptly at age 2 1/2, after we were on vacation with his older cousins for a week. He ate with them, slept with them, played with them, and didn't nurse all week. When we got home, he went right away to our favorite chair and climbed in my lap... but didn't know what to do. End of nursing. Period. He shrugged and walked away.
My second son was 2 1/2 when I was hospitalized with a brain abscess an hour from home. He saw me only once a week for a month and a half... and nursed at every visit. A couple *years* later, when I was probably stalling him more than I realized, he said one day, "You know, Mommy, sometimes I like to think about my favorite things. Like
ducks. And nursing. But sometimes when I think about my favorite things, then I don't have them anymore." I wasn't exactly sure what he meant, but I could tell it was important. "Oh, Eric," I said, "Is nursing that important to you?" "Yes," he said, sadly. "Well as long as it's important to you, you shall have it." "Even when I'm 13?" (still in the same sad voice). I couldn't help laughing. "Well I don't think you'll *want* to then, but yes, even when you're 13."
At that point he was nursing only once every few days, and I *knew* he'd want to nurse that night. He didn't. He just wanted permission. Toward the end of our nursing relationship, he was nursing for a matter of seconds every few weeks, so I don't even know for sure what year he weaned. But I *do* know that when he was 8 years old and cuddling in my lap one day, he squirmed down into a nursing position
and told me he wanted to nurse.
I knew that, biologically, there was nothing wrong with nursing at that age. But he was into Ninjas and bathroom humor. What did it do to an American child to nurse at age 8? And yet we had this contract... I kidded around with him, but he was pretty insistent. Then someone walked in the room, he was distracted, and the moment passed.
The next morning he woke up with chicken pox. I think he had known something was out of whack, and had known right down to his toes what would help.
So I've had one child at each end of the weaning window. Weaning isn't just about immunities or IQ. It's about personalities, and relationships, and love, and everything that makes one person different from another. It has nothing to do with pediatricians or experts or *anyone at all outside your own family*. This is not a tome written to convince your wife to nurse for a certain length of time. It's a tome written to encourage the four of you to find your own paths with the knowledge that there are no hazards waiting for you
down the longer paths if you should choose them. Any road hazard signs were put up out of ignorance. Enjoy.
Diane Wiessinger, MS, IBCLC
International Board Certified Lactation Consultant
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