Booby Traps Series: “When are you going to stop doing that?” and others things moms fear hearing from their providers when nursing past infancy.

mature children's doctor examining  babyAfter overcoming the many barriers to breastfeeding in the early weeks and months of breastfeeding, many women are understandably proud to continue nursing  into toddlerhood and beyond.*

But instead of a fist bump and words of encouragement, some moms instead find themselves on the defensive with their health care providers.

While there are countless supportive providers who share words of encouragement, we too often hear stories from moms in which their providers say:

“He’ll never learn to eat solid foods.”

“You don’t want to end up like one of those moms, do you?”

“Your milk has no nutritional value past a year.”

“Continuing to breastfeed is going to cause an unhealthy dependence in your child.”

“When are you going to stop?”

In Breastfeeding Older Children, author Ann Sinnott shares many of these stories.  She quotes one mother as reporting, “even a fairly progressive pediatrician tried to shame my son into giving it up at the age of three.”  Sometimes it’s even implied that mothers are only doing this “for themselves.”

Mothers’ fear about talking with their providers about sustained breastfeeding isn’t unfounded.  In an American Academy of Pediatrics survey of members who wanted to improve their breastfeeding office support (and so might be considered supportive of breastfeeding) fully 25% of participants discouraged breastfeeding after 2 years.

In another study of health care providers attitudes (which included a large number of medical students) only 61% of respondents agreed with the statement “I think that it is acceptable for 1 or 2 year old children to be breastfed by their mothers.”  That number dropped to 22% for children 3 to 4 years of age.  35% of  respondents said that they would encourage a woman breastfeeding her 1 to 2 year old to wean, and 65% said they’d encourage a woman breastfeeding her 3-4 year old to wean.  35% of respondents agreed with the statement, “In general, I think breastfeeding a child of 3 years or older could cause psychological damage to the child.”

The fear of judgement or discouragement is strong enough that one paper on the topic (unpublished) by Kathleen Kendall Tackett and Muriel Sugarman is entitled “Don’t Ask, Don’t Tell: What Women Say to Doctors about Extended Breastfeeding.”  In it, the authors note that “previous studies have found that women who continue to breastfeed frequently do so in secret, a phenomenon described in the literature as ‘closet nursing.’  Women and doctors participate in a conspiracy of silence.”

The authors tell the story of one mother whose fear of judgement led to adverse health consequences for her child:

Stephen D. (age 21 months) was seen by his doctor because of severe diarrhea and vomiting.  The mother was quite concerned and made repeated office visits and telephone calls.  The doctor did not initiate treatment because Stephen was not dehydrated and was not losing weight.  The doctor did not realize, however, that Stephen was breastfeeding approximately six times per day and at least two to three times at night.  After 17 days of daily vomiting and diarrhea, Stephen’s doctor prescribed Flagyl.  The symptoms lessened within 24 hours, and were gone within 48 hours.  Stephen’s mother never told the doctor that Stephen was still breastfeeding because she feared that the doctor would be critical. Stephen’s mother was an active and outspoken proponent of breastfeeding, yet in this situation, even she felt she could not reveal that she was still nursing.  In retrospect, she feels that the doctor not knowing this information may have delayed treatment.

Psychologists are particularly undone by the idea of sustained breastfeeding, says Sinnott.  Of psychologists in the UK she says:

Sustained breastfeeding runs so counter to the training of psychologists that it was difficult to get most of the UK psychologists with whom I spoke to countenance even the mere notion that long-term breastfeeding could be anything other than pathologic…  All of the psychologists I spoke to were surprised and sounded distinctly worried to hear that large numbers of children are currently breastfed in the developed world.

What’s the source of this discomfort?

Many of our providers don’t know much about sustained breastfeeding, and as a result view it as potentially harmful in a variety of ways.  This isn’t too surprising, since providers’ knowledge of breastfeeding even in the early months leaves a lot to be desired.  And since sustained breastfeeding is less common, and some is ‘closeted’ for fear of judgement, providers may be further thrown off when they encounter it.  (In this sense, are we complicit in the “conspiracy of silence?”)

