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Wednesday, October 19, 2011

Bullshitometer: No, the average age of weaning worldwide is not four years…

As we all know, the average age of weaning worldwide is four years. Or rather 4.7. Or possibly 4.2… or 4.5, or “about four”… As with all urban legends, there are dozens of subtle variations on the theme floating about on the parenting websites, blogs and forums, and even on the notorious Extraordinary Breastfeeding documentary, ranging from “the average age of weaning around the world is between two and seven” to “Globally, the average age at which children are weaned is four, according to WHO statistics.”

Being highly suspicious of this dubious-sounding “fact” (for which no sources are ever given), I did a little… well, I hesitate to call it “research,” really: the statement can be debunked with the most cursory of google searches. Just as a little challenge, try googling the phrase “average duration of breastfeeding” (or “mean duration of breastfeeding” does fine too) plus the name of basically any country you care to think of: India, Nigeria, Bangladesh, Bolivia, Egypt, Thailand, you name it. This search will direct you to actual papers written on infant feeding practices in developing countries. What you get is a load of figures like 21 months (Niger), 27.5 months (Nepal), 18-20 months (rural Thailand), 8.7 months (urban China), 18 months (Cameroon), 22 months (Kenya),  20 months (Nigeria), 28 months (Rwanda) and 19 months (Uganda)—that was a random selection, by the way. Seriously, I will mail a box of Godiva chocos to anyone who can find just one country where the average age is even close to four. The longest duration I was able to find was in Bangladesh (31 months) but even that’s a way off. Or, if you are feeling lazy, you could just refer to this table here

The table makes interesting reading for a number of reasons. Did you imagine that mums in sub-Saharan Africa would be nursing the longest? So did I. We’d be wrong, apparently. Also, check the figures for “exclusive” breastfeeding; looks like mums in a lot of poor countries introduce solids pretty early. But these are subjects for other posts.

I’m not sure where the “four years” thing came from, but I’m guessing that what happened at some point in the great game of Chinese whispers that is the internet, is that someone took a look at the Kathy Dettwyler paper (a paper which itself based on some pretty questionable logic, as Mainstream Parenting pointed out—although in fact Dettwyler herself describes the average-weaning-age-is-four-years thing as “neither accurate nor meaningful”) which states that the natural duration of breastfeeding is between 2.5 and seven years and basically stuck a pin halfway in between those two numbers. Presumably somebody else saw this figure being quoted in the same paragraph as the thing about the WHO recommending breastfeeding for two years, and sort of blurred the two statements together in her mind.And so on.

Bullshitometer verdict
So no, the average age of nursing across the world is not four; I’d hesitate to name a figure, but given that only about half the world’s kids between 20 and 23 months are still on the boob, it can’t be all that high. I’m not bringing this point up because I’m trying to tell mothers of four-year-old nurselings not to nurse them, as I guess that is their business. But I am a fact geek, and I do think it sets a poor precedent when we repeat things that aren’t true and don’t bother to check our sources. And then there are the mothers like that poster on a forum I regularly go to, who is tandem nursing a toddler and a baby despite being obviously fed up with it, and is basically trying to get through the experience by repeating to herself over and over again that “the average global age of weaning is four”; if the myth is being used to put pressure on women who want to wean older babies/toddlers, that’s not cool.

Finally, the very fact that people have unquestioningly swallowed such an improbable figure says something rather disturbing about our view of the world of 2011—like we actually think that 80% (or whatever) of the world’s population is still barefoot and living in the mud hut. But I’ll leave it to Hans Roslin to expand a little on this idea in Debunking Myths about the Third World—the video is great fun by the way and is worth watching for the graphics and presentation alone. Enjoy!


