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May 28, 2024/Pregnancy & Childbirth

How Long To Breastfeed: What the Guidelines Say and What To Consider

Recommendations encourage breast milk exclusively for baby’s first six months and continuing to provide human milk until age 2 and beyond

How and what you feed your baby is probably one of the most basic — and yet deeply personal — decisions you’ll face when you become a parent.

You’ll hear things like “breast is best.” As in, breastfeeding (chestfeeding) is the absolute best way to nourish your baby.

And then you’ll hear the retort, “fed is best.” Meaning breast milk (human milk) and formula are both fine. As long as your baby is getting nutrients in their belly, all is well.

Then come the opinions on how long you should breastfeed. (You’re still breastfeeding? You gave up on nursing already? You fed your baby formula?)

It can feel like there’s no right way to do it. And there’s some truth to that.

Because what works for one family may not be feasible for another. But that’s OK.

Breast milk can provide certain benefits that formula can’t mimic. But breastfeeding, especially for long periods of time, might not work for everyone. Or you may have been given the impression that you’ve continued providing human milk long after others think you “should.”

No one should feel guilt, shame or otherwise crummy about how they feed their baby. Let’s face it, mom guilt is tough enough as it is.

So, we talked with board-certified breastfeeding medicine physician Heidi Szugye, DO, about breastfeeding recommendations.

How long to breastfeed

Science shows that if you can give your baby human milk (either your own or a donor’s), it has its benefits. And the longer, the better, experts recommend.

The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) share these recommendations for breastfeeding duration:

  • Newborn to 6 months: Exclusive human milk.
  • 6 months to 12 months: Mostly human milk while introducing solid foods.
  • 12 months to 24 months (and beyond): Mostly solid foods with some human milk, as mutually desired by parent and child.

Previous recommendations called for providing breast milk until age 1. But these newer guidelines (implemented in 2022) are based on the understanding that human milk has benefits that continue long after baby’s first birthday. And they help to remove stigmas associated with people who choose to extend breastfeeding into toddlerhood.

“These recommendations are a call to action for everyone, and that includes hospitals, pediatricians and all physicians that are taking care of families,” Dr. Szugye states. “We want to make sure our practices and policies are set up to support people who choose to breastfeed beyond the first year of their child’s life.”

Think of the guidelines as the best-case scenario. If it works for you, your family, your child, your body and your life to breastfeed for two years or longer, you’re doing a great thing. And there’s no reason to stop until you and your child are ready.

If it doesn’t work for you, that’s OK, too. Your worth as a parent and your love for your child can’t be measured in ounces of milk.

Benefits of extended breastfeeding

The recommendations are based on research showing that human milk has some big benefits. And those perks continue for as long as you continue to supply it.

“Breastfeeding offers tremendous benefits — from custom-made nutrition and increased immunity to protecting you against some forms of cancer. And those benefits don’t go away as your baby ages,” Dr. Szugye shares. “We have more and more data supporting that there are benefits to breastfeeding for more than one year when possible.”

Breastfeeding can offer both you and your baby some big benefits:

Benefits for lactating parentsBenefits for baby
Lower risk of developing conditions like Type 2 diabetes, high blood pressure, cardiovascular disease, breast cancer and ovarian cancer.Decreased risk for ear infections, respiratory infections, gastrointestinal illnesses, SIDS, leukemia, diabetes, obesity, asthma and eczema.

“There are a lot of immunologic factors and components to human milk,” Dr. Szugye says. “One big advantage to human milk is that you pass antibodies to the baby. So, if you’re exposed to a respiratory illness or GI illness, those antibodies are passed on to the baby and then that makes them less likely to get sick. And if they do get sick, it’s less severe. It’s almost like a built-in immunity.”

Keeping up milk supply for the long haul

Some people can make enough milk to breastfeed for as long as they and their babies choose. But some don’t. At least not without taking some steps to keep it up.

If you suspect your supply is dwindling as your child gets older, there are ways to help promote more milk production if you want.

“Many people notice their supply drop and mistakenly assume it won’t return,” Dr. Szugye notes. “But if you want to continue to breastfeed, there are options that could help.”

