When I gave birth to my first baby, I was privileged to have every support imaginable to help me breastfeed successfully. I had prenatal breastfeeding classes and access to lactation consultants at the hospital where I delivered, as well as another lactation consultant who did home visits so I didn’t have to leave my apartment during the early newborn days. I had the means to purchase all the gear (nipple shields, nipple cream, a breastfeeding pillow) my lactation consultant recommended to make nursing a little easier and more comfortable. I was fortunate to have paid maternity leave and a free breast pump through my health insurance. Oh, and I worked at What to Expect, which meant I had spent the nine months of my pregnancy absorbing all the information on this website about breastfeeding.
Still, like so many new mothers, breastfeeding was difficult for me — more difficult than I could have imagined when I was pregnant. In my first week home from the hospital — while dealing with a painful combination of cracked nipples, thrush, mastitis and a baby who wouldn’t latch — I sobbed to my partner that nursing was “so much harder than labor.” I doubted whether I wanted to continue breastfeeding for six days, let alone the six months that had been my goal.
So my initial reaction to the new breastfeeding policy statement from the American Academy of Pediatrics (AAP), which recommends exclusive breastfeeding for the first six months of life and encourages support for mothers to breastfeed into the second year and beyond, was to think about how I might have felt if I’d read those headlines as a brand new parent. I surely would have been overwhelmed, intimidated and a little guilty that I didn’t want my breastfeeding journey to last anywhere near that long.
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As one mom in the What to Expect Community wrote in reaction to the new guidelines, “[They] just seem to put so much extra stress on women to further breastfeed or feel guilty that they couldn't in the first place.”
But experts say the AAP’s policy statement isn’t intended to make parents feel guilty, nor does it mean that you have to breastfeed for two years — rather, it highlights the benefits of breastfeeding for both mothers and babies, and acknowledges that all families need more support.
“It’s not meant to be intimidating, nor is it one-size-fits-all,” says Lauren Crosby, M.D., F.A.A.P, a pediatrician in Beverly Hills, California, and member of the What to Expect Medical Review Board. “It is meant to provide a framework and give guidance because there are benefits to breastfeeding and parents should at least be aware of them, then choose what is best for their own situation.”
Here are five things parents should keep in mind when considering the AAP’s updated breastfeeding recommendations — whether they breastfed their babies or not.
The AAP guidelines now align more closely with what the World Health Organization (WHO) recommends.
The biggest change from the previous AAP guidelines issued in 2012 is the recommendation that mothers breastfeed exclusively for the first six months of life and then continue, while adding complementary foods, for up to two years (an increase from the one-year recommendation in 2012) and beyond if desired. This guidance is consistent with what WHO suggests.
As was the case with the previous guidelines, breastfeeding for that long (or at all) won’t be feasible or desirable for every family — and that’s okay.
“The AAP continues to emphasize that breastfeeding should always be mutually beneficial for both baby and mother,” says Micah Resnick, M.D., F.A.A.P., a pediatrician in Cincinnati, Ohio, and member of the What to Expect Medical Review Board. “If it does not work for one of you, it does not work for both of you.”
Parents should feel empowered to breastfeed past the one- or two-year mark if they want to.
Extended breastfeeding is wonderful, and mothers who nurse their children into toddlerhood should feel supported in doing so.
“[The updated policy statement] is addressing the need to support and not shame mothers who choose to breastfeed beyond a year,” says Dr. Crosby.
Still, you don’t need to breastfeed for two years in order to benefit.
The latest guidelines highlight the health benefits of long-term breastfeeding for babies as well as moms, such as the lowered risk of breast and ovarian cancer. But you’re not completely missing out on those advantages if you stop breastfeeding before the two-year mark.
“Any length of time is good,” says Gina Posner, M.D., F.A.A.P., a pediatrician practicing at MemorialCare Medical Group in Fountain Valley, California, and member of the What to Expect Medical Review Board.
Families need more breastfeeding support and protections from policy makers.
“The AAP realizes that a lot needs to be done to support moms who do choose to breastfeed,” says Dr. Posner. All mothers, regardless of how long they nurse their babies, need policies that support and protect their right to breastfeed, such as universal paid family leave, access to affordable child care, health insurance that covers lactation consultants and breast pumps, and work breaks to pump breast milk.
Health care providers can better support families too by encouraging skin-to-skin contact after birth, delaying the first bath for 12 hours to allow more uninterrupted skin-to-skin time, allowing rooming-in at the hospital or birth center and providing outpatient support when they go home.
Breastfeeding isn’t always possible.
There are many reasons why breastfeeding doesn’t work out, nor is it an all-or-nothing proposition: Some families breastfeed exclusively; others supplement with formula or exclusively pump and bottle-feed; others formula-feed from day one. All these feeding methods deliver the nourishment a baby needs to grow and thrive.
“Being a mom means so much more than breastfeeding and how you feed your baby,” notes Dr. Crosby. “They will bond with you regardless of what you feed them.”
While my baby and I eventually got into a happy breastfeeding groove, in no small part thanks to the support I had, I’d be lying if I said I didn’t feel a little relieved when that journey ended. When my son was 9 months old, my supply started to drop and we transitioned to formula. I was proud of how far we’d come, but also, honestly, ready for the next phase.
Regardless of their circumstances, all families need nonjudgmental support when navigating the decision around when to stop breastfeeding, as well as whether they do it at all, experts stress.
“Having a baby should be an amazing experience, and though there are sometimes tough, tiring times, the key is to feed your baby whatever works for you and your family,” says Dr. Crosby. “Your baby will grow and thrive and do great.”
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