Ann sinnot 11.05am


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Ann sinnot 11.05am

  1. 1. Breastfeeding older children Myth v Reality
  2. 2. Common misconceptions <ul><li>1. No nutritional benefit </li></ul><ul><li>2. Sustained breastfeeding is unnatural </li></ul><ul><li>3. Mothers continue for themselves </li></ul><ul><li>4. Breastfeeding an older child is sexual </li></ul><ul><li>5. Children are developmentally harmed </li></ul><ul><li>6. Fathers are negatively affected </li></ul>
  3. 3. Reality <ul><li>Research studies </li></ul><ul><li>History </li></ul><ul><li>Survey results </li></ul><ul><li>Research study </li></ul><ul><li>(Presentation) </li></ul><ul><li>Fathers </li></ul>
  4. 4. Myth 5: C hildren developmentally harmed <ul><li>Children are: </li></ul><ul><ul><ul><ul><li>Out of control </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Over-dependent </li></ul></ul></ul></ul></ul>
  5. 5. Reality <ul><li>No evidence-base for assertions. </li></ul><ul><li>No psychosocial adjustment studies on children </li></ul><ul><li>breastfed for longer than one year. </li></ul><ul><li>Scientifically, the impact of sustained </li></ul><ul><li>breastfeeding on children is unknown . </li></ul>
  6. 6. Anecdotal evidence <ul><li>Evidence in Breastfeeding Older Children </li></ul><ul><li>on the psychosocial benefits of sustained breastfeeding </li></ul><ul><li>is significant and too strong to be ignored </li></ul><ul><li>More than 2000 mothers, from 48 countries, responded </li></ul><ul><li>to surveys. Irrespective of diverse locations and </li></ul><ul><li>different cultures, mothers echo and re-echo </li></ul><ul><li>each other about the positive effects </li></ul><ul><li>of long-term breastfeeding. </li></ul>
  7. 7. <ul><li>Assessment of an older breastfeeding child </li></ul>
  8. 8. <ul><li>Assessment of an older breastfeeding child </li></ul><ul><li>Milestones met exceedingly well </li></ul>
  9. 9. Children out of control <ul><li>Critics of sustained breastfeeding </li></ul><ul><li>rarely have direct experience. </li></ul><ul><li>Older breastfeeding children no </li></ul><ul><li>different to other children </li></ul><ul><li>The only difference: they also breastfeed. </li></ul>
  10. 10. <ul><li>Mothers of long-term breastfed children </li></ul><ul><li>no different to other mothers. </li></ul><ul><li>Daily life is full of opportunities for setting </li></ul><ul><li>boundaries, why choose breastfeeding? </li></ul><ul><li>Children do self wean </li></ul>
  11. 11. Children over-dependent <ul><li>Young children are dependent, but western culture </li></ul><ul><li>requires them to become independent, as soon </li></ul><ul><li>as possible, and believes independence </li></ul><ul><li>has to be i nduced . </li></ul>
  12. 12. <ul><li>Long-term breastfeeding mothers take a different view. </li></ul><ul><li>They believe children should be allowed to mature </li></ul><ul><li>at their own pace and not be forced into </li></ul><ul><li>self-reliance before they are ready. </li></ul>
  13. 13. <ul><li>When my children stopped they were emotionally ready, which was not the case when I tried to wean them earlier. They had outgrown the need, it was not forced on them. </li></ul><ul><li>South Africa. Ch 1: bfd 6yrs; Ch 2: bfd 4 yrs; Ch 3: bfdg 5yrs </li></ul><ul><li>I will stop when they want to stop. In my opinion this step is a very </li></ul><ul><li>important one to become independent. But what kind of independence </li></ul><ul><li>is this, if you were pushed into it against your own convincement? </li></ul><ul><li>Greece. Ch1: bfdg 6.1yr; Ch2: bfdg 4.1yr; Ch3: bfdg 1yr. </li></ul>
  14. 14. <ul><li>Many people think 3 years is too long, they don’t want it themselves </li></ul><ul><li>and a few think my child becomes too dependent on me. </li></ul><ul><li>My daughter is very strong and independent. </li></ul><ul><li>My son (2 years older) is much more dependent </li></ul><ul><li>and forms a contrast to his sister. </li></ul><ul><li>Netherlands. Ch 1: bfd 1.5yrs; Ch 2: bfdg 3.4yrs </li></ul>