If a supply boost is in order, you can try:

  • Nursing more often — Add sessions as long as your child will nurse. If you’re away from them during the day, try early evenings, mornings or weekends.
  • Pumping strategies — An extra session or several short “power pumping” sessions (think five to 10 minutes throughout the day) for several days in a row can trigger your body to make more milk.
  • Breast massage and compression — Easy-to-learn techniques can improve drainage when nursing or pumping.
  • Take care of yourself — Reduce stress, rest when possible, hydrate and eat a balanced diet with an extra 500 calories a day to support breastfeeding.

Not an ‘all-or-nothing’

If two or more years of breastfeeding seems daunting, remember that you have options.

For starters, giving your child human milk doesn’t always mean latching them to your breast and nursing. That’s just one way to do it. Pumping milk and putting it in a bottle, cup or spoon are also options.

And you may find that a donor bank could be a route to explore if you don’t lactate or if you have concerns about a low milk supply. Donor milk is pasteurized, screened for drugs, medications and infections, and tested for bacterial contamination before it’s stored and made available for purchase.

“Reach out to your pediatrician or women’s healthcare provider if you’re interested in obtaining donor milk. You may need a prescription from a healthcare provider,” Dr. Szugye suggests.

Remember, too, that any amount of human milk can be a benefit. If keeping up with your baby’s breastfeeding demands becomes too high a burden, there are alternatives.

Some parents may find that supplementing with formula (or other foods and milk after baby turns 1) can help give your child some human milk, while keeping up with their nutritional needs — and not burning yourself out in the process.

“It’s not an all-or-nothing thing,” Dr. Szugye reassures. “Any amount of human milk you can give is a benefit. If it doesn’t work for you to constantly supply human milk, that’s OK. We’re all just doing our best.”

If breastfeeding is going well for both you and your child, there’s no reason to give it up until you’re both ready to.

Feeding a baby is tough work, no matter how you do it. And chances are, you’re doing a fantastic job.

Muscles in your body are a use-or-lose proposition. You need to use them to keep them strong!@ClevelandClinic

cleveland muscles

Cleveland Clinic
@ClevelandClinic

Muscles in your body are a use-or-lose proposition. You need to use them to keep them strong!

You may not realize it, but we all start losing 1 percent of muscle mass each year after age 30. That’s why your diet in later years should not look the same as it did when you were younger, says endocrinologist Susan Williams, MD.

Skipping breakfast, eating fast food and being inactive in your 20s and early 30s might not hurt your health in the short term. However, poor nutrition and lifestyle habits take their toll over time.

People who embrace good habits early on really get ahead of the game, Dr. Williams says. But it’s never too late to start eating better and taking better care of your body.

Whether you’re 30 or 50, Dr. Williams offers three important tips to get started in eating right when you are thinking about your long-term health.

RELATED: Do You Know How Much Exercise You Really Need? 

1. Keep your weight in check

A roller coaster of weight gain and loss can change your body composition and leave you with more fat mass and less lean muscle mass.

2. Eat three balanced meals a day

You also want to limit your snacks in between. The word “balanced” is especially important because eating a wide variety of foods will help you prevent nutritional deficiencies.

Dr. Williams suggests this simple shopping list:

  • Lean proteins. Choose chicken, white fish, oily fish like salmon, eggs, tuna fish and red meat (less frequently than other protein).
  • Whole grains. This includes multigrain breads, and long-cooking rice or oats.
  • Veggies. Go for fresh or fresh frozen. Choose what’s in season and enjoy a variety to get the vitamins and minerals your body needs.
  • Fruit. Fresh fruit is best, followed by frozen. Canned fruit can be OK, but choose options in light syrup or water. Check the label and avoid added sugar.
  • Dairy. Choose milk, yogurts, cheeses and cottage cheese that are low-fat or fat-free.

Steer clear of cookies, cakes, pies, ice creams, juices and rich desserts. If that sounds like no fun, Dr. Williams advises treating these foods as treats. Save them for dining out or special occasions, but don’t make them part of your daily diet.

RELATED: Which Bread Is Best For You — Whole-Grain, Multigrain or Whole Wheat?

3. Use your muscles

Eating protein and being physically active are equal partners in the quest for maximum health, Dr. Williams says. Muscles are made of protein, but simply eating protein is not enough to save them.

