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As babies enter the third month of life, breast milk continues to support the digestive system. It also provides some babies with protection against allergens found in other foods and supplements.
Continued breastfeeding may help mom burn an extra to calories per day, which can help you to maintain a healthy postpartum weight. Breastfeeding may help with internal health for mom as well. Some research shows that nursing may lower the risk of type 2 diabetes, rheumatoid arthritis , and cardiovascular disease.
More research is needed to fully understand the connection. The benefits of breastfeeding continue even with the addition of table foods , which doctors recommend at 6 months of age. Breast milk can continue to provide energy and protein, as well as vitamin A, iron, and other key nutrients. Not only that, but breast milk continues to protect baby against disease and illness for as long as they consume it. For mom, reaching this milestone may reduce the risk of breast cancer and other cancers, like ovarian, endometrial, and uterine cancers.
In fact, according to a report released by the World Cancer Research Fund and the American Institute for Cancer Research in , for every five months of breastfeeding, a woman may reduce risk of breast cancer by 2 percent.
Exclusive breastfeeding may also provide up to 98 percent effective contraception in the first six months if the menstrual period has not yet returned and mom continues nightly feedings. Feeding recommendations between 6 and 12 months of age include breastfeeding on demand and offering other foods between 3 to 5 times a day. During this time, breast milk should still be offered before meals, with table foods considered supplemental.
With the exception of a possible continued reduction in the risk for breast cancer, sources do not note a continued lowering of the risk of other illnesses to moms who breastfeed longer than six months. Another benefit of breastfeeding long-term is cost savings. Babies who are breastfed for a year also may have stronger immune systems and may be less likely to need speech therapy or orthodontic work.
The theory is that all that sucking at the breast helps to develop muscles in and around the mouth. Feeding recommendations at a year and beyond include breastfeeding on demand and offering other foods five times a day.
Some older research suggests that longer duration breastfeeding may give kids an edge when it comes to IQ scores and social development. However, more recent research has found that the benefits to IQ may only be temporary. There are many reasons women decide to supplement feeding with bottles of breast milk or commercial formulas. Your baby can still benefit from receiving some breast milk. Some benefits of combination feeding include:.
In different parts of the world, the average weaning age is between 2 and 4 years old. Some children are breastfed until ages 6 or 7 in other cultures. That said, the decision over when to wean is personal. Actively dropping breastfeeding feeds is the next step in the process once meals are better established.
For cost reasons, most national surveys are cross-sectional and thus will conduct a hour recall only once. Even prospective research often uses repeat 24 hour recalls instead of asking whether any other food or fluid was introduced since the last questionnaire was administered.
Some research uses a 7-day diary to obtain detailed data on the current feeding pattern [ 18 ] but clearly this is not feasible for most surveys. While the duration of any breastfeeding tends to be recalled accurately even years later, recall of the ages when various other foods and fluids were introduced is much less accurate [ 19 ]. Bland et al. This problem is likely becoming worse in areas where exclusive breastfeeding is being widely promoted due to the social desirability bias.
In a recent Boston hospital sample followed prospectively for 3. Though only 0. Recall periods in large-scale retrospective surveys vary, and may do so even within the sample. For example, in a recent national survey in the USA [ 22 ], the average recall period was about 7 months but could be up to 13 months. Recall errors will certainly be smaller the shorter the recall period is. Thus the optimal approach for obtaining life-long data on exclusive breastfeeding might be to interview all mothers with babies less than 7 or perhaps 9 months of age and ask them for each of a comprehensive list of locally used early supplements when it was first given to the baby.
Since many infants will still be exclusively breastfed when the mother is interviewed, life table or survival approaches must then be used to make full use of all data in such an analysis. In using this method, the current age is used as the duration of exclusive breastfeeding for those who have not yet introduced anything and they are dropped from the denominator at ages beyond their current age at the time of their interview.
Since these babies will continue to be exclusively breastfed for some unknown period of time after their interviews, this approach somewhat underestimates the duration of life-long exclusive breastfeeding. Several studies have been based on obtaining retrospective data from representative samples of infants in a given geographical area less than seven months of age and using life-table methods to analyze the data [ 23 — 25 ]. In the UK, a national survey of feeding practices is conducted every five years via postal questionnaires.
The duration of exclusive breastfeeding is derived from responses to questions about the age at which various foods were introduced from repeated responses at birth, 6 weeks, and 2, 3, 4, and 6 months [ 26 ].
