Child Benefits of Breastfeeding After 6 Months of Age
by Anne Eglash MD, IBCLC, FABM
Breastfeeding rates drop every month postpartum due to several challenges such as returning to employment, low production, latch issues, pain, etc. Many families ask whether breastfeeding matters after 6 months when infants start complementary feeding.
The article for this week reviews the evidence regarding child benefits of breastfeeding after 6 months.
The authors start by reviewing changes in human milk over time. In general, bioactive factors including IgA, IgG, lysozyme, lactoferrin markedly increase after 12 months postpartum, supporting the health of the breastfed child by preventing infection and supporting growth and development over time.
What are the benefits of breastfeeding beyond 6 months? See the question!
- Breastfeeding beyond 6 months is associated with a lower risk of environmental and food allergies compared to breastfeeding for less than 6 months.
- Infants over 6 months who breastfeed have a lower risk of ear infections than those who don’t.
- Longer breastfeeding after 6 months is associated with lower blood pressure.
- Breastfeeding for more than 12 months is associated with a lower risk of dental caries.
- Breastfeeding after 6 months is associated with a lower risk for childhood hospitalization and respiratory infections.
- Breastfeeding for more than 6 months reduces the risk of childhood leukemia.
- Children breastfed for over 12 months have a lower risk of malaria.
See the Answer
Abstract
Breastfeeding is globally recognized as the optimal method of infant nutrition, offering health benefits for both the child and the mother, making it a public health priority. However, the potential advantages of breastfeeding extend well beyond initial months. Breast milk adapts to the evolving needs of the growing infant, and its immunological, microbiological, and biochemical properties have been associated with enhanced protection against infections and chronic diseases, improved growth and development, and lower rates of hospitalization and mortality. This review explores the evidence supporting the continuation of breastfeeding beyond six months. More meticulous studies employing consistent methodologies and addressing confounders are essential. This will enable a more accurate determination of the extent and mechanisms of the positive impact of prolonged breastfeeding and allow for the implementation of effective public health strategies.
Although not a rigorous systematic review, the authors provide a comprehensive summary of current evidence regarding the benefits of breastfeeding beyond 6 months.
The benefits of prolonged breastfeeding are divided into 3 categories based on strength of evidence. The ‘Convincing’ category includes allergic diseases, cognitive development, infections, inflammatory bowel disease, leukemia, and proper weight gain.
The ‘Probable’ category includes blood pressure, malaria, metabolic syndrome, oral health, and otitis media.
The areas that have ‘Limited’ strength of evidence include arthritis, celiac disease, lipid levels, neuroblastoma, retinoblastoma, rhabdomyosarcoma, sudden infant death syndrome, and type 2 diabetes.
The evidence weighs towards increased risk of caries among children breastfed after 1 year.
The authors summarize research that provides biologic plausibility for the benefits of prolonged breastfeeding. For example, the continued dosing of IgA and human milk oligosaccharides prevent infection and contribute to a healthy gut microbiome by preventing growth of pathologic bacteria that may be associated with inflammatory bowel disease and inappropriate immune responses.
I highly recommend this article as a good reference for teaching or for developing patient-facing breastfeeding education.