It also results from the prevalent view of breastfeeding as solely, or primarily, nutritional and immunological in purpose, and discomfort with the idea of breastfeeding as a normal part of psychological development.  Fear of creating an “unhealthy dependence,” can lead mothers to be discouraged from comforting or connecting with their children through breastfeeding past infancy.  Our providers are also subject to the same cultural messages we are about the the breast as sexual object, and can become concerned about nursing past infancy as somehow sexual in nature.

Are we expecting too much of our providers?  In Mothering Your Nursing Toddler, author Norma Jane Bumgarner writes, “Doctors and nurses are trained in identifying and treating illness.  It is not fair to them to expect them to also be experts in all aspects of child care and family living…  Their advice on child care tends to be no better and no worse than that of other reasonably well-informed adults.  That is as it should be, and it is a mistake to expect more.”

That would be fine if, at a minimum, our providers treated our choice to breastfeed long-term as they would treat our choice of diaper bag – an individual choice.  But repeated reports from moms and studies of provider attitudes suggest that their response is often far from it.

“Long-term breastfeeding is a growing phenomenon (in developed countries) and healthcare providers are lagging behind,” says Sinnott:

Health providers must overcome personal and cultural prejudice and inform themselves… It is imperative that health professionals acknowledge that their certainties are founded on nothing more than myth and received opinion, and understand that sustained breastfeeding has been integral to our species for 95% of all human existence, and is today still a normal practice in much of the world.

*In the absence of a perfect phrase, we refer to breastfeeding past infancy as “sustained breastfeeding” (as used in Breastfeeding Older Children) in this post.  It’s our wish that someday it will be known simply as “breastfeeding.”

Did you breastfeed into toddlerhood or beyond?  How did your health care providers react to your choice?  Did you feel uncomfortable telling your providers? 



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8 Comments | Last revised on 07/15/2013


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8 Responses to Booby Traps Series: “When are you going to stop doing that?” and others things moms fear hearing from their providers when nursing past infancy.

  1. Mary says:

    A doctor at Kaiser (not our pediatrician) told me that breastmilk is no longer nutritious after the baby is six months old! Crazy!! I couldn’t believe what she was telling me and confused that she would try to discourage me from breastfeeding.It seems like doctors are getting this misinformation from somewhere…medical school? Seminars?
    I am still breastfeeding my fifteen month old and this website is a great encouragement to keep going and ignore the opposition.

    • Jamie says:

      She must have gone to the same seminar as mine. Two weeks ago I was told by my DS’s ped. at his 9 month check-up that he should be getting most of his nutrition from solids now, that I can’t give him the calories he needs, that he’s not getting the fats his brain needs, and that he’s deficient in multiple vitamins(not that he was tested, mind you). Needless to say, I’m looking for a new pediatrician for my children.

  2. Chelsea says:

    I’m still breast feeding my two year old and neither one of us seems like we’re planning on stopping soon. I’ve always felt very comfortable telling my doctors I’m still breast feeding. My kid’s pediatrician is awesome and is the same pediatrician my husband went to as a child! Lots of knowledge both professional and personal (all five of his kids were breastfed).
    I feel like the younger generation of doctors has been misinformed or let their own personal feelings conflict with real breast feeding data. I got into an argument with a newly graduated doctor not long ago about sustained breast feeding. She was convinced it was unhealthy past one year of age and said that’s what she learned in medical school. I gave her an overwhelming body of evidence proving the opposite. But I still find it unacceptable that young doctors may be learning this and telling their patients this. Very sad.

  3. MamaMeeMoo says:

    People always remark on how healthy/happy/energetic/well-behaved my 3 year old daughter is. They often ask me what my ‘secret’ is.

    Ironically, it’s often these same people who throw out lines such as ‘oh, you are STILL feeding her?!?’…um, yeah…look at just how much it is obviously ‘damaging’ the child you just remarked upon…

  4. mrsdickson2508 says:

    MamaMeeMoo – I LOVE that! My 2.5 yr old was EBF to 4 months when we started solids (we did not know any better at that time! And by recommendation of our pediatrician!) By 8 months, he was partially breastfed, partially formula fed, solids (purees). He is definitely a lot more temperamental, fussy, etc.

