Breastfeeding toddlers: it's considered a social no-no, which means very few mothers end up breastfeeding their babies past 12 months of age. A University of Western Sydney researcher has carried out Australia's first study of mums and bubs who breastfeed beyond infancy - looking at why these women are bucking the trend against premature weaning, and asking the toddlers themselves how they feel about breastfeeding.
Dr Karleen Gribble from the UWS School of Nursing, Family and Community Health surveyed 107 Australian mothers aged 21 to 45 years, who were breastfeeding 114 children at least two years of age or older.
Dr Gribble asked the women about their breastfeeding history, how they felt about breastfeeding an older child, and aspects of the mother-child relationship. In a first, the survey also contained a number of questions for the mothers to ask the children, who ranged in age from 24 to 78 months.
Released to coincide with World Breastfeeding Week (1-7 August), the study not only sheds light on why the mothers continue to breastfeed, but reveals how the children - who spoke of 'being able to cuddle mummy' and enjoying the 'yummy' taste of breastmilk - play an important role in the decision-making process.
The overwhelming majority of mothers - 92 per cent - enjoyed breastfeeding their children, and felt it had helped strengthen the mother-child relationship.
However breastfeeding a toddler wasn't something the mothers had necessarily planned. 75 per cent didn't intend to breastfeed past 12 months, however their increased confidence and knowledge about breastfeeding, and a sense of their own enjoyment and that of the child, encouraged them to delay weaning.
92 per cent of mothers reported that breastfeeding their previous children had influenced their current experience, with many motivated to breastfeed for longer this time around.
Dr Gribble says despite recommendations by the World Health Organisation (WHO) that children be breastfed up to two years of age or beyond, and the proven health benefits for both mother and child, many still question the value of continuing to breastfeed beyond 12 months.
"The associated social stigma has meant the practice of breastfeeding older babies and toddlers is hidden behind closed doors. Less than one per cent of Australian children are breastfeeding on their second birthday. As a result, the breastfeeding of older toddlers has been largely ignored in research, and is poorly understood," says Dr Gribble.
Dr Gribble says her research reveals the decision to continue to breastfeed beyond infancy is as much a desire of the child as it is the mother.
"Only 7 per cent of women said they had intended to breastfeed this long. The choice to initiate and continue breastfeeding is usually couched in terms of maternal decision making, but it's evident from this study that as a child grows that it becomes a mutually-negotiated decision," says Dr Gribble.
"For these mothers, there was a change in their own attitude, usually as a result of seeing others breastfeed toddlers, or their increasing knowledge and confidence, or their own enjoyment of breastfeeding. However the most common reason for continuing to breastfeed was that the child simply enjoyed it, and did not want to wean."
Dr Gribble says many of mothers were happy to continue breastfeeding because they found it easier and more enjoyable than they first anticipated.
"60 per cent of mothers said breastfeeding had gotten easier over time, while just five per cent stated that breastfeeding had become more difficult. Many of the women had actually overcome significant difficulties to continue breastfeeding, such as early attachment problems, pain, post-natal depression, childhood sexual abuse, major illness, serious allergy, and multiple births," she says.
Mums believed their toddlers continued to enjoy breastfeeding primarily because it provided comfort; secondly, because of the intimacy and closeness involved; thirdly because they were hungry; and fourthly because they simply liked the taste of breastmilk - which was clearly backed up by the children.
"When children were asked about breastfeeding, nearly all said they breastfed because they loved it - they liked the milk and it made them feel happy or good," says Dr Gribble.
"Children made comments like: 'I like cuddling Mummy, it's my treat' or breastmilk tastes 'as good as chocolate' and 'better than ice-cream'."
Dr Gribble says low breastfeeding continuation rates are a major concern for health care professionals across Australia - not only because premature weaning means more illness in infants, but because of longer term consequences for the child and mother, contributing significantly to health care costs.
"We can learn a lot from the women in this study about how and why they persisted with breastfeeding. This may help to encourage more women to continue with breastfeeding through and beyond infancy for the benefit of both mothers and children," says Dr Gribble.
Dr Gribble will present the results of her study at an international breastfeeding conference in Hobart in September.
The theme of this year's World Breastfeeding Week is 'Breastfeeding and Family Foods' - drawing attention to the value of breastfeeding to two years or beyond.