Thus recall periods are quite short, but the accuracy of the data is still uncertain due to low response rates from younger mothers and those with lower socioeconomic status.
Recall bias of the kind reported by Burnham et al. But in addition, bias may be increasingly introduced due to the gradual decline in rates of subscription to landline telephones, the basis for sampling, especially in younger and lower income mothers who may now often possess only cell phones and may exclusively breastfeed less than others. However, the CDC has recently checked this and not found much change when a cell phone sample was added. How much the WHO indicator gives an exaggerated sense of the duration of uninterrupted exclusive breastfeeding will vary from one infant feeding culture to another and may vary over time, possibly making comparisons for the purpose of establishing trends over long periods of time somewhat inaccurate.
A first estimate of the extent of this bias came from a large, detailed, prospective study conducted from - in Sweden [ 29 ]. At that time, Swedish breastfeeding rates had already greatly increased from their lows of the early 70s, and knowledge of and encouragement to exclusively breastfeed were rapidly growing. Women tended to introduce solid foods quite gradually at 4 - 6 months of age, although some gave a relatively large volume of infant formula occasionally before that.
Over women recorded every day the types and amounts of everything they gave their babies for approximately the first nine months of life. This allowed a comparison of how many were currently exclusively breastfeeding at various ages with how many had been doing so the entire time since birth. Thus the proportional difference between the two approaches increased as infants got older [ 29 ]. If one can generalize from this, the extent to which the point-in-time estimate will vary from the life-long estimate increases, the older the infants are.
In Uganda, Engebretsen et al. No single indicator in common use will provide a complete and accurate measure of how many days of exclusive breastfeeding infants have received by the age of days.
This would be too complex and expensive to obtain and indeed provides unnecessarily precise data for most purposes. For example, we do not weigh humans to a precision of 0. For certain purposes including ORS may not be wise, especially where the water used is likely to be contaminated. Examples where life-long data would be critical to use include linking infant feeding to transmission rates among HIV-exposed infants [ 31 ] or examining the relationship between exposure to non-breast milk allergens and the later debut of allergic diseases.
The life-long approach might however under-estimate the exclusive breastfeeding of interest if for example one were estimating the link between breastfeeding patterns and infant diarrhea because the latter is likely to respond mainly to fluids and foods given in the past several days.
Exclusive breastfeeding is now widely recognized, measured and promoted. Yet, using the original 0 - 6 month point-in-time WHO indicator, the increase that has taken place after two decades of effort in the number of days babies have been exclusively breastfed probably appears smaller than it actually is.
At a meeting in , WHO justified use of the point-in-time 0 - 6 month indicator because it offered a relatively high baseline to start with. At that time, there probably were virtually no infants exclusively breastfed continuously from birth to six months of age and this was thought to risk discouraging policy makers.
However, over two decades later, that same high baseline results in it not appearing that much progress has been made. Each of the two major methods of measuring exclusive breastfeeding skews our perceptions of how much exclusive breastfeeding is going on, but they do so in opposite directions. In turn, it is not a very sensitive method to measure the improvement that has occurred since then. For many purposes, the life-long indicator penalizes too much for a single diversion from exclusive breastfeeding thus it would register that none took place in a society with universal prelacteal feeding, even if most went on to receive days of exclusive breastfeeding.
Thus the wisest approach for surveys, the purpose of which must be to provide the most accurate characterization of the duration of exclusive breastfeeding in a given sample, would be to report both point-in-time and life-long data.
One simple additional question would allow the life-long indicator to be created. All women who say they gave nothing but breast milk the day before the survey are then asked if they have EVER given anything else. This method has sometimes been used by researchers [ 33 , 34 ]. More accurate would of course be to ask those currently exclusively breastfeeding when any food or fluid was given to the infant in the past.
Exclusive breastfeeding ends when anything has been added; the duration of predominant breastfeeding could also be estimated as the first age when any solid food or milk was given. This has also been done by some researchers [ 35 , 36 ].
To obtain life-long data in national surveys would require extra effort and costs. Oversampling among infants younger than perhaps 7 or 9 months might be required; and the life-long data would need to be analyzed using life table or survival techniques [ 37 , 38 ]. It is commonly cited in ways that greatly exaggerate how prevalent exclusive breastfeeding actually is—at least that which has occurred continuously since birth.
Ted Greiner has worked on breastfeeding issues at research, program and policy levels, publishing dozens of articles and monographs since , when he conducted the first research to show that advertising influences how infants are fed.
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