AAP Extends Breastfeeding Recommendation to This Age

For the first time in a decade, the AAP's guidelines for breastfeeding have changed.

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Photo by: Jose Luis Pelaez Inc

Jose Luis Pelaez Inc

By: Amanda Mushro

The American Academy of Pediatrics (AAP) has updated breastfeeding guidelines for the first time in ten years. Previously, the AAP recommended infants be exclusively breastfed for the first 6 months. Then, parents should continue breastfeeding while introducing foods for the first year or longer. However, new guidelines say babies should be breastfed for at least two years and beyond, citing the medical and neurodevelopmental advantages of breastfeeding.

According to data from the CDC, more than 80% of babies born in the U.S. are breastfed for some length of time. However, most aren’t exclusively breastfed –meaning they receive formula as well, and many babies aren’t breastfed for as long as the AAP recommends. A recent survey shows that less than 57% of infants are breastfed at 6 months old and only 35% of infants are still breastfed at 1 year.

"We know that any breastfeeding is better than none…and the longer the total duration of breastfeeding the better," Dr. Joan Younger Meek, lead author of the AAP reports, told USA TODAY. "Breast milk is unique in its nutrients and protective effects, and really quite remarkable when you look at what it does for a child’s developing immune system."

The AAP says that extending breastfeeding is beneficial to toddlers and to mothers. "Preliminary data reveal that human milk in the second year of life continues to be a significant source of macronutrients and immunologic factors for growing toddlers. Studies and meta-analyses also have confirmed the impact of breastfeeding longer than 12 months on maternal health, in decreasing maternal type 2 diabetes mellitus, hypertension, breast cancer and ovarian cancer rates," the AAP mentioned in a statement.

Other recommendations made by the AAP:

  • Birth centers and hospitals should implement maternity care practices that improve breastfeeding initiation, duration, and exclusivity.
  • For mothers who choose to breastfeed beyond a year, there needs to be an increase of support from medical professionals and employers.
  • There need to be policies that protect breastfeeding, such as universal and paid maternity leave and the right to breastfeed at work, school, and in public.
  • Insurance coverage should include lactation support and breast pumps as well as on-site childcare.

The AAP also discussed the persisting stigma around extending breastfeeding and how many women have a lack of support when it comes to nursing and pumping at work — especially limiting those who want to breastfeed beyond one year.

Just recently in the news, many mothers began commenting on unclear TSA practices and rules about breastfeeding, pumping supplies, and traveling with milk. For many nursing moms, there is already a stigma around breastfeeding that makes feeding your baby feel impossible at times.

The AAP also noted that breastfeeding, formula feeding, or a combination of both is a decision that every parent has the right to make for their family. However, they want to ensure mom and baby are supported along the way.

"The ultimate decision about how to feed the baby is a family decision and health care providers need to really meet families where they are," Meek said. "We know that not every family is going to be able to do exclusive breastfeeding for six months. We know that not every family is going to continue breastfeeding for up to 24 months…For those families that, either for medical reasons or by choice, decide that breastfeeding isn't right for them, we need to equally support them and not make them feel shamed or bad because they made a different decision."

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