Breastfeeding beyond infancy: ‘It is very healthy and normal’

Whether to breastfeed or bottle-feed was a question that never entered Fiona Mulcahy’s mind as she planned for the arrival of her first born.

From the time she was pregnant, the mother of two always knew she would breastfeed.

“It wasn’t really a choice,” says Mulcahy. “I come from a breastfeeding family, my mother and sister both breastfed. Coming from that background helped – that was the norm for me.”

The former second-level teacher had attended La Leche League meetings from when she was five months pregnant and she realised that "most [breastfeeding] problems that may arise can be solved".

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What was less certain in her mind was how long she would breastfeed her daughter for. “I had it in my head to feed for as long as it was working out for me and working for her,” says Fiona, who lives outside Portarlington, Co Laois, with her husband, Glen, and their daughter and son, Luna and Glen Óg.

The stay-at-home mum breastfed her daughter until she was 2½, weaning her “gently” over a five-month period.

“Being pregnant was my impetus to encourage weaning,” says Mulcahy. “It was [also] a conscious decision, as I wanted to have the same one-to-one breastfeeding time with my second child as I had had with my first.”

Fast-forward a few years and she continues to breastfeed Glen Óg, now two years and nine months.

"We don't have any plans to stop. I don't see why we would when it's working for us," says Fiona, who is now a leader with her local La Leche League group in Portlaoise.

She is keen to stress that feeding a toddler is very different from feeding a small baby and is not as demanding.

“When you are exclusively feeding a baby, you are their one source of food, so it’s a lot more full-on ... While a newborn might feed 12 times in a 24-hour period, a toddler might only feed twice or three times, and maybe just for 20 seconds. That might be all that they need.”

And unlike mothers exclusively breastfeeding newborn babies, who need to be with their baby the majority of the time, if Fiona needs to go out by herself for a few hours and leave Glen Óg with his grandparents, it’s not a problem.

“It’s useful for other things like [to give comfort] if they are upset or sick. It’s kind of like a parenting tool. I see it as a relationship between the mother and child and a way of mothering. It can be just what they need to find a moment of calm if they are upset ... or to reconnect with me if he’s been off doing something himself.”

Older children

At the moment, Glen Óg might feed two or three times during the day, he feeds to sleep at bedtime and he sometimes feeds at night.

“If he’s trying to feed and it doesn’t suit me [like if I was in the middle of making dinner] I always explain that and offer something else in place of it. It’s a two-way relationship. There are days when I realise he hasn’t fed all day.

“People who aren’t used to breastfeeding might feel breastfeeding an older child is not normal, but it’s very normal for us,” says Mulcahy. “I don’t confine it to feeding at home, but I don’t feed everywhere.

“Usually when we’re out and about, he doesn’t need to feed. Sometimes if we are in a cafe, he might latch on. It is not something I would discourage just because we are out, but I would be discreet. A lot of the time people wouldn’t even know.”

She has never had a negative experience of breastfeeding in public.

"Maybe it's because I tend to move in breastfeeding circles. A lot of my friends breastfeed. I breastfed my daughter (aged two at the time) at my wedding in front of my friends and family. It was perfectly fine. I do think in Ireland, it's definitely a bottle-feeding culture, but I do think there are more women breastfeeding and realising the support is there, but you have to seek it." Breastfeeding support groups are very beneficial for all breastfeeding mothers, she believes.

Unlike the early days of breastfeeding, when women can encounter difficulties, whether it’s sore nipples or milk supply, breastfeeding a toddler is relatively straightforward, she says.

In the beginning, “With my daughter I had oversupply and that was something we had to overcome … With my son we had tongue-tie (I got the tongue-tie released when he was two weeks old) and he was colicky and that had to be overcome.

“Feeding my son, who is almost three, there aren’t any issues I deal with now. Breastfeeding is easy. It’s just part of our lives. I think the connection and attachment [that come with breastfeeding] is important for the children and the mother.

“I feel my daughter is very sure of herself and confident,” Mulcahy adds. “Maybe it’s a personality thing, but I feel perhaps it has helped we have that strong bond from breastfeeding.”

Two or more years

The HSE has no figures indicating the number of women who breastfeed beyond infancy (also known as extended breastfeeding), which involves breastfeeding a child over the age of one, but the Word Health Organisation and the Department of Health both recommend that infants are breastfed exclusively for the first six months of life, and as other foods are introduced, recommend that breastfeeding continue for up to two years or beyond.

According to the HSE, breastfeeding continues to provide immunity and important nutrients for the child beyond infancy and helps protect against illness and infection.

For mothers it helps protect against ovarian and breast cancer.

Siobhán Hourigan, national breastfeeding co-ordinator with the HSE, says breast milk is full of beneficial nutrients.

“For the older child it’s not just about food, it’s also about that comfort and time with mum, and for some mums who might have returned to work, it’s that time of reconnecting with their baby or child when they come home from work.”

Hourigan said breastfeeding mothers can access advice from lactation consultants (including advice on weaning) on breastfeeding.ie via live webchat and email.

Hourigan says there are no drawbacks to feeding an older baby or child.

“In Ireland we maybe aren’t as accepting of breastfeeding for longer so I certainly would urge people to [realise] that it is actually very healthy and normal.”

BREASTFEEDING FIGURES

– According to recent figures from the HSE, there was a modest increase in the rates of breastfeeding from 2014 to 2015.

– In 2015 some 58 per cent of infants were being breastfed on discharge from hospital (47.7 per cent exclusively), compared with 56.9 per cent of infants (46.3 per cent exclusively) in 2014.

– In 2016 some 56.8 per cent of babies were being breastfed at the first public health nurse visit (which generally occurs in the first week of a baby’s birth), while some 38.8 per cent of babies were being breastfed at three months.

– Breastfeeding initiation rates in Ireland are currently among the lowest in the world, compared with initiation rates of 90 per cent in Australia, 81 per cent in the UK and 79 per cent in the US.

– In the second year of life, breast milk provides 43 per cent of protein requirements, 36 per cent of calcium requirement, 75 per cent of vitamin A requirements, 94 per cent of vitamin B12 requirements, and 60 per cent of vitamin C requirements.