Thu, 04/24/2014 – 1:01 | No Comment

In this issue of Attached Family, we take a look at the cultural explosion of breastfeeding advocacy, as well as the challenges still to overcome. API writer Sheena Sommers begins this issue with “The Real Breastfeeding Story,” including …

Read the full story »
1. Pregnancy & Birth

Fertility and conception, pregnancy, childbirth, and the early postpartum period.

2. The Infant

From newborn to 17 months.

3. The Toddler

From 18 months to age 3.

4. The Growing Child

From age 4 to age 9.

5. The Adolescent

From age 10 to age 18.

1. Pregnancy & Birth, 2. The Infant »

World Breastfeeding Week 2014: The Real Breastfeeding Story
Fri, 1/08/14 – 10:00 | No Comment

By Sheena Sommers, MA

World Breastfeeding Week 2014The recent controversies generated by depictions of Attachment Parenting in the Western media and elsewhere have revealed a fairly astounding degree of misinformation about infant and child development. Most especially, the media’s fetishist focus on “extreme breastfeeding” has revealed the tremendously wide chasm that exists between official medical recommendations about breastfeeding and the actual reality and perception of the practice on the ground.

Discussions generated by overly sexualized and highly sensationalized depictions of breastfeeding have often helped only to bolster a set of beliefs about the practice that are as dangerous as they are inaccurate. Though breastfeeding is touted by almost every recognized medical body as being one of the best things a mother can do to ensure the health and well-being of her child, the fact remains that very few infants are exclusively breastfed during their first six months of life and even fewer still are breastfed beyond their first year as official medical guidelines recommend.

Breastfeeding older babies, sometimes referred to by advocates as full-term breastfeeding, means different things to different people. Though some feel that nursing an infant past one year should be considered full term, others define it as breastfeeding a child past the age of two. Perhaps more important than any specific age reference is instead a commitment to continue breastfeeding until a child initiates the weaning process.

While beliefs and approaches to breastfeeding have certainly varied widely through time and place, the current level of societal discomfort breastfeeding engenders is without doubt an anomaly. What has since our earliest days been central to our very survival as a species has, more recently, been made to seem—by some of the more vocal critics at least—as an unnatural, immoral and even perverse practice when engaged in beyond the first year of an infant’s life. Thus, mothers who breastfeed their toddlers and very young children have been called everything from odd and eccentric to sexually perverse and even abusive.

What may therefore come as a shock to many in the West today is that from an historic and cross-cultural perspective, breastfeeding older babies and very young children is the norm. As Cornell University (USA) anthropologist Meredith Small, PhD, surmises in her groundbreaking work Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent, the “hominid blueprint of the way babies were fed for 99% of human history indicates breast milk as the primary or sole food until two years of age or so, and nursing commonly continuing for several more years.”

Breastfeeding children until the age of three or four years has been the norm throughout much of human history and remains so in various parts of the world today. Even as late as 1800, an infant born in the United States could expect to be nursed for somewhere between two to four years.

What happened over the last 200 years to have so dramatically altered breastfeeding patterns is too complicated a history to review here. It is needless to say, however, that despite no shortage of scientific and medical evidence to support much longer-term breastfeeding, this has not been enough to sway popular practice or belief in any large measure. In the United States, Canada and elsewhere, breastfeeding beyond a year—or two for the more progressive types—raises eyebrows and even ire amongst some otherwise seemingly rational people. As discussed further below, though breastfeeding rates are on the rise, the increases are small, and breastfeeding older babies is still a far cry from the cultural norm in the West.

The Science

Not only does the historical and anthropological evidence suggest that weaning before age two is unusual, but from a purely biological perspective, nursing a child through the toddler years is not in the least bit abnormal. In fact, the typical age for child-led weaning from a physiological standpoint has been estimated to fall within the broad range of two and a half to seven years of age.

As Katherine A. Dettwyler, PhD, an anthropology professor at the University of Delaware (USA), has demonstrated, this large spectrum is based upon an analysis of various biological and physiological factors derived from comparisons to other mammals of similar size. When looking at the relationship between gestation times and weaning for instance, human babies are geared to wean somewhere around four and a half years of age. Other relevant mammalian comparisons also support a much longer breastfeeding duration, including:

  • the eruption of the first permanent molars—5.5 to 6 years
  • adult body weight—4 to 7 years
  • adult body size—2.8 to 3.7 years.

Even the most conservative estimate, derived from an analysis of human birth weights, would suggest natural weaning occurs between 25 and 32 months of age.

