Breastfeeding older children Breastfeeding older children

Myth v RealityMyth v Reality

Common misconceptions

1. No nutritional benefit

2. Sustained breastfeeding is unnatural

3. Mothers continue for themselves

4. Breastfeeding an older child is sexual

5. Children are developmentally harmed

6. Fathers are negatively affected

RealityReality

1. Research studies2. History

3. Survey results 4. Research study 5. (Presentation)

6. Fathers

1. Research studies2. History

3. Survey results 4. Research study 5. (Presentation)

6. Fathers

Myth 5: Children developmentally harmed

Children are:

• Out of control

• Over-dependent

RealityReality

No evidence-base for assertions.

No psychosocial adjustment studies on children

breastfed for longer than one year.

Scientifically, the impact of sustained breastfeeding on children is unknown.

No evidence-base for assertions.

No psychosocial adjustment studies on children

breastfed for longer than one year.

Scientifically, the impact of sustained breastfeeding on children is unknown.

Anecdotal evidenceAnecdotal evidence

Evidence in Breastfeeding Older Children on the psychosocial benefits of sustained

breastfeeding is significant and too strong to be ignored

More than 2000 mothers, from 48 countries, responded

to surveys. Irrespective of diverse locations and

different cultures, mothers echo and re-echo

each other about the positive effects

of long-term breastfeeding.

Evidence in Breastfeeding Older Children on the psychosocial benefits of sustained

breastfeeding is significant and too strong to be ignored

More than 2000 mothers, from 48 countries, responded

to surveys. Irrespective of diverse locations and

different cultures, mothers echo and re-echo

each other about the positive effects

of long-term breastfeeding.

Assessment of an older breastfeeding child

Assessment of an older breastfeeding child

Assessment of an older breastfeeding child

Milestones met exceedingly well

Assessment of an older breastfeeding child

Milestones met exceedingly well

Children out of controlChildren out of control

Critics of sustained breastfeeding

rarely have direct experience.

Older breastfeeding children no

different to other children

The only difference: they also breastfeed.

Critics of sustained breastfeeding

rarely have direct experience.

Older breastfeeding children no

different to other children

The only difference: they also breastfeed.

Mothers of long-term breastfed children

no different to other mothers.

Daily life is full of opportunities for setting boundaries, why choose breastfeeding?

Children do self wean

Mothers of long-term breastfed children

no different to other mothers.

Daily life is full of opportunities for setting boundaries, why choose breastfeeding?

Children do self wean

Children over-dependentChildren over-dependent

Young children are dependent, but western

culture

requires them to become independent, as soon

as possible, and believes independence

has to be induced.

Young children are dependent, but western

culture

requires them to become independent, as soon

as possible, and believes independence

has to be induced.

Long-term breastfeeding mothers take a

different view.

They believe children should be allowed to

mature

at their own pace and not be forced into

self-reliance before they are ready.

Long-term breastfeeding mothers take a

different view.

They believe children should be allowed to

mature

at their own pace and not be forced into

self-reliance before they are ready.

When my children stopped they were emotionally ready, which was not the case when I tried to wean

them earlier. They had outgrown the need, it was not forced on them.

South Africa. Ch 1: bfd 6yrs; Ch 2: bfd 4 yrs; Ch 3: bfdg 5yrs

I will stop when they want to stop. In my opinion this step is a very

important one to become independent. But what kind of independence

is this, if you were pushed into it against your own convincement?

Greece. Ch1: bfdg 6.1yr; Ch2: bfdg 4.1yr; Ch3: bfdg 1yr.

When my children stopped they were emotionally ready, which was not the case when I tried to wean

them earlier. They had outgrown the need, it was not forced on them.

South Africa. Ch 1: bfd 6yrs; Ch 2: bfd 4 yrs; Ch 3: bfdg 5yrs

I will stop when they want to stop. In my opinion this step is a very

important one to become independent. But what kind of independence

is this, if you were pushed into it against your own convincement?

Greece. Ch1: bfdg 6.1yr; Ch2: bfdg 4.1yr; Ch3: bfdg 1yr.

Many people think 3 years is too long, they don’t want it themselves

and a few think my child becomes too dependent on me.

My daughter is very strong and independent. My son (2 years older) is much more

dependent and forms a contrast to his sister.

Netherlands. Ch 1: bfd 1.5yrs; Ch 2: bfdg 3.4yrs

Many people think 3 years is too long, they don’t want it themselves

and a few think my child becomes too dependent on me.

My daughter is very strong and independent. My son (2 years older) is much more

dependent and forms a contrast to his sister.