    My 11.5 month old is still exclusively breast fed and without realizing nor intending to, we are doing “baby led weaning.” He nibbles on stuff at meal times, bits and pieces of peas, banana, crackers, etc. He is extremely healthy, extremely happy and good natured, skin tone is very robust. Have not taken him to my pediatrician since 6 months, finally found a new holistic dr in our town. Our old pediatrician made comments that were pressuring about getting him to sleep thru the night, and that he should not be nursing at night time past a year….

    I am thankful for the comment in this article about doctors parenting advice is no better than any other adult’s advice – that was encouraging to me. Too many people idolize whatever comes out of a doctor’s mouth.

    I loved meeting with my primary care doctor yesterday – she and I were able to dialogue as two educated adults about my health concerns. Together, TOGETHER, we decided which tests were necessary for me, rather than me just naming off my symptoms and then her telling me what to do or writing off a prescription. THAT is what I am talking about!

  5. Dee says:

    I so wanted to breastfeed my children for 2 to 3 years, however my supply was never enough. I had even tried everything out there to boost my supply. Thankfully my pedi understands how important it is to breastfeed. Cow’s milk is for cows. My children are happy healthy human beings, not bovine.

  6. Tammy says:

    My oldest son is adopted and the way things unfolded, I didn’t have the opportunity to breastfeed him. That was something I’ve always regretted.

    When my middle son was born, I struggled and researched and learned all I could on my own because I didn’t know anyone who had breastfed their children. He was still nursing regularly at the age of four, when he died unexpectedly. I don’t know how long he would have continued if circumstances had been different. Our doctor was very supportive of my sustained breastfeeding.

    Mt third son nursed until he was six-and-a-half years old. Our doctor never encouraged me to wean him, and treated both my son and me with respect and dignity. I’m so thankful for her support. She didn’t “know” much about breastfeeding, never having experienced it herself, but was willing to listen encourage me. My son is now 13 and seems perfectly normal and as well-adjusted as any boy his age. He’s very independent and self sufficient, and I believe that’s a direct result of the whole “attachment parenting” mindset — having his needs met as soon as they became known, co-sleeping and nursing for comfort as well as nutrition.

    The future remains to be seen, of course, and I’m looking forward to it!

  7. Sarah says:

    My daughter voluntarily weaned at the ripe old age of 8 years. I had been talking to her about the concept of weaning since she was 2, and at 3 yo I promised her she could choose to stop in her own time. She was a high-need baby and still is in some respects — she was recently diagnosed with sensory processing disorder (SPD) — and I believe this is at least part of the reason she felt the need to nurse for so long. As part of our SPD journey, she has been seen by our family doctor, a pediatric neurologist, a psychologist, and an occupational therapist. None of them are aware of her breastfeeding history, but all agree that (aside from the SPD) she is a healthy, happy, well-adjusted, and highly intelligent child. In fact, she is so well-adjusted that it has been a struggle to get her help for the SPD; apparently the prevailing paradigm is that only maladjusted children deserve help.

    Unless they asked specifically, I stopped telling doctors that she was “still” nursing once she reached 4 years. And by that age, most doctors assume that children have weaned, so they usually don’t ask! Only once did I get a negative reaction from a young pediatrician (new to the office — our regular ped was out) regarding nursing: dd was 18 months and on the low end of the growth chart for weight; the doctor told me that breastfeeding was the culprit and that she should be drinking dairy milk instead of nursing. I ignored him, and at dd’s 2yr check-up I made sure we saw our regular pediatrician; she had only gained a few ounces since her 18-month visit, and he thought she was doing fine. “Breastfed children don’t follow the standard charts,” he told me, and said I shouldn’t worry.

    Luckily, as an older mom (37 when dd was born), I don’t feel obligated to pay much attention to other people’s advice. Every child is unique, and children can tell you a lot about their own needs if you will just pay attention.

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