  15. 15. <ul><li>Jack Newman, a Canadian doctor and breastfeeding advocate: </li></ul><ul><li>‘ Often we push children to become ‘independent’ too quickly. </li></ul><ul><li>To sleep alone too soon, to wean from the breast too soon, </li></ul><ul><li>to do without their parents too soon, to do everything </li></ul><ul><li>too soon. Don’t push and the child will become </li></ul><ul><li>independent soon enough’. 5 </li></ul>
  16. 16. Corroboration <ul><li>Correlations between descriptions of </li></ul><ul><li>long-term breastfeeding children </li></ul><ul><li>Attachment Theory/Secure Attachment </li></ul><ul><li>Neuroscience research </li></ul>
  17. 17. Attachment Theory <ul><li>Bowlby and Ainsworth identified the necessity in early life </li></ul><ul><li>of positive mother-child interactions for the </li></ul><ul><li>formation of secure attachment. </li></ul><ul><li>Both recognised the efficacy of breastfeeding </li></ul><ul><li>to nurture secure attachment. </li></ul>
  18. 18. <ul><li>Secure attachment fostered when a child’s needs are met </li></ul><ul><li>in a timely manner by a sensitive, responsive </li></ul><ul><li>mother well-attuned to the child’s cues. </li></ul><ul><li>Long-term breastfeeding a strong measure of </li></ul><ul><li>maternal sensitivity and responsiveness. </li></ul>
  19. 19. <ul><li>Bowlby: ‘The infant and young child should experience </li></ul><ul><li>a warm, intimate, and continuous relationship </li></ul><ul><li>with his mother…in which both find </li></ul><ul><li>satisfaction and enjoyment’. </li></ul><ul><li>By definition, long-term breastfeeding is a warm, </li></ul><ul><li>intimate and continuous relationship. </li></ul>
  20. 20. <ul><li>It’s a wonderful feeling to have been fully trusted, and to know that I fulfilled her needs until she was ready to complete the journey. My daughter is my best friend. I owe our closeness to breastfeeding because it </li></ul><ul><li>taught us both how to respect and trust one another. </li></ul><ul><li>Hawaii. Ch1: bfd 7.6yrs. </li></ul><ul><li>There is no simpler, more effective way to both intuitively and physically respond to a child’s needs than to breastfeed; you just know your </li></ul><ul><li>child to such a subtle degree that you find you can anticipate </li></ul><ul><li>all the moments when a stop at the breast is needed . </li></ul><ul><li>USA. Ch1: bfd 4yrs; Ch2: bfd 6.5yrs. </li></ul>
  21. 21. <ul><li>From the early days of breastfeeding, I found the look of absolute bliss the baby would have after a feed just about spoke volumes. Even today, the way that ‘tuck-in’ and grin as they do so shows the pure pleasure it gives them. </li></ul><ul><li>England. Ch1: bfdg 4yrs; Ch 2: bfdg 2.6yrs. </li></ul><ul><li>My oldest loved to nurse. He would tell me it </li></ul><ul><li>was his favorite part of the day. </li></ul><ul><li>USA. Ch1: bfd 4yrs; Ch2: bfdg 7mths. </li></ul>
  22. 22. <ul><li>‘ Internal working model’ of self and other(s). </li></ul><ul><li>Basis of the child’s thoughts, feelings, memories, </li></ul><ul><li>beliefs and expectations of relationships. </li></ul><ul><li>Primary relationship establishes child’s self-esteem </li></ul><ul><li>and is the template for all other relationships. </li></ul>
  23. 23. <ul><li>A securely-attached child is self-confident and independent. </li></ul><ul><li>Long-term breastfed children closely </li></ul><ul><li>match indicators of secure attachment. </li></ul><ul><li>happy, secure, self-confident, out-going, </li></ul><ul><li>independent, sociable, well-adjusted. </li></ul>
  24. 24. <ul><li>Emotionally, he’s really confident and outgoing. He always had me there, so he always knew he could go and I’d be there, really be there closely, when he </li></ul><ul><li>chose to come back. England. Ch 1: bfdg 4.3yrs </li></ul><ul><li>Both children are very independent and happy, well-adjusted. </li></ul><ul><li>USA. Ch 1: bfd 2.3yrs; Ch 2: bfd 3.2yrs. </li></ul><ul><li>[Breastfeeding long-term] Makes it easy to know you are loved no matter what, [and is] helpful in learning how to socialize with other children and adults as well . Guatemala. Ch 1: bfd 3yrs; Ch 2: bfd 3.3yrs </li></ul>