Netherlands. Ch 1: bfd 1.5yrs; Ch 2: bfdg 3.4yrs

Jack Newman, a Canadian doctor and breastfeeding advocate:

‘Often we push children to become ‘independent’ too quickly.

To sleep alone too soon, to wean from the breast too soon,

to do without their parents too soon, to do everything

too soon. Don’t push and the child will become independent soon enough’.5

Jack Newman, a Canadian doctor and breastfeeding advocate:

‘Often we push children to become ‘independent’ too quickly.

To sleep alone too soon, to wean from the breast too soon,

to do without their parents too soon, to do everything

too soon. Don’t push and the child will become independent soon enough’.5

CorroborationCorroboration

Correlations between descriptions of

long-term breastfeeding children

• Attachment Theory/Secure Attachment

• Neuroscience research

Correlations between descriptions of

long-term breastfeeding children

• Attachment Theory/Secure Attachment

• Neuroscience research

Attachment TheoryAttachment Theory

Bowlby and Ainsworth identified the necessity in early life

of positive mother-child interactions for the

formation of secure attachment.

Both recognised the efficacy of breastfeeding

to nurture secure attachment.

Bowlby and Ainsworth identified the necessity in early life

of positive mother-child interactions for the

formation of secure attachment.

Both recognised the efficacy of breastfeeding

to nurture secure attachment.

Secure attachment fostered when a child’s needs are met

in a timely manner by a sensitive, responsive mother well-attuned to the child’s cues.

Long-term breastfeeding a strong

measure of maternal sensitivity and responsiveness.

Secure attachment fostered when a child’s needs are met

in a timely manner by a sensitive, responsive mother well-attuned to the child’s cues.

Long-term breastfeeding a strong

measure of maternal sensitivity and responsiveness.

Bowlby: ‘The infant and young child should experience

a warm, intimate, and continuous relationship with his mother…in which both find

satisfaction and enjoyment’.

By definition, long-term breastfeeding is a warm,

intimate and continuous relationship.

Bowlby: ‘The infant and young child should experience

a warm, intimate, and continuous relationship with his mother…in which both find

satisfaction and enjoyment’.

By definition, long-term breastfeeding is a warm,

intimate and continuous relationship.

It’s a wonderful feeling to have been fully trusted, and to know that I fulfilled her needs until she was ready

to complete the journey. My daughter is my best friend. I owe our closeness to breastfeeding because

it

taught us both how to respect and trust one another. Hawaii. Ch1: bfd 7.6yrs.

There is no simpler, more effective way to both intuitively and physically respond to a child’s needs

than to breastfeed; you just know yourchild to such a subtle degree that you find you can

anticipate all the moments when a stop at the breast is needed.

USA. Ch1: bfd 4yrs; Ch2: bfd 6.5yrs.

It’s a wonderful feeling to have been fully trusted, and to know that I fulfilled her needs until she was ready

to complete the journey. My daughter is my best friend. I owe our closeness to breastfeeding because

it

taught us both how to respect and trust one another. Hawaii. Ch1: bfd 7.6yrs.

There is no simpler, more effective way to both intuitively and physically respond to a child’s needs

than to breastfeed; you just know yourchild to such a subtle degree that you find you can

anticipate all the moments when a stop at the breast is needed.

USA. Ch1: bfd 4yrs; Ch2: bfd 6.5yrs.

From the early days of breastfeeding, I found the look of absolute bliss the baby would

have after a feed just about spoke volumes. Even today, the way that ‘tuck-in’ and grin

as they do so shows the pure pleasure it gives them.

England. Ch1: bfdg 4yrs; Ch 2: bfdg 2.6yrs.

My oldest loved to nurse. He would tell me it was his favorite part of the day.

USA. Ch1: bfd 4yrs; Ch2: bfdg 7mths.

From the early days of breastfeeding, I found the look of absolute bliss the baby would

have after a feed just about spoke volumes. Even today, the way that ‘tuck-in’ and grin

as they do so shows the pure pleasure it gives them.

England. Ch1: bfdg 4yrs; Ch 2: bfdg 2.6yrs.

My oldest loved to nurse. He would tell me it was his favorite part of the day.

USA. Ch1: bfd 4yrs; Ch2: bfdg 7mths.

‘Internal working model’ of self and other(s).

Basis of the child’s thoughts, feelings, memories,

beliefs and expectations of relationships.

Primary relationship establishes child’s self-esteem

and is the template for all other relationships.

‘Internal working model’ of self and other(s).

