Breastfeeding Beyond 12 Months: Is There Evidence for Health Impacts?

Abstract

Because breastfeeding provides optimal nutrition and other benefits for infants (e.g., lower risk of infectious disease) and benefits for mothers (e.g., less postpartum bleeding), health organizations recommend that healthy infants be exclusively breastfed for 4 to 6 months in the United States and 6 months internationally. Recommendations related to how long breastfeeding should continue, however, are inconsistent. The objective of this article is to review the literature related to evidence for benefits of breastfeeding beyond 1 year for mothers and infants. In summary, human milk represents a good source of nutrients and immune components beyond 1 year. Some studies point toward lower infant mortality in undernourished children breastfed for >1 year, and prolonged breastfeeding increases interbirth intervals. Data on other outcomes (e.g., growth, diarrhea, obesity, and maternal weight loss) are inconsistent, often lacking sufficient control for confounding variables. There is a substantial need for rigorous, prospective, mixed-methods, cross-cultural research on this topic. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Prolonged Breastfeeding and the Risk of Plasmodium vivax Infection and Clinical Malaria in Early Childhood: A Birth Cohort Study

“…Standard regression models were used to analyze anemia as an outcome. Two critical explanatory variables were prolonged breastfeeding, defined as exclusive or partial breastfeeding lasting for ≥12 months, 23 and malaria in pregnancy, defined as one or more infections diagnosed by microscopy during sick visits to health facilities or by real-time PCR at delivery. 24 All variables considered in the unadjusted analysis are listed in Figure 1 25 to select covariates that, in addition to age and wealth index, were retained in downstream analyses because (1) they were associated with the outcome at a significance level of <10% or (2) their inclusion in the model changed the risk measures by ≥10%.…”

“…Standard regression models were used to analyze anemia as an outcome. Two critical explanatory variables were prolonged breastfeeding, defined as exclusive or partial breastfeeding lasting for ≥12 months, 23 and malaria in pregnancy, defined as one or more infections diagnosed by microscopy during sick visits to health facilities or by real-time PCR at delivery. 24 All variables considered in the unadjusted analysis are listed in Figure 1, Supplemental Digital Content 1, http://links.lww.com/INF/E760 and Figures 2, Supplemental Digital Content 1, http://links.lww.com/INF/E761.…”

Factors Affecting the Breastfeeding Duration of Infants and Young Children in China: A Cross-Sectional Study

“…Continuous breastfeeding has benefits for both infants and mothers [ 5 ]. For short-term effects, continuous breastfeeding can reduce infant mortality and prevent diseases such as diarrhea, respiratory infections, and otitis media [ 1 , 5 , 6 ].…”

“…Continuous breastfeeding has benefits for both infants and mothers [ 5 ]. For short-term effects, continuous breastfeeding can reduce infant mortality and prevent diseases such as diarrhea, respiratory infections, and otitis media [ 1 , 5 , 6 ]. For long-term effects, breastfeeding for a longer duration can reduce the risk of overweight and obesity and improve intelligence in children [ 1 , 5 , 6 ].…”

“…For short-term effects, continuous breastfeeding can reduce infant mortality and prevent diseases such as diarrhea, respiratory infections, and otitis media [ 1 , 5 , 6 ]. For long-term effects, breastfeeding for a longer duration can reduce the risk of overweight and obesity and improve intelligence in children [ 1 , 5 , 6 ]. As for mothers, continuous breastfeeding can extend the birth interval and reduce the risk of breast cancer, ovarian cancer, and type II diabetes [ 1 , 5 , 6 ].…”