“Muscles in your body are a use-or-lose proposition,” she says. “You need to use them to keep them strong.”

Can’t carve out time for the gym? Try this daily routine:

  1. In the morning, stretch for 10 minutes.
  2. At lunch, eat and then walk for 10 minutes.
  3. After dinner, spend 10 minutes with stretch bands or light weights.

Even a half hour of physical activity can make a world of difference, especially if you make it a habit in your 30s. “Don’t let your weight creep up while your muscle mass creeps down over your 30s and 40s,” Dr. Williams says. The longer you wait, the harder it will be to get started — and the more muscle you will have already lost.

You might not be worried about the flu, but it’s a serious illness that merits proactive measures. Here’s why you should get the flu vaccine and when to get it @ClevelandClinic #kidshealth

Healthcare providers across the country are bracing for another season of treating respiratory viruses like the flu, respiratory syncytial virus (RSV) and COVID-19.

And while the flu might not seem like something to worry about, it’s a virus we should all be prepared for. So, you may be wondering, Should I get a flu shot?

“Influenza is a very serious disease, and during a normal flu season, around 40,000 or more people die from it,” says infectious disease specialist Kristin Englund, MD. “So, with any preventable disease, we should do everything we can to protect ourselves.”

Getting your flu vaccine is vital to not just keeping you and your family healthy, but also relieving our over-burdened healthcare system.

To learn more about the importance of getting the flu vaccine, we talked to Dr. Englund, along with infectious disease clinical pharmacist Kaitlyn Rivard, PharmD.

Why the vaccine matters

First of all, Dr. Englund notes that it’s just good practice to get a flu shot every year. She adds that the vaccine’s prevention-geared properties are key.

“When people get influenza or get the flu, it’s not only just the symptoms that they have, like a cough, fever and an infection in the lungs,” she says. “It taxes the body and really puts a lot of stress on all of the other systems.”

That can cause some serious complications, she continues. “You can have a heart attack or even a stroke as a side effect from having influenza. So, we want to make sure that we’re keeping everybody healthy from all of these complications.”

Dr. Englund says that a flu shot is especially important this year because other respiratory viruses like COVID-19 and RSV will be circulating.

“We’re going to have influenza, RSV and COVID-19 coexisting and there’s a lot of overlap between the symptoms,” she states. “We also anticipate that there will be some people who have co-infections, which could be difficult.”

When to get the flu vaccine

We bet you’re now wondering: So, when should I get a flu shot?

Dr. Englund and Dr. Rivard advise getting a flu vaccine as soon as it becomes available. Many healthcare providers, including the Cleveland Clinic, begin offering the flu vaccine at the beginning of September.

And in case you were wondering, the flu vaccine doesn’t interfere with the COVID-19 vaccine or the RSV vaccine.

“All available COVID-19 and RSV vaccines can be given at the same time as the flu vaccine,” clarifies Dr. Rivard. “If someone is coming in for their flu shot and they’re eligible for a COVID-19 vaccine or RSV vaccine but haven’t received it yet, we can offer that. In fact, both the CDC [U.S. Centers for Disease Control and Prevention] and the Advisory Committee on Immunization Practices recommend co-administering almost any two vaccines together.”

She adds that there are very few instances in which certain vaccines can’t be administered at the same time, noting that children often receive multiple vaccines during one visit to their pediatrician.

And there’s no concern about overloading our immune systems with multiple vaccines.

“We’re exposed to things that stimulate our immune system all the time,” Dr. Englund says. “Our immune system is constantly responding to various exposures even if you don’t realize it.”

Why it’s important to get a flu shot every year

One reason it’s so important to get your annual flu shot is this: Protecting yourself is a lot easier than treating the flu.

“There are some treatments available for the flu that are evolving,” Dr. Englund says. “But to avoid the disease altogether or to only have a mild case because you’ve been vaccinated is much better than trying to treat it. Prevention is best.”

And that goes equally for kids — it’s also crucial to get them vaccinated for the flu.

“It’s important for children to get the flu vaccine, too, because the circulation of flu in children, if nothing else, puts adults at risk, too,” emphasizes Dr. Englund.

