Feeding & Eating

Extended Breastfeeding Decisions

Medically reviewed by Dr. Rachel Kim, MD, RDN · Pediatric Nutrition Specialist

Content reviewed against published AAP, WHO, NIH guidelines

Editorial policy

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Feeding challenges are one of the most common concerns new parents face. When it comes to extended breastfeeding decisions, here is what the guidelines recommend.

The short answer

Extended breastfeeding, meaning breastfeeding beyond 12 months, is supported by both the AAP and the WHO. The WHO recommends breastfeeding up to 2 years or beyond, and the AAP supports continued breastfeeding for as long as mutually desired by mother and child. Extended breastfeeding continues to provide nutritional, immunological, and emotional benefits for toddlers and is a normal biological practice worldwide.

Key takeaways

  • Extended breastfeeding, meaning breastfeeding beyond 12 months, is supported by both the AAP and the WHO. The WHO recommends breastfeeding up to 2 years or beyond, and the AAP supports continued breastfeeding for as long as mutually desired by mother and child. Extended breastfeeding continues to provide nutritional, immunological, and emotional benefits for toddlers and is a normal biological practice worldwide.
  • Usually normal when: Your toddler nurses one to three times per day, primarily for comfort around sleep times or after a fall
  • Call your doctor if: You are experiencing breastfeeding-related pain that could indicate an infection or other medical issue
“The AAP recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, for 2 years or beyond.”
— Breastfeeding and the Use of Human Milk, American Academy of Pediatrics (AAP)

Thousands of parents search for this exact thing. You are not alone.

What Parents Should Know

According to AAP, WHO, NIH guidelines, extended breastfeeding, meaning breastfeeding beyond 12 months, is supported by both the AAP and the WHO. The WHO recommends breastfeeding up to 2 years or beyond, and the AAP supports continued breastfeeding for as long as mutually desired by mother and child. Extended breastfeeding continues to provide nutritional, immunological, and emotional benefits for toddlers and is a normal biological practice worldwide. At 12-24 months, breast milk continues to provide valuable nutrients, antibodies, and immune factors during the second year. Toddlers who breastfeed benefit from the comfort and security it provides during a period of rapid development and growing independence. Nursing at this age is typically less frequent and often happens around nap time, bedtime, or when your child needs comfort. It is generally considered normal when your toddler nurses one to three times per day, primarily for comfort around sleep times or after a fall. However, you should contact your pediatrician promptly if you are experiencing breastfeeding-related pain that could indicate an infection or other medical issue.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Your toddler nurses one to three times per day, primarily for comfort around sleep times or after a fall
You are experiencing breastfeeding-related pain that could indicate an infection or other medical issue
Your child eats a full range of solid foods and drinks other fluids while also breastfeeding
Your toddler is exclusively breastfeeding and refusing all solid foods, which could indicate an underlying feeding or developmental concern
Breastfeeding feels like a positive part of your relationship with your child
You are facing significant social pressure or relationship conflict about your decision to continue breastfeeding
Your child occasionally goes a day or more without nursing and then resumes, especially during illness
Your toddler is nursing so frequently that it interferes with eating adequate solid foods

By Age

What to expect by age

12-24 months

Breast milk continues to provide valuable nutrients, antibodies, and immune factors during the second year. Toddlers who breastfeed benefit from the comfort and security it provides during a period of rapid development and growing independence. Nursing at this age is typically less frequent and often happens around nap time, bedtime, or when your child needs comfort.

24-36 months

Breastfeeding a child over 2 years is less common in many Western cultures but is the biological norm globally. If you and your child are happy with the arrangement, there is no medical reason to stop. You may face social pressure or questions from others. Having a confident response prepared, such as citing the WHO recommendation, can help. The decision to continue or stop is entirely yours and your child's.

What to Tell Your Pediatrician

  • Describe when you first noticed extended breastfeeding decisions and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you are facing significant social pressure or relationship conflict about your decision to continue breastfeeding.
  • Mention if your toddler is nursing so frequently that it interferes with eating adequate solid foods.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Your toddler nurses one to three times per day, primarily for comfort around sleep times or after a fall
  • Your child eats a full range of solid foods and drinks other fluids while also breastfeeding
  • Breastfeeding feels like a positive part of your relationship with your child
  • Your child occasionally goes a day or more without nursing and then resumes, especially during illness
Mention at your next visit when...
  • You are facing significant social pressure or relationship conflict about your decision to continue breastfeeding
  • Your toddler is nursing so frequently that it interferes with eating adequate solid foods
  • You want to continue breastfeeding but are struggling with breastfeeding aversion or feeling touched out
  • You are considering weaning and want to discuss the best approach for your child's age
Act now when...
  • You are experiencing breastfeeding-related pain that could indicate an infection or other medical issue
  • Your toddler is exclusively breastfeeding and refusing all solid foods, which could indicate an underlying feeding or developmental concern