  1. Love it!! Can you debunk some more breastfeeding "facts"? I remember with my first little one, I was told:

    1. breastfeeding burns 500 calories an hour
    2. smearing breastmilk on baby acne clears it right up!
    3. your baby will not have eczema if you breastfeed
    4. if you breastfeed and your baby has eczema, smearing breastmilk on it will clear it right up!
    5. your baby will not get ear infections if you breastfeed
    6. if your baby gets an ear infection and you're breastfeeding, just drizzle some breastmilk in the ear; clears it right up!
    7. poop of breastfed babies does not stink

    Yeah, I've got lots more ;)

    1. Breastfeeding burns 300-500 calories per day, not per hour, fact.
      Breastfeeding contains live cells with anitbacterial and healing properties, fact.
      Breastfeeding makes ear infections less likely, the babies ear anatomy can override this rule, fact.
      Breastfeeding babies poop in relation to formula fed babies poop does not smell the same. One has a right to believe one stinks more than the other....

    2. My second child had her 1st ear infection at 6 weeks. She was never given formula or bottles, only breast fed. She had severe reflux, and the breast milk would get in her eustation tubes.

    3. Ah, but ok BK has the facts, yo! Totally get that you thought you had a point, honey, but here's a fact: breast milk is not a miracle potion. It does not prevent eczema, obesity, idiocy, diabeetus, or autism. FACT :)

    4. The 300-500 cal/day didn't make sense for me. I looked at the calories (in formula) my infant was supposed to be eating, and that would only hold true for very young infants. And I think I also threw in some conversion maths (I think I assumed that my body was 80% efficient in converting calories to breast milk, which I felt was pretty generous). So you're looking at way more once the kid starts getting bigger-- especially if you EBF.
      That being said, it wasn't as if I lost any weight in the process but I do remember that I was eating a whole lot.

    5. BK has the correct information. Aleah, I'm sorry if you and your baby did not benefit from breastfeeding, but you are in the minority. Also, you have ironically misspelled the word diabetes directly after using the word idiocy. Honey. :)

    6. RhS… you're as stuck up as a flag pole aren't you.

  2. It is Katherine Dettwyler, not Dewlett. Otherwise I like this post. This has been irritating me for ages!

    Even in "traditional cultures," exluding developed areas, the normal age of weaning is closer to 2 1/2 to 3. I once read a tongue-in-cheek quip in a book on mothering by an anthropologist: "The only people who breastfeed for five years are the !Kung and female anthropologists."

  3. Oops, typo (or whatever it was) duly corrected! I was too busy checking the links all worked correctly. I love the quote about female anthropologists!

  4. Good work!! I love to see facts not myth. I also don't think there is anything wrong with breastfeeding as long as mother and child are both happy, but I like accuracy.

  5. Yikes.....OK, I am a huge supporter of breastfeeding, but if the "average" is 4 years, and knowing how many do not breastfeed anywhere near that long, that means that there are hundreds of kids in elementary and even middle school that are still breastfeeding! Ew!

  6. If all this is fact, why does the WHO recommend breastfeeding for at least 2 years? Granted that is not 4 years, but doing it for at least 2 years must be the norm in a big part of the world for the WHO to have enough evidence to suggest this.

  7. Hi BK,

    To be honest, I don't know what the WHO recommendations are based on... I should imagine that they looked at child survival rates for children in developing country environments and decided that these were better if children were nursed for around two years or more, rather than weaned at an earlier age. In places without clean water or pasteurized milk, I should thing two years of nursing would indeed increase child survival rates. I don't think there is any particular reason why the average weaning age would have to be four for the WHO to make this decision. :)

  8. What forum did you find this woman? You are describing me to a "T".

  9. You can't see me, but I'm shaking my head with my fingers pressed on my nose between my eyes all dramatic like, do note i had to remove my glasses to do so, as i read this blog and the comments.

  10. Ditto at your post Jessica.

  11. BK, I am with you. The WHO recommends breastfeeding two years or longer.
    BFwithoutBS, it did not take much research to find where the WHO recommendation are based on.

    :The Data Bank is maintained and managed in keeping with internationally accepted definitions and indicators. It pools information mainly from national and regional surveys, and studies dealing specifically with the prevalence and duration of breastfeeding and complementary feeding. The Global Data Bank on Infant and Young Child Feeding is continually updated as new studies and surveys become available.

    Data for inclusion are based on indicators from household surveys and for some countries from facility based surveys.

    Further more, you need to do your research on un-Pasteurized milk before you make assumptions about it.

  12. Aleah, if there was such a think as a miracle potion, then breast milk would be the closest thing we have to that. You need to check your fact before you open your mouth...

