Breastfeeding a child after the first year

Does breastfeeding change as my child grows?

Every child is different. Their breastfeeding behaviour varies with their needs and personality and with the mother’s availablity and preferences. These change over time. One-year-old children will have a word to use when they want to breastfeed. At two years, they will bring it up in conversation. Breastfeeding benefits both mothers and children, and there are good reasons to do it even at three years and older. Mothers may breastfeed while pregnant and choose to breastfeed an older child along with a new baby. Nearly every major health organization concerned with mothers and babies recommends breastfeeding for at least two years and no group has put a limit on the duration. 

A) Considerations for extended breastfeeding

A two-year-old child breastfeeding.

Nearly every major health group concerned with the health of mothers and babies recommends breastfeeding for two or more years because of the unique benefits for both mother and child. Examples include a reduced risk of infection and chronic disease for children and a delay in the return of periods (menses). No major group has recommended a limit on the duration of breastfeeding.

Breastfeeding can also continue if the mother is pregnant and there is no risk of early labour and the mother is gaining enough weight and healthy. Mothers can breastfeed a baby and an older sibling (tandem breastfeeding) at the same time and all three benefit.

In spite of these recommendations, acceptance of extended breastfeeding varies from country to country, culture to culture, and family to family.

Seek out support if you are finding breastfeeding difficult. If you are in a public situation in which you cannot easily breastfeed, unlike babies, children past one year of age can usually wait until you are able to do so.

Breastfeeding children may need vitamin D supplements if their diet does not provide enough. Some organizations recommend giving vitamin D until the child has weaned.

Once teeth are present, they need regular brushing to avoid dental caries (cavities).

B) Changes in breastfeeding patterns with age

A child’s breastfeeding patterns and behaviour are unique. They vary with the child’s needs and personality and the mother’s availability and preferences. These change as the child grows. Past 12 months of age, children may breastfeed eight times in one day and others only a few times as they slowly wean themselves. Most feeds are short and children are very distractible. Before-bed and night-time feeds tend to be a little longer and more settled.

Feeds also vary based on the reason for the feed, and can include hunger, thirst, fear, boredom, feeling cold or tired, and pain.

1) Breastfeeding the one-year-old

A one-year-old child will have a word they use for breastfeeding. Examples include num-num, mimi, or milky. Some mothers will teach the child a code name to avoid having the child scream for “boobies” when in public. It’s up to the two of you! 

If the mother has resumed working outside of the house, entering child care can be a startling experience for a child, and arriving home to snuggle and breastfeed can ease the transition.

2) Breastfeeding the two-year-old

At two years, children will speak about breastfeeding. They will:

  • Ask to breastfeed.
  • Bring up breastfeeding in conversation. 
  • Comment on breastfeeding.

All of these are normal.

3) Breastfeeding the three-year-old and beyond

Children who are three years or older are very busy, but breastfeeding provides a great opportunity for mothers to snuggle their babies.

If your child is older and breastfeeding is working for both of you, there is no reason to stop.

C) Changes in breastfeeding positions

Child breastfeeding with her head slightly away resulting an asymmetrical latch. Photo by Luiza Braun on Unsplash

Children will often insist on their breastfeeding position and will position themselves. These can be unique and can vary between feeds and even during feeds. 

A common position is for the mother to use the cradle hold with the child's bum resting on her lap. Children frequently turn their head slightly away from the breast so they can watch the goings-on around them, resulting in a latch that is not symmetrical.  

The asymmetrical latch is normal and will rarely cause nipple pain when practiced by an older child. It can cause nipple yeast infections to affect one part of the central areola more than the other.

If a newborn sibling is breastfeeding at the same time, older children will work their way around the new baby. Mothers may need to change how they hold the baby to accommodate the child’s size and preferences.