What You Can Do at Home

  • Keep track of when you notice extended breastfeeding decisions — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that your toddler nurses one to three times per day, primarily for comfort around sleep times or after a fall — this is generally within the range of normal.
  • At 12-24 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Offer feeding in a calm, distraction-free environment. Avoid forcing or pressuring your baby to eat.
  • While monitoring at home, seek immediate care if you are experiencing breastfeeding-related pain that could indicate an infection or other medical issue.
Guide

Feeding & Nutrition Guide

Complete guide to breastfeeding, formula feeding, and solid food introduction.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is extended breastfeeding decisions normal?
Extended breastfeeding, meaning breastfeeding beyond 12 months, is supported by both the AAP and the WHO. The WHO recommends breastfeeding up to 2 years or beyond, and the AAP supports continued breastfeeding for as long as mutually desired by mother and child. Extended breastfeeding continues to provide nutritional, immunological, and emotional benefits for toddlers and is a normal biological practice worldwide.
When should I call the doctor about extended breastfeeding decisions?
You are experiencing breastfeeding-related pain that could indicate an infection or other medical issue Your toddler is exclusively breastfeeding and refusing all solid foods, which could indicate an underlying feeding or developmental concern
When is extended breastfeeding decisions normal?
Your toddler nurses one to three times per day, primarily for comfort around sleep times or after a fall Your child eats a full range of solid foods and drinks other fluids while also breastfeeding Breastfeeding feels like a positive part of your relationship with your child
What causes extended breastfeeding decisions?
Extended breastfeeding, meaning breastfeeding beyond 12 months, is supported by both the AAP and the WHO. The WHO recommends breastfeeding up to 2 years or beyond, and the AAP supports continued breastfeeding for as long as mutually desired by mother and child. Extended breastfeeding continues to provide nutritional, immunological, and emotional benefits for toddlers and is a normal biological practice worldwide. Common explanations include: Your toddler nurses one to three times per day, primarily for comfort around sleep times or after a fall. Your child eats a full range of solid foods and drinks other fluids while also breastfeeding.
What should I mention to my pediatrician about extended breastfeeding decisions?
You should mention extended breastfeeding decisions at your next visit if: You are facing significant social pressure or relationship conflict about your decision to continue breastfeeding. Your toddler is nursing so frequently that it interferes with eating adequate solid foods. You want to continue breastfeeding but are struggling with breastfeeding aversion or feeling touched out.
Is extended breastfeeding decisions normal at 12-24 months?
Breast milk continues to provide valuable nutrients, antibodies, and immune factors during the second year. Toddlers who breastfeed benefit from the comfort and security it provides during a period of rapid development and growing independence. Nursing at this age is typically less frequent and often happens around nap time, bedtime, or when your child needs comfort.
Is extended breastfeeding decisions normal at 24-36 months?
Breastfeeding a child over 2 years is less common in many Western cultures but is the biological norm globally. If you and your child are happy with the arrangement, there is no medical reason to stop. You may face social pressure or questions from others. Having a confident response prepared, such as citing the WHO recommendation, can help. The decision to continue or stop is entirely yours and your child's.
Should I go to the ER for extended breastfeeding decisions?
Seek emergency care if you are experiencing breastfeeding-related pain that could indicate an infection or other medical issue, or if your toddler is exclusively breastfeeding and refusing all solid foods, which could indicate an underlying feeding or developmental concern. When in doubt, call your pediatrician's after-hours line for guidance.
Does extended breastfeeding decisions go away on its own?
In many cases, extended breastfeeding decisions resolves on its own, especially when your toddler nurses one to three times per day, primarily for comfort around sleep times or after a fall.
AAPWHONIH

References

  1. [1]American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Pediatrics. AAP
  2. [2]World Health Organization. Infant and Young Child Feeding. WHO
  3. [3]National Institutes of Health. Breastfeeding Beyond Infancy. NCBI. NIH

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Extended Breastfeeding Decisions.

Things to mention

  • Describe when you first noticed extended breastfeeding decisions and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you are facing significant social pressure or relationship conflict about your decision to continue breastfeeding.
  • Mention if your toddler is nursing so frequently that it interferes with eating adequate solid foods.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • You are facing significant social pressure or relationship conflict about your decision to continue breastfeeding
  • Your toddler is nursing so frequently that it interferes with eating adequate solid foods
  • You want to continue breastfeeding but are struggling with breastfeeding aversion or feeling touched out

Urgent signs to report immediately

  • You are experiencing breastfeeding-related pain that could indicate an infection or other medical issue
  • Your toddler is exclusively breastfeeding and refusing all solid foods, which could indicate an underlying feeding or developmental concern

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Related Resources

Food Introduction GuideFeeding & Pumping GuideBaby Meal PlannerEar Infection TriageBaby Tracker

Bottom line

Most cases of extended breastfeeding decisions are normal. Talk to your pediatrician if you are experiencing breastfeeding-related pain that could indicate an infection or other medical issue.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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