  25. 25. <ul><li>One of the most important things for us was the independence breastfeeding seemed to give my son. I often watched other toddlers the same age, who were formula-fed or only breastfed for a short time, and noted how confident my son seemed in comparison. He has never been clingy at toddler groups, </li></ul><ul><li>just full of life and ready to try new things. </li></ul><ul><li>England. Ch 1: bfd 3yrs; Ch2: bfdg 11mths. </li></ul><ul><li>From an emotional point of view, it has helped them form a very </li></ul><ul><li>close and secure attachment with me and as a result </li></ul><ul><li>they are very confident and happy. </li></ul><ul><li>Rep of Ireland, Ch 1: bfdg 6yrs; Ch 2: bfdg 4yrs; Ch 3: bfdg 1yr </li></ul>
  26. 26. Neuroscience 6 <ul><li>Validation and extension of Attachment Theory. </li></ul><ul><li>Early years identified as a critical window. </li></ul><ul><li>Action of oxytocin in development </li></ul><ul><li>of mother-infant bonding. </li></ul>
  27. 27. <ul><li>Oxytocin released in response to pleasurable </li></ul><ul><li>interactions, including breastfeeding . </li></ul><ul><li>Higher oxytocin levels and more, and better quality, </li></ul><ul><li>oxytocin-receptors, in infants that receive </li></ul><ul><li>lots of maternal attention, compared </li></ul><ul><li>to those that receive less. </li></ul>
  28. 28. <ul><li>Sustained breastfeeding: </li></ul><ul><li>Repeated daily opportunities for maternal </li></ul><ul><li>attention and pleasurable interactions </li></ul><ul><li>maintained over several years. </li></ul>
  29. 29. Joy and pleasure <ul><li>Feelings of joy and pleasure induced by </li></ul><ul><li>physical contact, eye-gazing and other </li></ul><ul><li>enjoyable mother-child interactions, </li></ul><ul><li>crucial for neural growth. </li></ul>
  30. 30. <ul><li>Children’s pleasure and enjoyment evident . </li></ul>
  31. 31. Children speaking <ul><li>Human milk is yummy, delicious </li></ul><ul><li>Compare to favourite foods/treats. </li></ul><ul><li>‘ Pet’ names for breasts and for milk </li></ul><ul><li>‘ Amecitos’, ‘Happy milk’. </li></ul><ul><li>I love your boobys, mummy! </li></ul>
  32. 32. Humour and play <ul><li>He can’t really talk, but he sometimes sucks until the milk lets down </li></ul><ul><li>and then pulls off, laughing as it sprays in his face! </li></ul><ul><li>England. Ch1: bfdg 1.4yrs. </li></ul><ul><li>She used to have a very entertaining relationship with my breasts – </li></ul><ul><li>talking to them, patting them, making jokes about them. </li></ul><ul><li>Scotland. Ch 1: bfd 4.10yrs; Ch2: bfdg 1.7yrs </li></ul>
  33. 33. Wider implications <ul><li>Oxytocin ‘glue of society’. </li></ul><ul><li>Plays vital role in formation of: </li></ul><ul><li>All affectional and affiliative bonds </li></ul><ul><li>Social emotions. </li></ul>
  34. 34. Right hemisphere of brain <ul><li>Development of ability to ‘read’ others </li></ul><ul><li>and a capacity for empathy. </li></ul><ul><li>Right hemisphere linked to limbic area. </li></ul><ul><li>Positive mother-child interactions </li></ul><ul><li>critical for right hemisphere development. </li></ul>
  35. 35. <ul><li>Long-term breastfed children: </li></ul><ul><li>Securely-attached </li></ul><ul><li>Kind, generous, sensitive, compassionate, empathic , </li></ul><ul><li>Ability to ‘read’ and interpret need </li></ul><ul><li>and unhappiness in other children. </li></ul>
  36. 36. <ul><li>He is very empathic towards other babies and children who are crying… he’ll say, ‘The baby’s crying, he needs a hug and some milk’. When he was 18 mths old there was a baby crying on the plane and he said, ‘Baby crying, baby need milk’. </li></ul><ul><li>England. Ch 1: bfdg 2yrs. </li></ul><ul><li>Emotionally I feel it has been of great benefit to E as a form of contact </li></ul><ul><li>and reassurance. She now seems very confident and ready to </li></ul><ul><li>take on her daily life at school, but also very empathic </li></ul><ul><li>and aware of the feelings of others and the </li></ul><ul><li>need for closeness and cuddles. </li></ul><ul><li>Jersey, CI. Ch1: bfdg 4yrs </li></ul>
