Wednesday, July 21, 2010

Here's to a long and milky nursing future!

Zekie got his first tooth last week. It's coming in slowly, and only just peeking above the gum. But it's there, and it's sharp!

Many people in America have the misconception that the appearance of teeth mean it's time to begin weaning. But how can this be, when teeth can come in as early as 4 months (And rarely, even earlier!) and the American Academy of Pediatrics strongly advises exclusive breastfeeding for the first 6 months, and with complementary solids for the first year? If an infant is weaned before then, he must be given human milk replacement, since the nutrition that breastmilk provides is absolutely essential for the first year.

Further, the AAP recommends that breastfeeding should continue for as long as is mutually desired by the mother and child beyond age one. The World Health Organization recommends at least two years of breastfeeding, and thereafter for as long as is mutually desired. Breastmilk continues to provide not only very beneficial nutrition like healthy fats, proteins, and vitamins, but also protective immune qualities. The immune system of a child under 2 is very underdeveloped, and continues to develop through childhood. While solid "adult" foods will become a larger and larger part of the child's diet until he is no longer nursing, there is no denying that breastmilk has valuable benefits well into toddlerhood and young childhood.

On a side note, I learned that the ancient Hebrew word for a child under the age of 5 essentially means "nursling". And a child under the age of 5 was almost exclusively his mother's responsibility, after which a male child would increasingly enter his father's world. So it would have been considered normal for a child to be nursing to some degree up until about age 5. And in Mongolian culture, there is a saying that a child who nurses until the age of 6 will be a strong wrestler (a very popular sport in Mongolia). Looking at physical and psychological child development, it is biologically normal and expected for a child to nurse for several years, and then gradually wean all on his own. In developing countries, it is normal for a woman's fertility to not return until a child is nursing much less often (signaling to the body that the child has been appropriately cared for and it is ready to devote its energy to a new tiny baby), and then for the child to naturally wean the rest of the way during pregnancy when the milk supply often diminishes. And, we even refer to a child's baby teeth as "milk teeth", which naturally fall out and make room for adult teeth beginning around age 5-7.

So...if getting teeth doesn't have to mean weaning, then the next question is: what about biting? Or, doesn't it hurt to nurse a child with teeth? This would seem to be a natural question, since even though a baby clamping down with his gums can be very painful, teeth can break the skin. But, even a baby can learn that there are rules and "manners" to nursing. Watch your baby's signals: biting often happens at specific times, like when baby is bored/done nursing, frustrated, teething, or playful. By addressing your baby's needs and keeping an eye out for the signals that he may bite, you can avoid a lot of biting episodes. If you start to feel him biting down, you can insert a finger in his mouth to break the suction and unlatch him. Put him down and say in a stern voice, "No biting! Biting hurts mommy!" He will learn that biting ends the nursing session, and if he wants to continue nursing, he had better use his "manners" and no bite! I have actually been doing this with Zekie, and it does seem to work quite well.

Also, since with a proper latch, the baby takes the nipple far back in the mouth to the soft palate and gently massages the breast with the gums to stimulate milk flow, any teeth simply "lay" on the breast rather than ever coming in contact with the nipple, or biting down on anything. There may be a re-learning period as new teeth come in, but a proper latch will not hurt, even with teeth.

Whether you're a nursing mother or someone who loves and supports one, you can help to inform people around you and create a culture that supports, rather than tears down, nursing mothers and especially those who are nursing toddlers and beyond.

Here's to a long and milky nursing future for us and for any other mamas (and babies) who are reading!

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