Basis of the child’s thoughts, feelings, memories,

beliefs and expectations of relationships.

Primary relationship establishes child’s self-esteem

and is the template for all other relationships.

A securely-attached child is self-confident and independent.

Long-term breastfed children closely match indicators of secure attachment.

happy, secure, self-confident, out-going,independent, sociable, well-adjusted.

A securely-attached child is self-confident and independent.

Long-term breastfed children closely match indicators of secure attachment.

happy, secure, self-confident, out-going,independent, sociable, well-adjusted.

Emotionally, he’s really confident and outgoing. He always had me there, so he always knew he could

go and I’d be there, really be there closely, when he chose to come back. England. Ch 1: bfdg 4.3yrs

Both children are very independent and happy, well-adjusted.

USA. Ch 1: bfd 2.3yrs; Ch 2: bfd 3.2yrs.

[Breastfeeding long-term] Makes it easy to know you are loved no matter what, [and is] helpful in

learning how to socialize with other children and adults as well. Guatemala. Ch 1: bfd 3yrs; Ch 2: bfd

3.3yrs

Emotionally, he’s really confident and outgoing. He always had me there, so he always knew he could

go and I’d be there, really be there closely, when he chose to come back. England. Ch 1: bfdg 4.3yrs

Both children are very independent and happy, well-adjusted.

USA. Ch 1: bfd 2.3yrs; Ch 2: bfd 3.2yrs.

[Breastfeeding long-term] Makes it easy to know you are loved no matter what, [and is] helpful in

learning how to socialize with other children and adults as well. Guatemala. Ch 1: bfd 3yrs; Ch 2: bfd

3.3yrs

One of the most important things for us was the independence breastfeeding seemed to give my son. I often watched other toddlers the same age, who were

formula-fed or only breastfed for a short time, and noted how confident my son seemed in comparison.

He has never been clingy at toddler groups, just full of life and ready to try new things.

England. Ch 1: bfd 3yrs; Ch2: bfdg 11mths.

From an emotional point of view, it has helped them form a very

close and secure attachment with me and as a result they are very confident and happy.

Rep of Ireland, Ch 1: bfdg 6yrs; Ch 2: bfdg 4yrs; Ch 3: bfdg 1yr

One of the most important things for us was the independence breastfeeding seemed to give my son. I often watched other toddlers the same age, who were

formula-fed or only breastfed for a short time, and noted how confident my son seemed in comparison.

He has never been clingy at toddler groups, just full of life and ready to try new things.

England. Ch 1: bfd 3yrs; Ch2: bfdg 11mths.

From an emotional point of view, it has helped them form a very

close and secure attachment with me and as a result they are very confident and happy.

Rep of Ireland, Ch 1: bfdg 6yrs; Ch 2: bfdg 4yrs; Ch 3: bfdg 1yr

Neuroscience6Neuroscience6

Validation and extension of Attachment Theory.

Early years identified as a critical window.

Action of oxytocin in development of mother-infant bonding.

Validation and extension of Attachment Theory.

Early years identified as a critical window.

Action of oxytocin in development of mother-infant bonding.

Oxytocin released in response to pleasurable

interactions, including breastfeeding.

Higher oxytocin levels and more, and better

quality,

oxytocin-receptors, in infants that receive

lots of maternal attention, compared

to those that receive less.

Oxytocin released in response to pleasurable

interactions, including breastfeeding.

Higher oxytocin levels and more, and better

quality,

oxytocin-receptors, in infants that receive

lots of maternal attention, compared

to those that receive less.

Sustained breastfeeding:

Repeated daily opportunities for maternal

attention and pleasurable interactions

maintained over several years.

Sustained breastfeeding:

Repeated daily opportunities for maternal

attention and pleasurable interactions

maintained over several years.

Joy and pleasureJoy and pleasure

Feelings of joy and pleasure induced by

physical contact, eye-gazing and other

enjoyable mother-child interactions,

crucial for neural growth.

Feelings of joy and pleasure induced by

physical contact, eye-gazing and other

enjoyable mother-child interactions,

crucial for neural growth.

Children’s pleasure and enjoyment

evident.

Children’s pleasure and enjoyment

evident.

Children speakingChildren speaking

• Human milk is yummy, delicious

• Compare to favourite foods/treats.

• ‘Pet’ names for breasts and for milk ‘Amecitos’, ‘Happy milk’.

• I love your boobys, mummy!

• Human milk is yummy, delicious

• Compare to favourite foods/treats.

• ‘Pet’ names for breasts and for milk ‘Amecitos’, ‘Happy milk’.