  37. 37. <ul><li>Both boys weaned themselves, have happy memories of nursing and are strong advocates of their baby sister breastfeeding. They both have an abiding understanding of the value and experience of nursing </li></ul><ul><li>‘ til they were ready to be done. </li></ul><ul><li>USA. Ch1: bfd 6.6yrs; Ch2: bfd 6yrs; Ch3: bfdg 5mths. </li></ul><ul><li>I felt happy and cosy and sleepy when I was having lolo. If I see </li></ul><ul><li>a baby having lolo it makes me happy because I remember </li></ul><ul><li>me having lolo. If I see a baby having a bottle, it makes </li></ul><ul><li>me worry a bit, I feel a bit sad, I don’t know why. </li></ul><ul><li>England. Ch1: bfd 3.9yrs; Ch2: bfd 7.3yrs. </li></ul>
  38. 38. Negative emotions <ul><li>Attachment Theory and Neuroscience </li></ul><ul><li>Importance of: </li></ul><ul><li>maximising positive emotions </li></ul><ul><li>diffusing negative emotions. </li></ul>
  39. 39. <ul><li>Attachment Theory </li></ul><ul><li>Young child developmentally unable to regulate itself </li></ul><ul><li>– dependent on intervention. </li></ul><ul><li>Needs unmet </li></ul><ul><li>Negative emotions unmodulated </li></ul><ul><li>I nsecure-attachment likely outcome. </li></ul>
  40. 40. <ul><li>Neuroscience </li></ul><ul><li>Oxytocin believed to work by reducing stress. </li></ul><ul><li>Early oxytocin-deficiency can lead to </li></ul><ul><li>greater stress-reactivity in later life. </li></ul><ul><li>Low levels of oxytocin </li></ul><ul><li>Less inclination to seek social interaction. </li></ul>
  41. 41. <ul><li>Deficiency in oxytocin, or in the number and quality </li></ul><ul><li>of oxytocin-receptors, has a negative impact </li></ul><ul><li>on the central nervous system, </li></ul><ul><li>with behavioural consequences. </li></ul><ul><li>Personality disorder </li></ul><ul><li>Social dysfunction </li></ul><ul><li>Schizophrenia, Autism </li></ul>
  42. 42. <ul><li>Increased levels of cortisol in episodes of crying and distress. </li></ul><ul><li>Stress hormones can affect oxytocin-receptor </li></ul><ul><li>binding in central nervous system. </li></ul><ul><li>High cortisol levels linked to developmental delay. </li></ul><ul><li>Reduction in size of hippocampus – involved </li></ul><ul><li>in learning and memory storage </li></ul>
  43. 43. <ul><li>Western culture tends not to attach much </li></ul><ul><li>importance to distress in children. </li></ul><ul><li>Crying unavoidable. </li></ul><ul><li>Is this true? </li></ul><ul><li>Two distress scenarios: </li></ul>
  44. 44. Weaning <ul><li>Young children often highly resistant. </li></ul><ul><li>Distress </li></ul><ul><li>Trauma </li></ul><ul><li>Pleading, tears, screams, anger </li></ul><ul><li>Many children left with long-lasting </li></ul><ul><li>feelings of loss and longing. </li></ul><ul><li>. </li></ul>
  45. 45. The ‘terrible twos’ (and threes and fours…) <ul><li>Child caught up in whirlwind of agitation and rage that ratchets </li></ul><ul><li>ever-upwards until, locked into a storm of frustration </li></ul><ul><li>and anger, the child, shocked and frightened by the </li></ul><ul><li>ferocity of its own emotions, spirals up into </li></ul><ul><li>a screaming emotional hurricane. </li></ul><ul><li>Devastating experience for all concerned. </li></ul>
  46. 46. <ul><li>Long-term breastfed children rarely cry. The ‘terrible twos’ usually not terrible at all! Many mothers report not even a hint of a tantrum. </li></ul><ul><li>Should a tantrum begin, or other distress occur, mothers, </li></ul><ul><li>quickly able to neutralise distress, calm children </li></ul><ul><li>and quickly restore equilibrium. </li></ul>
  47. 47. <ul><li>If I were to choose one word that characterised my daughter throughout her </li></ul><ul><li>childhood, it would be ‘serene’. Tantrums were non-existent. </li></ul><ul><li>England. Ch1: bfd 6.6yrs. </li></ul><ul><li>For a baby who was so stressed-out from the earliest moments of his life (surgical </li></ul><ul><li>procedure for tongue-tie), he was calmed easily with nursing - and it sure </li></ul><ul><li>calmed him down when he was injured or really mad. </li></ul><ul><li>USA. Ch1: bfd 5.3yrs. </li></ul><ul><li>I often referred to breastmilk as the ‘mood enhancer’ because it </li></ul><ul><li>was remarkable how it could change their mood. </li></ul><ul><li>The transformation was astonishing and immediate. </li></ul><ul><li>Rep of Ireland. Ch1: bfd 5yrs; Ch 2: bfd 5.3yrs. </li></ul>was