The health benefits of breastfeeding are, of course, much more widely acknowledged. Not only do breastfed babies suffer fewer childhood illnesses and recover faster when ill, but the benefits continue to accrue throughout their adult lives. In every scientific study comparing breastfed babies and formula-fed babies, the breastfed babies have been shown to have a lower risk of disease  and to score higher on cognitive functioning.

Breastfed babies have a much lower risk of dying from Sudden Infant Death Syndrome (SIDS) than do their non-breastfed counterparts; the formula-fed infants being, in fact, twice as likely to die from SIDS. According to “The Surgeon General’s Call to Action to Support Breastfeeding 2011,” formula-fed infants are also at a higher risk of common childhood infections, including gastrointestinal problems and ear infections, with the risk of the latter being a whopping 100% higher than in their breastfed counterparts.

The same report goes on to say that babies who are exclusively breastfed during the first four months of life have a 250% lower risk of being hospitalized for lower respiratory tract disease and a lower risk of respiratory infections. Breastfed babies also have a lower risk of developing leukemia. Formula feeding, as opposed to breastfeeding, is furthermore associated with an increased risk of some of the most serious chronic diseases of our time, including type 2 diabetes, childhood obesity and asthma.

While the early months are by far the most important with regard to the benefits of breastfeeding, research has shown that the health benefits of breast milk are cumulative. Thus, babies breastfed for 18 to 24 months do better than those breastfed for only the first six months, though as mentioned, the early months are certainly the most crucial.

While as of yet no large scale studies have been published on the specific health benefits of breastfeeding past two years of age, as Dettwyler and others have convincingly argued, there is little reason to believe the rewards cease immediately upon a child’s second birthday. Research has conclusively shown that the specific qualities of breast milk change over time in order to meet the nutritional needs of children as they grow. As such, there is evidence to suggest that breastfeeding beyond two years continues to offer important health benefits. As one of the foremost experts on the subject, Jack Newman, MD, at the International Breastfeeding Centre in Toronto, Ontario, Canada, argues, “Breastmilk still contains immunologic factors that help protect the child even if he is two or older.”

Mothers benefit enormously from the breastfeeding relationship too. For instance, it has been shown that the longer a woman spends breastfeeding, the lower her risk of ever developing breast cancer. Likewise, women who have never breastfed have a 27% higher risk of developing ovarian cancer compared to women who have breastfed for some period of time. Studies have also shown that breastfeeding for longer can maximize these protective effects. Overall, the report by the U.S. Surgeon General cited above concludes that “exclusive breastfeeding and longer durations of breastfeeding are associated with better maternal health outcomes.”

Breastfeeding Rates

The “Breastfeeding Report Card—United States, 2012,” published by the U.S. Centers for Disease Control and Prevention (CDC), found that while national breastfeeding rates are on the rise, there is still a very long way to go in terms of meeting guidelines set out by almost every recognized medical body or health association across the globe.

While current recommendations as set by the World Health Organization (WHO) and echoed by many other organizations suggest that breastfeeding be continued for two years or longer if mutually desired by mother and child, the majority of infants in the United States are weaned by six months of age. Thus, although 76.9% of women in the United States initiate breastfeeding at birth, just under half of these women are nursing at six months and only a quarter of them are still breastfeeding at one-year postpartum.

WHO guidelines likewise stress the importance of exclusive breastfeeding for the first six months of an infant’s life. Exclusive breastfeeding means giving the baby nothing but breast milk during this time. Again, despite the slew of data on the vital importance of following these recommendations, according to the U.S. National Immunization Survey (latest data for 2008), only 14.6% of babies are exclusively breastfed at six months.

As surmised by the Surgeon General’s 2011 Call to Action, although “many mothers in the United States want to breastfeed, and most try … within only three months after giving birth, more than two-thirds of breastfeeding mothers have already begun using formula.” This statistic is hardly surprising when one considers that in a study co-funded by the CDC and the U.S. Food and Drug Administration, it was found that almost half of breastfed newborns were being supplemented with formula while still in the hospital.

From a purely economic vantage point, these findings are extremely important. In fact, a study published in the April 2010 issue of the journal Pediatrics examined the costs (adjusted to 2007 dollars) associated with various illnesses including SIDS, hospitalization for lower respiratory tract infection in infancy, atopic dermatitis, childhood leukemia, childhood obesity, childhood asthma and type 1 diabetes, and found that if “90% of U.S. families followed guidelines to breastfeed exclusively for six months,” the direct and indirect savings of medical expenses would equal some $13 billion annually.

