Breastfeeding your baby past the first year of life is one of the best ways to keep him happy and healthy. Every major organization in the world, from the American Academy of Pediatrics to the World Health Organization to the Centers for Disease Control, agrees that breast milk should be a child’s primary source of food for the first twelve months of life, and that it can and should continue for more than a year whenever possible. More and more mothers are heeding this advice, but unfortunately, some are taking it too far. An increasing number of moms, in an attempt to improve their babies’ health, are forgoing solid food altogether and exclusively breastfeeding their babies for one year or more, without adding any solids to their babies’ diets. This is a dangerous practice that isn’t recommended by any reputable health organization in the world.
The consequences of this can be very grim. I’m a member of several “lactivist” groups that encourage breastfeeding, including so-called extended breastfeeding that lasts beyond the first year. I’ve encountered many moms who have chosen to avoid solids altogether for a year or more, and so far, none of them have had positive results. One baby I know was found to be critically anemic at 18 months of age after breastfeeding exclusively for the first year. Another had a healthy pattern of growth for most of her life but became underweight, and was eventually diagnosed with failure to thrive, at twelve months, when she was still given no solid food. It’s no coincidence that organizations dedicated to children’s health unanimously agree that babies need to begin eating solid food after about six months of age.
I asked two pediatricians about this trend when I was beginning to introduce my own kids to solid food and heard nothing but firm “no”s from the experts. They pointed out that breast milk production starts leveling off at around six months for most moms. At that point, the baby can continue nursing, but the supply will not increase enough to keep up with the needs of a rapidly-growing and very large baby. Breastfed babies are also prone to certain deficiencies if they don’t receive some solids. The two most common deficiencies in breastfed babies are vitamin D and iron, which are found in many baby-friendly foods but found in only trace amounts in breast milk. The amount of iron and vitamin D in breast milk seems to be enough to get a baby through the first six months, but after that point, their needs gradually increase beyond what breast milk can provide. While breast milk should still be the primary source of nutrition for babies until at least twelve months, it is not safe for it to be the only source of nutrition after about six or seven months.
Moms who want to delay solids beyond twelve months often point out that solid food in the first year is just for “practice.” That’s true enough: almost any nutritionist or pediatrician will agree that the main purpose of solids in the first year is to get babies into the habit of eating actual food. However, it can be “practice” and yet still be important. A baby who doesn’t get to eat solids until he is twelve months old will enter the period of growth in which he urgently needs the extra nutrition that solid food provides, but he won’t have the know-how or the habits needed to actually meet those nutritional needs. No mother can produce enough milk, with enough nutrition, to exclusively meet the needs of a toddler, and that’s why it’s important to get the kiddo into the habit of eating solids before, not after, toddlerhood begins.
Finally, there’s no reason to think that exclusively breastfeeding for more than a year would provide any benefit. Breastfeeding for more than a year certainly is beneficial, but all of the studies on the topic have involved babies and toddlers who were given solid food in addition to breast milk– not given breast milk alone. We also know that it’s best to “delay” solids for at least four to six months, and to avoid giving it to babies under four months of age, to prevent problems like obesity and malnutrition. Still, that’s not a good idea to take the advice to an extreme and to exclusively breastfeed a one-year-old.
Follow your doctor’s advice and get in touch with a qualified lactation consultant or pediatric nutritionist to find out how to best meet your baby’s nutritional needs. Except in perhaps a very few rare situations, it’s not in your baby’s best interest to be exclusively breastfed without solids for twelve months of age or more. In general, if your baby is at least four months old (preferably a bit older) and shows all the signs of readiness for solids, it’s a good time to start bringing out the purees. Waiting too long can create unnecessary, and potentially dangerous, problems for you and your little one.