Extended breastfeeding

As of today (more about that later - with photos!) I'm officially tandem nursing two "big kids" - a 3 year old and 5 year old. I never expected to be still nursing at this point, but I'm glad it's worked out this way.

Appropriately, the Boston Globe had an excellent article about this very topic on Saturday:

Supply and demand

Evidence suggests more women are breast-feeding their children until they're toddlers and older -- and they're not just earth-mother stereotypes

By Barbara F. Meltz, Globe Staff | March 31, 2007

On a recent Saturday evening, Ruth Tincoff and Bruce Inglehart of Wellesley had a party for Gwen, their not-quite-5-year-old daughter. They served six squealing girls squiggly pasta with red sauce and Gwen's favorite dessert -- vanilla cake with raspberry - and - lemon frosting. While the adults munched on veggies and dip, the girls played dress-up.

Gwen's birthday is coming up in April, but this wasn't an early celebration. This was Gwen's weaning party.

"Just before I cut the cake, I said, 'We are here to celebrate Gwen's important decision.' Everybody already knew what it was, so that was pretty much it," Tincoff says matter-of-factly.

Few children have weaning parties, let alone at such an advanced age. Even though there is wide acceptance nowadays of nutritional and immunological benefits of breast-feeding for infants, Americans, by and large, look askance at mothers who nurse toddlers, preschoolers, or even kindergartners. Anecdotal evidence suggests there are more of them than ever, however, and they aren't just earth-mother types in Birkenstocks who homeschool their children. Tincoff, for instance, works full time as a visiting assistant professor at Wellesley College. She also had not expected to be nursing Gwen until she was nearly 5.

"Gwen wasn't a big fan of eating," she says. At first, she stayed with it to give Gwen the nutrition she needed. Then it became part of their relationship and a way to comfort her daughter. "It helped Gwen to manage her emotions. If she was cranky or had a tantrum, nursing helped restore her," Tincoff says.

Figures from the Centers for Disease Control and Prevention and from Abbott Labs' Ross Mothers Survey show a steady increase in the number of women who initiate breast-feeding, from 57 percent in 1994 to 72 percent in 2005. Less well-known is the gradual increase in the age at which breast-feeding stops. In 1997, 26 percent of mothers were still nursing their babies at six months; in 2005, 39 percent were. In 1997, 14.5 percent of mothers were still breast-feeding at 12 months; by 2005, the number had climbed to 20 percent.

No one keeps count beyond 18 months, not even La Leche League International, a lactation support system. Katherine Dettwyler , the nation's leading breast-feeding researcher, says women who continue to nurse typically keep quiet about it, sometimes even to family members, because the culture is so biased against it.

"People say, 'Oh, he's going to think he's having sex with his mother!' " she says. "Well, no. Only if you socialize him to think that way. This is a biological process. Human beings are wired to naturally wean sometime after 2 1/2."

"Nursing an older child is no longer uncommon, but women know people today tend to be judgmental and feel free to share their opinions," says Heather Bingham of Arlington, a La Leche leader for nine years. Gail Levy, an international board-certified lactation consultant with the Center for Early Relationship Support at Jewish Family and Children's Services, says she sees more women weaning after 12 months.

"We call these women 'closet nursers,' " says Dr. Ruth Lawrence , a pediatrician who specializes in infant nutrition at the University of Rochester. Lawrence, who chairs the American Academy of Pediatrics' section on breast-feeding, helped write the academy's 2005 position statement that reaffirms breast-feeding for at least a year and "beyond for as long as mutually desired by mother and child." The World Health Organization's recommendation, adopted in 1979, is for a minimum of two years.

Tincoff says she knows at least 10 women who are nursing preschoolers; all the girls at Gwen's party had recently weaned or are still nursing. Amanda Lappen of Jamaica Plain, who nurses her 19-month-old twins, says she knows 20 women who nurse children older than hers. Wendy Bosland of North Attleborough, whose third child, Henry, stopped breast-feeding this winter at 5 1/2, says she sees many more women now who nurse long term than 11 years ago when she nursed her first child.

Public health campaigns account for the increase in women who breast-feed, says Lawrence. Those who stay with it, particularly beyond 18 months, tend to be highly educated. "This is not a cult," she says. "It's about education and learning that the benefits persist." Research shows that breast-feeding provides continued protection against infection and allergies.

There is also the matter of the mother-child relationship. For a working mother who is separated from her child all day, nursing in the morning and at night is a loving way to reconnect, says Naomi Bar-Yam of the Massachusetts Breastfeeding Coalition.

Bar-Yam points out that breast-feeding a 3-year-old is very different from breast-feeding a 3-month-old. Nursing lasts only a few minutes instead of 20 or 30, and typically happens once or twice a day, not six or more times. An advantage of nursing an older child is the ability to communicate. Mara Rest of Wayland, who weaned her 5-year-old last August and still nurses her 2 1/2-year-old, likes that she can tell her son, "This isn't a good time. How about when we get home?"

The ability to set boundaries on nursing is one characteristic of a healthy nursing relationship, says Dr. Jane Morton, a pediatrician who is a clinical professor at Stanford Medical School as well as a member of the AAP breast-feeding section.

"There are no medical or psychological reasons not to nurse long term," she says. "It's frowned on in the US because the breast has become so highly sexualized." She says it's a myth to think that a child who nurses long term will not develop autonomy.

There is not unanimous agreement on this. Some professionals support the notion that breast-feeding beyond a certain point can create an unhealthy dependency on the mother. But Texas psychologist Linda Sonna of the American Psychological Association says there is growing recognition that it's best to let the child determine when she's ready to wean. Many children "may not be ready until 5, 6, or even later," says Sonna, who has written many parenting books including "The Everything Toddler Book."

"There's no reason to think it is abnormal or pathological or sick," says Nancy Holtzman , board-certified lactation consultant at Isis Maternity parenting programs in Arlington, Brookline, and Needham.

Norma Jane Bumgarner, author of "Mothering your Nursing Toddler," says women who experience hostility often are those who invite criticism. "Especially with older children, a person has to think about what she wants to deal with," she says.

Rest says she was very private about nursing because she sensed that even her husband, Dan Balter, was a little squeamish. If that's true, Balter says, he's over it now. Last week, when they were at a computer store, Rest disappeared to a corner to discreetly nurse 2 1/2-year-old Joachim. Balter didn't think twice about dragging the salesman over so they could ask her opinion. "He didn't bat an eyelash, and neither did I," Balter says.

When long-term nursers wean, they usually do so gradually.

Last fall, Tincoff's bedtime nursing disappeared because she was teaching at night, so Gwen and her father created a new bedtime ritual of bath and book. Months later, when days might go by without the morning nursing, Tincoff asked Gwen, "Do you want to be done with mama-milk? I'm OK with that if you are." She was.

Contact Barbara Meltz at meltz@globe.com.