• I love your boobys, mummy!

Humour and playHumour and play

He can’t really talk, but he sometimes sucks until the milk lets down

and then pulls off, laughing as it sprays in his face!

England. Ch1: bfdg 1.4yrs.

She used to have a very entertaining relationship with my breasts –

talking to them, patting them, making jokes about them.

Scotland. Ch 1: bfd 4.10yrs; Ch2: bfdg 1.7yrs

He can’t really talk, but he sometimes sucks until the milk lets down

and then pulls off, laughing as it sprays in his face!

England. Ch1: bfdg 1.4yrs.

She used to have a very entertaining relationship with my breasts –

talking to them, patting them, making jokes about them.

Scotland. Ch 1: bfd 4.10yrs; Ch2: bfdg 1.7yrs

Wider implicationsWider implications

Oxytocin ‘glue of society’.

Plays vital role in formation of:

• All affectional and affiliative bonds

• Social emotions.

Oxytocin ‘glue of society’.

Plays vital role in formation of:

• All affectional and affiliative bonds

• Social emotions.

Right hemisphere of brainRight hemisphere of brain

• Development of ability to ‘read’ others

and a capacity for empathy.

• Right hemisphere linked to limbic area.

• Positive mother-child interactions

critical for right hemisphere development.

• Development of ability to ‘read’ others

and a capacity for empathy.

• Right hemisphere linked to limbic area.

• Positive mother-child interactions

critical for right hemisphere development.

Long-term breastfed children:

• Securely-attached

• Kind, generous, sensitive, compassionate,

empathic,

Ability to ‘read’ and interpret need

and unhappiness in other children.

Long-term breastfed children:

• Securely-attached

• Kind, generous, sensitive, compassionate,

empathic,

Ability to ‘read’ and interpret need

and unhappiness in other children.

He is very empathic towards other babies and children who are crying… he’ll say, ‘The baby’s

crying, he needs a hug and some milk’. When he was 18 mths old there was a baby crying on the

plane and he said, ‘Baby crying, baby need milk’.England. Ch 1: bfdg 2yrs.

Emotionally I feel it has been of great benefit to E as a form of contact

and reassurance. She now seems very confident and ready to

take on her daily life at school, but also very empathic

and aware of the feelings of others and the need for closeness and cuddles.

Jersey, CI. Ch1: bfdg 4yrs

He is very empathic towards other babies and children who are crying… he’ll say, ‘The baby’s

crying, he needs a hug and some milk’. When he was 18 mths old there was a baby crying on the

plane and he said, ‘Baby crying, baby need milk’.England. Ch 1: bfdg 2yrs.

Emotionally I feel it has been of great benefit to E as a form of contact

and reassurance. She now seems very confident and ready to

take on her daily life at school, but also very empathic

and aware of the feelings of others and the need for closeness and cuddles.

Jersey, CI. Ch1: bfdg 4yrs

Both boys weaned themselves, have happy memories of nursing and are strong advocates of their baby sister

breastfeeding. They both have an abiding understanding of the value and experience of

nursing ‘til they were ready to be done.

USA. Ch1: bfd 6.6yrs; Ch2: bfd 6yrs; Ch3: bfdg 5mths.

I felt happy and cosy and sleepy when I was having lolo. If I see

a baby having lolo it makes me happy because I remember

me having lolo. If I see a baby having a bottle, it makes me worry a bit, I feel a bit sad, I don’t know why.

England. Ch1: bfd 3.9yrs; Ch2: bfd 7.3yrs.

Both boys weaned themselves, have happy memories of nursing and are strong advocates of their baby sister

breastfeeding. They both have an abiding understanding of the value and experience of

nursing ‘til they were ready to be done.

USA. Ch1: bfd 6.6yrs; Ch2: bfd 6yrs; Ch3: bfdg 5mths.

I felt happy and cosy and sleepy when I was having lolo. If I see

a baby having lolo it makes me happy because I remember

me having lolo. If I see a baby having a bottle, it makes me worry a bit, I feel a bit sad, I don’t know why.

England. Ch1: bfd 3.9yrs; Ch2: bfd 7.3yrs.

Negative emotionsNegative emotions

Attachment Theory and Neuroscience

Importance of:

• maximising positive emotions

• diffusing negative emotions.

Attachment Theory and Neuroscience

Importance of:

• maximising positive emotions

• diffusing negative emotions.

Attachment Theory

Young child developmentally unable to regulate itself

– dependent on intervention.