“Influenza is a serious disease and it’s unpredictable, and otherwise healthy children are unfortunately hospitalized and die every year because of it. So, even for normal, healthy children, it’s really important to get vaccinated every year.”

Just about any yoga pose that challenges you can help strengthen your core. But some can be particularly helpful for targeting those muscles.

Yoga has a lot going for it. It can help you tune in to your breath, relieve stress, and improve your balance and flexibility. It can also help tone your muscles — including your core.

“Understanding how to activate your core and utilize your core muscles is central to the physical practice of yoga,” says yoga instructor Valerie Williams, E-RYT 500.

Williams shares ways that yoga can help strengthen your core muscles and guides us through five poses that target your midsection.

Yoga poses to strengthen your core

Just about any yoga pose that challenges you can help strengthen your core. But some can be particularly helpful for targeting those muscles.

Start by holding each of the following poses for about two to three breaths at first. As they become easier, challenge yourself by holding them longer.

1. Tabletop balance

This pose can help strengthen your core and lengthen your spine, but it may not be right for you if you have chronic knee problems or difficulty with mobility in your arms or shoulders.

Person doing tabletop balance yoga pose
  1. Start on your hands and knees.
  2. Engage your core by pulling your belly muscles inward and keeping your lower back flat.
  3. Reach forward with your right arm. Keep your chin tucked.
  4. Lift your left knee and straighten it behind you. Keep your hips level and toes pointed downward.
  5. Return your hand and knee to the floor.
  6. Repeat on the other side.

2. Plank

This simple pose can help develop strength in your upper body, forearms, wrists and front abdominal muscles.

Person doing a plank yoga pose
  1. Start on your hands and knees.
  2. Lift your hips and straighten your legs out behind you, like you’re about to do a push-up.
  3. Engage your core by pulling your belly button upward.
  4. Pull your shoulder blades together and squeeze your front thigh muscles.
  5. Keep your body in a straight line from the crown of your head through your heels.

Variation: Drop to your knees to lighten the load.

3. Side plank

Side planks can help improve your balance and work your core without putting too much pressure on your back.

Person doing side plank yoga pose
  1. Start in a plank position.
  2. Plant your left hand on the floor as you turn your body and raise your right arm above you.
  3. Balance on the outside of your left foot, with your right foot on top.
  4. Make a straight line from your left palm, through your shoulders and all the way to the tips of the fingers on your right hand. Keep your hips stacked on top of each other with your bottom hip lifted away from the mat.
  5. Repeat on the other side.

Variation: To make this pose easier, bring your bottom knee to the floor.

4. Boat pose

This pose can be challenging at first. But it can give your core a good workout.

Person doing yoga boat pose
  1. Start in a seated position, with your knees bent.
  2. Lean back about 45 degrees and place your hands, palms down, on the mat behind you, bending your arms slightly.
  3. Lift your feet off the floor and hold your shins parallel to the mat. Balance on your sit bones (butt).
  4. Pull your belly muscles inward. Keep your chest lifted and your back straight. Point your toes up.

Variation: For an added challenge, extend your arms in front of you, parallel to the mat, or straighten both knees. At its most challenging, your body will take the shape of the letter ‘V.’

5. Chair pose

This standing pose puts a lot of focus on your thighs and ankles, demanding more from your core muscles.

Person doing yoga chair pose
  1. Stand up straight with your feet together.
  2. Bend your knees slightly and press your inner thighs together as you shift your weight to your heels.
  3. Drop your tailbone toward the ground, like you’re sitting in an invisible chair.
  4. Bring your palms together and raise your arms above your head.

Variation: To make this pose easier, bring your palms together in front of your chest. For an added challenge, sink your butt deeper into your “seat.”

Tips for your safety

Before you jump in, consider these guidelines to build your core strength with yoga safely:

  • Focus on your breath. Throughout your practice, keep your breath slow and deliberate. Breathe in through your nose and out through your mouth.
  • Move with care. Transition in and out of poses slowly to protect your muscles and joints.
  • Be gentle. Don’t try to force poses that aren’t working for your body. You should feel a stretch, but never pain.
  • Seek advice. If you are in pain, are recovering from injury or are concerned about whether yoga is safe for you, talk with a qualified health care provider, like a physical therapist, before starting any exercise program.