    Breast feeding does lower your chances of Obesity
    Breastfed Infants are less likely to have an ear infection. That does not mean that a breast fed child will never have an ear infection, but the numbers are a lot lower.
    It is a fact that in general breast fed babies are healthier. There is no disputing that.

    If you want to breast feed or not is your choice, but don't distort the truth.

    1. Source on ANY of this? There is certainly NO PROVEN CAUSAL LINK between breastfeeding and obesity. A correlation has been observed. But gosh, I bet if you put on your critical thinking cap, you could come up with your very own confounding factors for those findings. Same with this vague and unsubstantiated claim of "healthier."

    2. There are too many factors that contribute to obesity to PROVE a causal link. I'm afraid that a correlation is the best we're gonna get on this one.

    3. The causal link between obesity and breastfeeding is likely a situation of "A does not cause B; C causes both A and B".

      I imagine a notable portion of bf mothers who choose to breastfeed to so because they want to choose the best, healthiest option for their child based on the best available evidence. Those same mums are also likely to continue to make nutritional choices or their children based on that line of thinking. It does not mean that all breastfeeding mothers will be motivated by the same reasons and will apply good nutritional values later on, it does not mean that formula feeding mothers will encourage bad eating habits, and it does not mean that breastfeeding will prevent obesity. It just means that a large enough number of bf mothers are attuned to issues of health and nutrition to show an impact on figures.

      (/my best guess, anyway.)

    4. The PROBIT study (which is the closest thing we have, so far, to a randomized control study of breastfeeding vs formula) did not find that breastfeeding compared to formula feeding lowered the chance of obesity at age 6, although of course it's entirely possible that something might come up as the groups grow older.

  13. correction.

    Breast feeding lower your babies chance of obesity not yours. However breast feeding does suck the calories away for the mom. That is also a fact.

  14. Thanks for the facts!! What drives me crazy about bf debates is how rude and vicious comments can get! Lets just calm down and be nice, people.

  15. I think this is a great post that sheds light onto how the western world tends to co-opt the experiences of the impoverished developing world and romantize it as normal and natural and inherently better. Just because women in the developing world tend to breastfeed until the age of two or three doesn't mean it is the right thing to do for women and children everywhere or that "we" ought to try to follow that as a model. To use that argument as a basis for long term breastfeeding is to ignore swaths of particulars about their lives and the diversity of the developing: do women want to breastfeed? Do they want to breastfeed for so long? Do they have access to clean water? Does poverty affect their decision to breastfeeding? Does affluence affect their decision to breastfeed? Do they have access to refrigeration? Do they have access to a strong labor market that would pull them away from breastfeeding? I realize WHO bases their studies and surveys on more than just the developing world, but many of their studies on breastfeeding come from there.

    Anonymous July 28, 2012 2:11 PM, the issue being discussed was what studies does WHO base its recommendation on to breastfeed for two years. What you listed as what the base their recommendation on "The Data Bank" in no way cites the studies they use to come up with this guideline. If BFwithoutBS had said oh, the base it on information from "The Data Bank" I doubt that would have been helpful.

    They do have a section on infant and young child feeding which looks amazingly detailed:

    Additionally there is an article called "Infant and Young Child Feeding" where the main argument for breastfeeding until the age of two is that many children are malnourished and breast milk affords an readily accessible sanitary complement to food. So less of an issue if you are not worried that your child is malnourished or in danger of becoming malnourished due to lack of food. Interestingly they still don't cite to studies even showing how they came up with the figures below.

    "Breast milk is also an important source of energy and nutrients in children 6 to 23 months of age. It can provide one half or more of a child's energy needs between 6 and 12 months of age, and one third of energy needs between 12 and 24 months. Breast milk is also a critical source of energy and nutrients during illness and reduces mortality among children who are malnourished."

  16. The reason they say breast feeding helps shed pounds is bc it induces oxytocin which makes the uterus shrink back down quicker via small contractions. And the numbers would be a lot higher if people didn't think it was so gross to bf in public and most mothers quit around 6 months bc that when teeth start coming in. It's all a matter of tolerance... Both with pain and with negative judgements.