Challenges and Barriers

As evidenced above, it is quite clear that the widely available wealth of information concerning the array of physical, physiological, social, emotional, cognitive and even fiscal benefits breastfeeding provides has not been enough to alter public practice on a large scale. Thus, though the medical evidence is unambiguous and educational campaigns to shore up support for breastfeeding are now common, very few families seem to be able to actually put these recommendations into practice.

Why might this be? As revealed by a 2005 U.S. National Survey conducted by the nonprofit Families at Work Institute, more than 60% of mothers of infants and young children work outside the home. U.S. law requires only 12 weeks unpaid maternity leave be afforded to new mothers and this only for companies with 50 employees or more. A report by the National Partnership for Women and Families found that almost two-thirds of women are left without access to employer-provided short-term disability benefits, while nine out of 10 members of the workforce are unable to draw upon employer-provided paid leave to care for a new infant.

Another study published in the February 2012 issue of the journal American Sociological Review revealed that those women who breastfeed their infants beyond six months see a steeper decline in their earnings than those working women who use formula or wean their babies earlier. As Phyllis Rippeyoung, one of the study’s researchers suggested, the results of the study demonstrate that “at least as work is organized right now in the U.S., there does seem to be an incompatibility between breastfeeding for a long duration and working for many women.”

This is, of course, not to say that women who work outside the home do not, or cannot, practice longer-term breastfeeding. However, as only about a third of even the largest companies in the United States provide women with a secure area to express breast milk, doing so can often require an extremely high level of ingenuity and commitment.

Studies like those above highlight a reality too often ignored in breastfeeding campaigns: breastfeeding is both time and labor intensive. Without adequate economic, political, practical and community support for breastfeeding—spanning from the institution of much better maternity leave policies to more family-friendly workplace arrangements—many mothers will continue to face a variety of obstacles that make conforming to ideal breastfeeding practices extremely challenging at best.

Though these barriers certainly require redress if exclusive and full-term breastfeeding is to become more common, providing better maternity leave by itself may not necessarily translate into major improvements. If one looks at the Canadian situation in which maternity leave policies are a good deal better, the numbers are almost as dismal. At three months postpartum, less than half of Canadian mothers are exclusively breastfeeding, and by six months, only 14% are offering nothing but breast milk. At 12 months, about a quarter of Canadian infants are receiving some breast milk, a number only marginally better than the U.S. figures.

It seems, therefore, that something else must also be afoot. As Small and others have pointed out, underpinning these very real structural barriers to breastfeeding is a belief system that is fundamentally at odds with the biological imperatives of infant and child development. In a culture in which independence and autonomy are so highly prized that infants as young as a few months are expected to self-soothe, parents are all too frequently made to feel conflicted about responding to the cues of their infants.

This rather peculiar state of affairs has unfortunately also led to the abandonment of a host of practices that have historically been integral to exclusive and full-term breastfeeding. Regrettably, many of the practices that have traditionally helped to ensure the success of the breastfeeding relationship have become marginalized and, in some cases, even vilified in the West.

The practice of cosleeping—which had been the norm throughout most of human history and continues to be in much of the world today—though never fully eradicated, was until very recently effectively forced underground by a campaign of misinformation. Practices such as cosleeping, babywearing and comfort nursing (soothing baby with the breast instead of a breast substitute such as a pacifier or bottle), to name just a few, support breastfeeding by allowing for unrestricted access to the breast. Unrestricted access encourages a mother’s milk production and ensures a healthy feedback loop. Unrestricted access is, however, precisely that which is so often lacking today.

In sum, the abandonment of practices that support breastfeeding necessarily hampers the effect of even the most progressive policy initiatives on the ground. Simply declaring the importance and sanctity of the breastfeeding relationship, however vociferously, will have very little effect in a society that in actual fact values, and even incentivizes, mother-infant separation from an early age. Unfortunately, we live in a time in which mainstream culture sanctions by both word and deed an approach to parenting that is totally out of sync with the needs of our children. As such, the hyperbolic reactions generated by images of older babies breastfeeding and the dire state of actual breastfeeding practices are together merely twin symbols of the very widespread misunderstanding of the attachment relationship and of infant development more generally.

The fact remains that while educational initiatives and institutional changes may help to increase breastfeeding initiation among new mothers, without a fairly dramatic re-evaluation of our current beliefs, practices, values and priorities surrounding infant and child care at large, exclusive and full-term breastfeeding will continue to be a practice of only a minority.