• Needs unmet

• Negative emotions unmodulated

Insecure-attachment likely outcome.

Attachment Theory

Young child developmentally unable to regulate itself

– dependent on intervention.

• Needs unmet

• Negative emotions unmodulated

Insecure-attachment likely outcome.

Neuroscience

• Oxytocin believed to work by reducing stress.

Early oxytocin-deficiency can lead to greater stress-reactivity in later life.

• Low levels of oxytocin

Less inclination to seek social interaction.

Neuroscience

• Oxytocin believed to work by reducing stress.

Early oxytocin-deficiency can lead to greater stress-reactivity in later life.

• Low levels of oxytocin

Less inclination to seek social interaction.

Deficiency in oxytocin, or in the number and quality

of oxytocin-receptors, has a negative impact on the central nervous system, with behavioural consequences.

• Personality disorder• Social dysfunction

• Schizophrenia, Autism

Deficiency in oxytocin, or in the number and quality

of oxytocin-receptors, has a negative impact on the central nervous system, with behavioural consequences.

• Personality disorder• Social dysfunction

• Schizophrenia, Autism

• Increased levels of cortisol in episodes of crying and distress.

• Stress hormones can affect oxytocin-receptorbinding in central nervous system.

• High cortisol levels linked to developmental delay.

• Reduction in size of hippocampus – involved in learning and memory storage

• Increased levels of cortisol in episodes of crying and distress.

• Stress hormones can affect oxytocin-receptorbinding in central nervous system.

• High cortisol levels linked to developmental delay.

• Reduction in size of hippocampus – involved in learning and memory storage

Western culture tends not to attach much

importance to distress in children.

Crying unavoidable.

Is this true?

Two distress scenarios:

Western culture tends not to attach much

importance to distress in children.

Crying unavoidable.

Is this true?

Two distress scenarios:

WeaningWeaning

Young children often highly resistant.

• Distress

• Trauma

• Pleading, tears, screams, anger

Many children left with long-lasting

feelings of loss and longing.

.

Young children often highly resistant.

• Distress

• Trauma

• Pleading, tears, screams, anger

Many children left with long-lasting

feelings of loss and longing.

.

The ‘terrible twos’ (and threes and fours…)

The ‘terrible twos’ (and threes and fours…)

Child caught up in whirlwind of agitation and rage that ratchets

ever-upwards until, locked into a storm of frustration

and anger, the child, shocked and frightened by the

ferocity of its own emotions, spirals up into

a screaming emotional hurricane.

Devastating experience for all concerned.

Child caught up in whirlwind of agitation and rage that ratchets

ever-upwards until, locked into a storm of frustration

and anger, the child, shocked and frightened by the

ferocity of its own emotions, spirals up into

a screaming emotional hurricane.

Devastating experience for all concerned.

Long-term breastfed children rarely cry. The ‘terrible twos’ usually not terrible at all! Many mothers report not even a hint of a

tantrum.

Should a tantrum begin, or other distress occur, mothers,

quickly able to neutralise distress, calm children

and quickly restore equilibrium.

Long-term breastfed children rarely cry. The ‘terrible twos’ usually not terrible at all! Many mothers report not even a hint of a

tantrum.

Should a tantrum begin, or other distress occur, mothers,

quickly able to neutralise distress, calm children

and quickly restore equilibrium.

If I were to choose one word that characterised my daughter throughout her

childhood, it would be ‘serene’. Tantrums were non-existent.

England. Ch1: bfd 6.6yrs.

For a baby who was so stressed-out from the earliest moments of his life (surgical

procedure for tongue-tie), he was calmed easily with nursing - and it sure

calmed him down when he was injured or really mad.USA. Ch1: bfd 5.3yrs.

I often referred to breastmilk as the ‘mood enhancer’ because it

was remarkable how it could change their mood. The transformation was astonishing and immediate.

Rep of Ireland. Ch1: bfd 5yrs; Ch 2: bfd 5.3yrs.

If I were to choose one word that characterised my daughter throughout her

childhood, it would be ‘serene’. Tantrums were non-existent.

England. Ch1: bfd 6.6yrs.

For a baby who was so stressed-out from the earliest moments of his life (surgical

procedure for tongue-tie), he was calmed easily with nursing - and it sure

calmed him down when he was injured or really mad.USA. Ch1: bfd 5.3yrs.

I often referred to breastmilk as the ‘mood enhancer’ because it

was remarkable how it could change their mood. The transformation was astonishing and immediate.

Rep of Ireland. Ch1: bfd 5yrs; Ch 2: bfd 5.3yrs.

was