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Extended Breast-feeding
Extended breast-feeding was at one time a very common practice worldwide. Dr. Martin Stein wrote in Parental Concerns about Extended Breastfeeding in a Toddler that “The discussion about extended nursing is similar to that of co-sleeping. They are both characteristics of child rearing that are closely linked to time and place. In most cultures before the 20th century, both practices were the norm. Changes in social, economical, and sexual expectations altered our views of the meaning of breastfeeding and bed sharing.” Extended breastfeeding was encouraged in Ancient Greek, Hebrew, and Muslim cultures. The Koran, the Talmud, and the writings of Aristotle all recommend breastfeeding for 2 to 3 years. In Breastfeeding Beyond 6 Months: Mothers' Perceptions of the Negative and Positive Consequences, Dr. S. B. Reamer states that “Over the past 100 years of American history, the acceptance of unrestricted nursing decreased and the age acceptable for weaning dropped dramatically, until the average weaning age was 3 months in the 1970's.” The current average weaning age in America is 12 months.

Global Practices
While breastfeeding beyond 1 year of age is considered extended breastfeeding in the United States, experts say that the average age of weaning worldwide is 4 to years. In Guinea-Bissau, West Africa, the average length of breastfeeding is 22.6 months and in India, mothers commonly breastfeed their children until 3 to 4 years of age. Stein says that “In India, women often wean their 3 or 4-year-old by putting the juice of a bitter gourd or melon on their nipples.” Although the American Academy of Pediatrics stated in 1997 that “It is recommended that breastfeeding continue for at least 12 months, and thereafter as mutually desired”, the World Health Organization recommends breastfeeding for at least 2 years.

Western Practices
Elizabeth Baldwin says in Extended Breastfeeding and the Law, that “Because our culture tends to view the breast as sexual, it can be hard for people to realize that breastfeeding is the natural way to nurture children.” In Western countries such as The United States of America, Canada, and Great Britain, extended breastfeeding is a very taboo act. It is difficult to obtain accurate information and statistics about extended breastfeeding in these countries because of the mother's embarrassment. Mothers that nurse longer than the social norm sometimes hide their practices from all but very close family members and friends. This is called “closet nursing”. There are several organizations in place to support mothers that practice extended breastfeeding. These organizations include the International Childbirth Education Association and La Leche League International. In a study published by the Journal of Tropical Pediatrics, 24% of mothers nursing past 6 months felt social hostility towards them. This number grew to 42% when mothers were nursing after 1 year of age. Also, 10% of mothers claimed embarrassment when more mobile, verbal toddlers made known in public the fact that they were nursed.

Health Effects
Priscilla Colletto stated in Beyond Toddlerhood: The Breastfeeding Relationship Continues, “The adverse health effects of weaning a child before or during toddlerhood are well documented for Third World countries such as Guinea-Bissau, where children who were no longer breastfed at ages 12-35 months had a 3.5 times higher mortality rate than did their peers who continued to breastfeed.” Dr. Laurence Grummer-Strawn observed that breastfeeding is protective against diarrheal diseases and other infections, breastfed children aged 12 to 36 months in Indonesia have much greater mid-arm circumference than children who have been weaned, and the incidences of malnourishment in breastfed Indonesian children are 3-5% less common than generally encountered in Indonesian clinics. Studies suggest that extended breastfeeding may reduce the chances of otitis media allergies, leukemia, and lymphoma for the toddler, and premenopausal breast cancer in the mother. This is attributed to the fact that the levels of lysozyme, lactoferrin, and secretory IgA are stable and even increase in the breast milk of mothers who are breastfeeding for over 1 year. (Stein 1507). In one study, artificially-fed infants had 2 to 3 times as many episodes of significant illnesses (defined as “otitis media, lower respiratory disease, significant vomiting or diarrhea, and any illness requiring hospital admission”). However, there are also some studied risks involved in extended breastfeeding. Breastfeeding could impair a child's growth if they are not taught to eat other foods as well. Breast milk is alone is not enough for children over 6 months of age and some have observed that children that have been breastfed longer than the norm have less of an appetite for added foods. Stein says that “As long as a toddler is eating a variety of grains, vegetables, fruits, and foods or supplements that provide adequate iron and vitamin D, nutrition will be adequate and appropriate growth and development will be ensured.”

Psychological Effects
In A Time to Wean by Katherine Dettwyler, it states that “Western, industrialized societies can compensate for some (but not all) of the immunological benefits of breastfeeding with antibiotics, vaccines and improved sanitation. But the physical, cognitive, and emotional needs of the young child persist.” Many children who are breast-fed into their toddler years use the milk as a comforting, bonding moment with their mothers. In a 1974 survey of 152 mothers, 17% said that the security their toddlers obtained through extended breastfeeding helped them become more independent, 14% said that extended breastfeeding created a strong mother-child bond, and 14.6% said that extended breastfeeding strengthened their abilities as a mother. Four mothers said that they felt their child was too dependent and one mother considered her child a poor eater. Dr. Stein said that “A mother in my practice who breastfed 2 children until 2 years if age explained that she would slowdown and giver her undivided attention to her child several times each day when breastfeeding. Her children knew that she always had time for those moments each day. This time was also important to the mother for relaxing and unwinding....For many nursing toddlers, the breast comes to serve the same function as a favorite blanket or stuffed animal in providing comfort and a sense of security.” One issue with extended breastfeeding is the ability of the mother and the child to separate. Some say that the desire for extended breastfeeding comes from the mother's inability to let go of “her baby”. Baldwin refutes this statement, saying that the child is the one who chooses when they are weaned, as it is very difficult to force a child to breastfeed.

Legal Issues

There have been several cases where children have been taken away from their mother's care because the courts found the mother's extended breastfeeding to be inappropriate. In 1992, a New York State mother lost custody of her child for a year. She was still breastfeeding the child at age 3 and had reported experiences of sexual arousal while breastfeeding the child. The authorities took the child from the home in the fear that the mother might sexually abuse the child. Later, the social service agency that took over the case said that there was more to the case than could be released to the press due to confidentiality laws In 2000, an Illinois child was removed from the mother's care after a judge ruled that the child might suffer emotional damage because of not being weaned. The child was later returned to the mother and the judge vacated the finding of neglect (Baldwin) A social service agency in Colorado removed a 5-year-old child from the mother, because she was still breastfeeding, but the court ordered the child returned to its family immediately