You can read more in the double "Voices of Breastfeeding" issue of Attached Family magazine, in which we take a look at the cultural explosion of breastfeeding advocacy as well as the challenges still to overcome in supporting new parents with infant feeding. The magazine is free to API members--and membership in API is free! Visit www.attachmentparenting.org to access your free issue or join API.

You can read more in the double “Voices of Breastfeeding” issue of Attached Family magazine, in which we take a look at the cultural explosion of breastfeeding advocacy as well as the challenges still to overcome in supporting new parents with infant feeding. The magazine is free to API members–and membership in API is free! Visit www.attachmentparenting.org to access your free issue or join API.

Different, Not Disordered: An Interview with Dr. Barbara Probst
Sun, 27/07/14 – 10:13 | No Comment

By Rita Brhel, API’s publications coordinator, managing editor of Attached Family magazine and an API Leader (Hastings, Nebraska, USA). Originally published in the 2013 “Loving Uniquely” issue of Attached Family magazine (available free of charge to …

Separation Anxiety?
Sun, 13/07/14 – 10:56 | No Comment

By Naomi Aldort, author of Raising Our Children, Raising Ourselves, www.AuthenticParent.com.
When my children were young, it was common for me to take them when I traveled for speaking engagements. At their stages of development, they …

Spotlight On: The Girl Behind the Door
Sat, 28/06/14 – 0:31 | No Comment

The Girl Behind the Door by John Brooks chronicles a father’s experience from the adoption of his only child to her suicide in her teen years, including the exploration of the role of an attachment disorder. 
Editor’s …

Traumatic Birth, Healing Birth: Melissa’s Story
Tue, 17/06/14 – 10:00 | 4 Comments

By Melissa Brennan
My name is Melissa, and I am a mama to four kiddos. I’ve been an Attachment Parenting mama since before I knew it was a phrase. For me, having the “perfect birth” with …

Featuring API Leaders: An Interview with Thiago Queiroz
Thu, 12/06/14 – 3:06 | No Comment

By Rita Brhel, API’s publications coordinator, managing editor of Attached Family magazine and an API Leader (Hastings, Nebraska, USA).
In celebration of Attachment Parenting International’s 20th Anniversary, the “Featuring API Leaders” series honors the unique paths …

Saved by AP and Now 8 Kids Later: An Interview with Margie Wilson-Mars
Thu, 5/06/14 – 0:34 | One Comment

By Rita Brhel, API’s  publications coordinator, managing editor of Attached Family magazine and an API Leader (Hastings, Nebraska, USA).
My husband and I have three children, and we consider our family to be quite busy especially …

For Grandparents: When Your Adult Kids’ Parenting Drives You Crazy
Tue, 3/06/14 – 4:50 | No Comment

By Naomi Aldort, author of Raising Our Children, Raising Ourselves, www.AuthenticParent.com.
Q: My daughter-in-law is into a way of raising our grandchildren that includes cosleeping, organic food, wooden toys and so on. She and our son …

API Reads June 2014: Attached at the Heart
Mon, 2/06/14 – 7:50 | No Comment

Get ready… we are beginning the long awaited discussion of Attached at the Heart (2nd Edition) by Barbara Nicholson and Lysa Parker.
The  topics we’ll be discussing in June will be:

Introduction

Charting a New Course: Breaking …

Creative Education: An Interview with Dr. Carolina Blatt-Gross
Thu, 29/05/14 – 12:18 | No Comment

By Rita Brhel, API’s publications coordinator, managing editor of Attached Family magazine and an API Leader (Hastings, Nebraska, USA).
It’s amazing how far our understanding of children has come in the last two decades since 1994, …

Generation AP: An Interview with Patricia Mackie
Tue, 27/05/14 – 8:38 | No Comment

By Rita Brhel, API’s publications coordinator, managing editor of Attached Family magazine and an API Leader (Hastings, Nebraska, USA).
In celebration of Attachment Parenting International’s 20th Anniversary, we are pleased to present two series of interviews …

The Chemistry of Attachment
Thu, 22/05/14 – 3:54 | 2 Comments

By Linda Folden Palmer, DC, member of API’s Editorial Review Board and author of The Baby Bond (www.babyreference.com).
Human babies are born helpless, needing to be entirely cared for and protected. Luckily, they are born with …

API Announces “Voices of Breastfeeding” Double Edition of Attached Family
Mon, 19/05/14 – 23:38 | No Comment

New Magazine Issue Advocates for Increased Support of Compassionate Infant-Feeding Choices
In honor of the millions of women who have come together throughout history to support one another in motherhood, Attachment Parenting International (API) is pleased …