  17. For anyone interested in more on this topic here's a link to a Katherine Dettwyler piece.

  18. Interesting post. That was the mum on the Time cover, right?

  19. I would guess that women who live in cultures where they are encouraged to stay at home, including farming/gardening near the home, would breastfeed for longer than women in other cultures. That would lead me to guess that certain parts of Asia and North Africa would have the longest avg. nursing period. Women in sub-Saharan Africa quite commonly have jobs or businesses or work in family fields located a long walk away from their homes.

    I read somewhere (sorry, no source) that Mongolian women tend to wean when a new baby is born, so average length of nursing is two years for all children EXCEPT the last-borns, who tend to nurse for additional years, even up to age 7. I think the "average" (is it mean or median?) duration of breastfeeding probably obscures a lot of different patterns in different places, such as this one (even if this one is not accurate). National average is a really crude measure and it's not specially useful when comparing countries with very different health care systems, nutrition problems, rates of manual labor, etc.

    Also, defining "weaned" is not so simple. What about a kid who nurses only when sick? Or one who nurses for comfort at least once a week, but doesn't actually drink much while on the breast? Or a kid who nurses most days, but gets 90% of his/her calories from other food?

    Chef Carvey, no, that is not the reason they say breastfeeding helps women lose weight. After the baby and placenta are out, most of the extra weight left on the woman is 1. water, due mainly to additional blood volume and 2. fat stored in anticipation of lactation.

    The reason that breastfeeding CAN cause women to lose pregnancy weight gain is that milk production draws down that store of fat. HOWEVER this is not universal. In my own case I was ravenous for a week or two after giving birth and, while I was not weighing myself, my hip measurement increased. When I was weaning my daughter I lost about 10 pounds and went back to fitting into my pre-pregnancy clothing. It seems that in my case my body wanted a constant "reserve fund" of 10lb of extra fat available for making milk. I'm sure I'm not the only woman to have experienced this phenomenon. I make a great anecdotal example, since I always ate what I felt like, so there were no confounding factors besides lactation.

    - RW

  20. Miranda in MelbourneFebruary 24, 2013 at 7:47 PM
    "These results support the hypothesis that duration of lactation may be associated with a healthier metabolic profile and healthier anthropometric measurements, especially lipid levels and waist-to-hip ratio, even years after weaning."

    Breastfeeding for 10 months resulted in better cholesterol levels and skinnier waists even years after weaning.

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  24. It's is virtually impossible for breastfeeding to go beyond the age of 3 in most places around the world.

    In the vast majority of humans, the enzyme that allows the body to break down lactose (the sugar in breastmilk) stops being produced around the age of 2, but usually by the time they are 3 years old. Attempting to continue breastfeeding after that age causes toddlers to become ill, learn to associate breastfeeding with being sick, and self wean.

    Most European descendents and two tribes in Africa have genetic mutations that cause the enzyme to continue to be produced for life. That's why dairy is a major part of the European diet, and you see the dairy cattle farmers among certain African tribes. Everyone else (Asians, other Africans, Australian Aborigines, etc) consider dairy products to be a treat, to be eaten in small amounts, otherwise they get sick.

    American Indians and African Americans tend to have high rates of European genetics after hundreds of years of interbreeding (I won't call it intermarriage, because an awful lot of it was rape of slaves and tribal women) but have what people would consider to be a "high rate of lactose intolerance" compared to those of purely European heritage.

  25. I do not believe that women should be looked at badly or judged for extended breastfeeding. There are millions of stupid things westerners do that we culturally try to impose on other cultures. The decision to breastfeed a toddler is completely up to the family, and we should not be assuming the worst of a mother when she does so in public. There are millions of men molesting their children behind closed doors, worry about that not the woman who wants to have a close relationship with their child and give them the best odds for the future. I Would like to hear another argument against extended breastfeeding other than : ew! He can ask for it!, He can walk! ... that's just wrong! I would like to assume we are all smart women here. Denfend your position with real arguments. What are the actual Cons, and find the proof.. beyong google search. The same thing that is happening with breastfeeding is happening to birth, the naturality of it is being taken away.

