Wednesday, May 29, 2013

When to Wean - Then and Now

The question of when to wean a baby is something every mother asks herself, and probably her doctor. When a mother chooses to breastfeed (and is successful), there comes a time when work or life or any number of things get in the way. Another choice needs to be made, struggle through it and persist or wean the baby. Sometimes the baby chooses to wean herself before mom is ready. Sometimes mom is ready to be done before baby is ready. There is a lot that should go into this decision, so what is the right way?

The American Academy of Pediatrics suggests breastfeeding exclusively until at least 6 months with the gradual introduction of solids after that in conjunction with continued nursing until the age of 1 and then until is mutually desired by baby and mother. 

The World Health Organization suggests exclusive breastfeeding until the age of 6 months and then continued with the introduction of solids until at least the age of 2 and beyond. 

Most pediatricians suggest exclusive breastfeeding until 4-6 months and then slowly introducing solids until the age of 1. The success of the nursing mother often comes because of support at home (moms need a lot of encouragement, dads! Let the baby have her breasts for a little while, it's the best form of nutrition and you are one of the biggest factors for success or failure!) and from the child's pediatrician and lactation consultants. 

We are so lucky to have some amazing hospitals here that have lactation consultants on staff. One came in at least once a day every day I was in the hospital and made sure we were latching ok and comfortable. If I had questions or trouble, I just had to press my button and the lactation on staff came to help. One of the reasons I went with our pediatrician is because of the support staff in his practice. He has lactation consultants in the office. Because they are a part of his practice, he has nursing moms and babies come in for an appointment with them, covered by insurance (check with your insurance provider - it worked for us because they were in the practice, if we went elsewhere, it would not have been fully covered). The Hubs was ever supportive, not really knowing what to do or say, but always an advocate.

So now, at 22 months, we are still nursing. Just once or twice a day, but it's still good for Buddy and me. And who knows how long it will last.

Is this normal? I've had a few inquisitive looks of, "You're STILL breastfeeding? At his age?" Ever wonder when our ancestors weaned? How about when the cavemen weaned? Researchers are starting to figure out that question! This week in the journal Nature, scientists used the tooth of a Neanderthal baby, in conjunction with a broader study of modern humans and macaques, to figure out that question. 

This kid, who can clearly feed himself, is still 
nursing because he wants to and so do I for so many reasons.

The study authors looked at barium-calcium ratios in baby teeth from the macaques and modern humans and then assumed the pattern to be consistent with the Neanderthal tooth. What they found is that very little barium is incorporated into the teeth until the baby is born, when the barium concentration shoots up immediately because breast milk contains high levels of the element. Barium levels dropped off as solid foods were introduced and were again very low when the child was weaned. 

These are  gibbons, but we didn't get a picture 
of the macaques and they're both apes ...

Although the researchers only used a single tooth so no broad conclusions can be drawn, the implications of this new knowledge is intriguing. The authors found that the infant was exclusively breastfed for 7 months, when solids were introduced gradually. Then at 14 months, barium levels decreased abruptly, suggesting instant weaning. This may have been the common practice, but more realistically, the mother either fell ill or died. 

14 months is a short time compared to how long babies in non-industrialized countries nurse today - 2.5 years on average. It will be interesting to see where this research leads as more Neanderthal teeth and teeth from other pre-humans and early humans are analyzed. 

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