How Parents Can Support Their Budding Performers: An Interview with Actress Elisa Llamido
Tue, 13/05/14 – 11:41 | No Comment

By Rita Brhel, API’s publications coordinator, managing editor of Attached Family magazine, and an API Leader (Hastings, Nebraska, USA)
From the beginning, 20 years ago, Attachment Parenting International has been a community of parents coming together …

API Reads May 2014: Giving the Love That Heals
Tue, 13/05/14 – 11:40 | No Comment

We’re finishing up talking about Giving the Love That Heals by Harville Hendrix, PhD and Helen LaKelly Hunt, PhD. The  topics we’ll be discussing in May will be:

The Stage of Concern

The Stage of Intimacy

The Possibilities for …

Screen-Free Week: An Interview with the Campaign for a Commercial-Free Childhood
Thu, 1/05/14 – 4:04 | No Comment

By Rita Brhel, managing editor of Attached Family magazine, API’s Publications Coordinator and an API Leader (Hastings API, Nebraska, USA)
Television, computers and other technology can offer a lot in terms of education and entertainment. Living in …

Stop Hitting Kids in School: An Interview with Nadine Block
Tue, 29/04/14 – 10:55 | One Comment

By Lisa Lord, editor of The Attached Family.com.
Though research continues to show that spanking and other forms of physical punishment are both ineffective and harmful, and despite many nations across the globe instituting bans on …

Breastfeeding into Toddlerhood
Thu, 24/04/14 – 0:00 | 19 Comments

By Debbie Page, RN, IBCLC, CEIM, director of TheNewBornBaby.com. Originally published on The Attached Family.com on September 28, 2009.
In Western societies, it is commonplace to expect a child to breastfeed for six months to a …

Every Birth is Natural
Wed, 23/04/14 – 3:34 | One Comment

By Kelly Coyle DiNorcia, API Leader. Originally published in the 2009 “New Baby” issue of Attached Family magazine
When I became pregnant with my daughter, I had every intention of having a “natural” childbirth. I wanted …

The Importance of Sharing Birth Stories
Wed, 23/04/14 – 2:59 | No Comment

By Tamara Parnay. Originally published in the 2009 “New Baby” issue of Attached Family magazine.
 
Birthing is a hugely important subject for parents and parents-to-be. We have a great deal to learn from and share with …

The Beauty of Breastfeeding: An Interview with Photographer Christine Santos
Thu, 17/04/14 – 3:22 | 2 Comments

In May 2013, a Kickstarter campaign was launched to raise funds for an innovative art exhibit featuring the work of photographer Christine Santos: “Nursing is Natural … Naturally Beautiful.” This exhibit was intended to revolutionize …

API Announces New Attached Family Edition: “Voices of Breastfeeding” Double Issue
Wed, 16/04/14 – 4:42 | No Comment

By Rita Brhel, Editor of Attached Family magazine, API’s Publications Coordinator, and an API Leader (Hastings, Nebraska, USA)
The core of Attachment Parenting is responding with sensitivity.
API recognizes that breastfeeding can be difficult in our society. …

Navigating Military Life with API’s Eight Principles of Parenting
Thu, 10/04/14 – 3:00 | 3 Comments

By Kathryn Abbott, API Leader. Kathryn led an API Support Group in Skagit County, WA, in 2011-2012 and then served as a Co-Leader for San Diego County API in 2012-2013. She plans to start a new …

40 Percent of Children Miss Out on the Parenting Needed to Succeed in Life
Wed, 9/04/14 – 6:07 | No Comment

Press release issued March 21, 2014, by the University of Bristol.
Four in 10 babies don’t develop the strong emotional bonds–what psychologists call “secure attachment”–with their parents that are crucial to success later in life. Disadvantaged children …

An Ever-Changing Village: The Importance of Parent Support for Military Families
Tue, 8/04/14 – 3:25 | No Comment

By Kit Jenkins, Master babywearing educator for Babywearing International, Event Liaison for API and a co-founder of The Carrying On Project (www.carryingonproject.org).
We are celebrating Attachment Parenting International’s 20th anniversary this year. One of the main …

API Cofounders Featured in Parenting with Presence Summit
Thu, 3/04/14 – 4:48 | No Comment

World peace, for many, may seem like an unattainable ideal. Not so for families finding support through Attachment Parenting International (API), whose research-backed parenting approach promotes healthy relationships rooted in nonviolent communication and respectful interactions, …