And, above all, enjoy the many benefits.

“Yoga is highly adaptable to your skill level and your goals,” Williams says. “And while it can certainly help strengthen your core and promote stronger muscles, it can also help you to live more mindfully and get in tune with your body.”

You might not be worried about the flu, but it’s a serious illness that merits proactive measures. Here’s why you should get the flu vaccine and when to get it @ClevelandClinic #kidshealth

Healthcare providers across the country are bracing for another season of treating respiratory viruses like the flu, respiratory syncytial virus (RSV) and COVID-19.

And while the flu might not seem like something to worry about, it’s a virus we should all be prepared for. So, you may be wondering, Should I get a flu shot?

“Influenza is a very serious disease, and during a normal flu season, around 40,000 or more people die from it,” says infectious disease specialist Kristin Englund, MD. “So, with any preventable disease, we should do everything we can to protect ourselves.”

Getting your flu vaccine is vital to not just keeping you and your family healthy, but also relieving our over-burdened healthcare system.

To learn more about the importance of getting the flu vaccine, we talked to Dr. Englund, along with infectious disease clinical pharmacist Kaitlyn Rivard, PharmD.

Why the vaccine matters

First of all, Dr. Englund notes that it’s just good practice to get a flu shot every year. She adds that the vaccine’s prevention-geared properties are key.

“When people get influenza or get the flu, it’s not only just the symptoms that they have, like a cough, fever and an infection in the lungs,” she says. “It taxes the body and really puts a lot of stress on all of the other systems.”

That can cause some serious complications, she continues. “You can have a heart attack or even a stroke as a side effect from having influenza. So, we want to make sure that we’re keeping everybody healthy from all of these complications.”

Dr. Englund says that a flu shot is especially important this year because other respiratory viruses like COVID-19 and RSV will be circulating.

“We’re going to have influenza, RSV and COVID-19 coexisting and there’s a lot of overlap between the symptoms,” she states. “We also anticipate that there will be some people who have co-infections, which could be difficult.”

When to get the flu vaccine

We bet you’re now wondering: So, when should I get a flu shot?

Dr. Englund and Dr. Rivard advise getting a flu vaccine as soon as it becomes available. Many healthcare providers, including the Cleveland Clinic, begin offering the flu vaccine at the beginning of September.

And in case you were wondering, the flu vaccine doesn’t interfere with the COVID-19 vaccine or the RSV vaccine.

“All available COVID-19 and RSV vaccines can be given at the same time as the flu vaccine,” clarifies Dr. Rivard. “If someone is coming in for their flu shot and they’re eligible for a COVID-19 vaccine or RSV vaccine but haven’t received it yet, we can offer that. In fact, both the CDC [U.S. Centers for Disease Control and Prevention] and the Advisory Committee on Immunization Practices recommend co-administering almost any two vaccines together.”

She adds that there are very few instances in which certain vaccines can’t be administered at the same time, noting that children often receive multiple vaccines during one visit to their pediatrician.

And there’s no concern about overloading our immune systems with multiple vaccines.

“We’re exposed to things that stimulate our immune system all the time,” Dr. Englund says. “Our immune system is constantly responding to various exposures even if you don’t realize it.”

Why it’s important to get a flu shot every year

One reason it’s so important to get your annual flu shot is this: Protecting yourself is a lot easier than treating the flu.

“There are some treatments available for the flu that are evolving,” Dr. Englund says. “But to avoid the disease altogether or to only have a mild case because you’ve been vaccinated is much better than trying to treat it. Prevention is best.”

And that goes equally for kids — it’s also crucial to get them vaccinated for the flu.

“It’s important for children to get the flu vaccine, too, because the circulation of flu in children, if nothing else, puts adults at risk, too,” emphasizes Dr. Englund.

“Influenza is a serious disease and it’s unpredictable, and otherwise healthy children are unfortunately hospitalized and die every year because of it. So, even for normal, healthy children, it’s really important to get vaccinated every year.”

Pets help raise their owners’ fitness levels, improve blood pressure, cholesterol and blood sugar levels, and boost overall happiness and well-being.😀🤩😜 @American_Heart