  26. I do not believe that women should be looked at badly or judged for extended breastfeeding. There are millions of stupid things westerners do that we culturally try to impose on other cultures. The decision to breastfeed a toddler is completely up to the family, and we should not be assuming the worst of a mother when she does so in public. There are millions of men molesting their children behind closed doors, worry about that not the woman who wants to have a close relationship with their child and give them the best odds for the future. I Would like to hear another argument against extended breastfeeding other than : ew! He can ask for it!, He can walk! ... that's just wrong! I would like to assume we are all smart women here. Denfend your position with real arguments. What are the actual Cons, and find the proof.. beyong google search. The same thing that is happening with breastfeeding is happening to birth, the naturality of it is being taken away.

  27. I am still breastfeeding my 3 1/2 year old.I don't care about anything people say.all I know is that she does not get sick much, she is very smart ( she can read at a 6th grade level in two languages and is a baby genious).she is almost done breasfeeding but I will let her decide when to stop.
    I don't care if people say mean things to me...people that know me are ok with it now since they know how amazing my child is in so many ways. So smart, healthy and very independent too.
    I think breasfeeding has something to do with all she can do but since she is my only child I cannot prove it.
    Say what you want to does not bother me :)

    1. My only child nursed until the age of 8. I called it nursing after about the age of 1-2 yrs., due to his primary nourishment coming from food. I was completely fine with doing the child-led weaning. He would spend the night at his grandparents, cousins, and peers - and not nurse. I agree with you about doing what seems best for you and your child. My son will be 26 this month. I still recall his response to my mother's question about when was he going to stop nursing. Despite his "never" answer, of course he did stop. He continues to have an exceptionally strong immune system, received his undergraduate degree in 2.5 yrs., and is confident, secure, and independent. It is a very individual choice. I think a 2nd child would have made us both do it for much less time. I did go back to school and then worked full-time since he was 1.5 yrs. Breastfeeding, nursing, the family bed, carrying him in a "rebozo," and the support of family/friends (our "village") - worked for us. Compassion, acceptance, and non-judgement of what works for others is paramount. We each try to do our best with the moments we have.

  28. Hmmmm… this study here found a duration of only 15.4 months for the children in the study, but it was a small study of only 86 children. It may well be longer for Mongolia as a whole. I doubt it's as long as four years, though.

    For what it's worth, my child is almost three now, and we are still nursing…. just about. Not every day, but still. I love nursing and totally support extended nursing; I'm just questioning the urban legend about the worldwide weaning age of four. :)

  29. I lived in Cameroun in the early 80s and in different regions among different groups, the consensus at the time was 16 months according to the mums. It also was a country with labour laws that required a break every 4 hours for women to nurse.

  30. The statistic of 4.2 years comes from here:

    And is referenced from authoritative guides such as here:

    You can see that this is not the world average, but a voluntary survey of a group of children who were breast fed over 3 years.

  31. When children are permitted to follow nature's design and wean when they are emotionally ready to, completely devoid of societal shaming and cultural judgment, in my experience it goes beyond four years just as Ms Dettwyler suggested. I have done my own case studies with my kids. My oldest self-weaned at 5.5 and my second hasn't yet at 4.3 yrs. Whether her research was "scientific" enough for you or not does not negate the fact when children are allowed to choose, they will tell you the answer of what their norm is and what their needs are. There has been a lack in many replies here of woman who have the experience to shed light on the subject! As for children getting ill by a lack of lactase enzyme being produced at 3 years of age as Jean above reported, lactase is produced so long as lactose is present, so no, children (including mine) don't get sick nursing beyond 3! And further, are less likely to be ill due to immunoglobulins being transferred from mom still --this happens as long as nursing continues.
    If you really want to know how long before children naturally wean, LET THEM wean naturally. We can argue stats til we are blue in the face. Experience will show you the answer. Men, you can observe in children who are permitted to lead their own weaning.
    We do need to take into account subsequent pregnancies interfering with milk supply and children who quit earlier than they might have emotionally wanted to had a pregnancy not occurred during their nursing experience, so taking abrupt disruptions and nursing strikes out of the equation, we can get a sense of where the truth lies in reality by living the experience and letting our kids show us.