How Long Should You Breastfeed a Newborn Baby?

Breastfeeding is an ancient and natural way to feed a newborn baby. But it isn’t easy. If you’ve ever had a child, it’s likely someone has shared an opinion about how you fed them — and for how long. 

In 2022, the American Academy of Pediatrics (AAP) created a new set of guidelines to help guide and support new parents who breastfeed their babies. 

These guidelines are meant for pediatricians, family practice doctors, and others who work with babies and new parents. The goal of the guidelines is to gather the existing science on breastfeeding and provide real-life recommendations so that parents can make informed decisions.

What do the new breastfeeding guidelines recommend?

The 2022 breastfeeding guidelines lay out some recommendations based on the results of scientific research. 

After studying the data, here’s what the experts recommend:

• Nearly all babies should be offered breast milk shortly after birth.

• If exclusively breastfeeding, breast milk is the only nutrition babies need for the first 6 months of life.

• Starting at 6 months of age, other foods can be given in addition to breast milk.

• Breastfeeding should be continued until a baby is at least 12 months old.

• If possible, breastfeeding should be continued until a baby is 24 months old, or longer.

Why should babies avoid other foods until 6 months?

Breast milk is a complete source of nutrition for babies. It contains the right amounts of protein, sugar, fat, and vitamins that babies need to thrive. It also contains inflammatory regulators, immune system antibodies, and other molecules. These bonus ingredients help shape a baby’s immune system and microbiome. 

Research shows that babies who have only breast milk for the first 6 months of life are healthier than babies who don’t. And this advantage sticks around even as they get older.

Why should breastfeeding continue after the first birthday?

The advantages of breastfeeding don’t end at 6 months. At 6 months, many babies are ready to explore other types of foods. But they likely won’t get a balanced meal that way. Breast milk offers complete nutrition through the first year of life — plus the other bonus ingredients that babies can’t get anywhere else. 

Current vs. previous guidelines: What's new?

The clear advice to continue breastfeeding until a baby’s second birthday, or even longer, is new. Older guidelines recommended breastfeeding only until a baby’s first birthday. 

The other recommendations haven’t changed much, and the guidelines describe how well people are following them. 

Here’s what recent data shows: 

• More than 4 out of 5 babies try breastfeeding at some point.

• At 3 months old, just under 1 in 2 babies have only breast milk.

• At 6 months old, about 1 in 4 babies have only breast milk.

• At 6 months old, more than 1 in 2 babies have some breast milk.

• At 12 months old, more than 1 in 3 babies have some breast milk.

What are the benefits of breastfeeding?

Scientific research shows that there are health benefits for both breastfeeding babies and their parents. 

Benefits for babies

Compared to babies who eat other things, babies who breastfeed have lower rates of:

• Lung infections (pneumonia or bronchiolitis) and wheezing

• Severe diarrhea

• Ear infections (otitis media)

• Eczema

• Infant death due to SIDS (sudden infant death syndrome)

• Certain types of bowel disease, obesity, high blood pressure, and Type 2 diabetes later in life

Benefits for parents

Compared to parents who don’t breastfeed, those who breastfeed for at least 12 months have a lower risk of:

• Diabetes

• Hypertension (high blood pressure)

• Ovarian or breast cancer

When is breastfeeding not recommended?

Nearly all babies can be breastfed, but there are a few situations when breastfeeding is a bad idea. Breastfeeding is not recommended when the:

• Baby has classic galactosemia (a genetic disorder that affects metabolism)

• Breastfeeding parent has HIV, brucellosis, human lymphotropic virus, or ebola

• Breastfeeding parent is using certain prescription medications 

• Breastfeeding parent is using illegal drugs

Parents with other contagious diseases should talk to their medical provider before breastfeeding. In some cases, pumping breast milk and feeding it to the baby in a bottle is a safer option.

What are the biggest challenges these guidelines face?

Breastfeeding has clear health advantages. But choosing to breastfeed can be difficult for many families. Breastfeeding can be especially challenging when:

• A baby is born preterm or with a low birthweight, especially if they need to spend time in the NICU (neonatal intensive care unit).

• A baby has feeding problems or health problems.

• The breastfeeding parent is gender diverse (there can be social and/or biological issues). 

• The breastfeeding parent has a medical condition that makes breastfeeding difficult.

• The baby has an adoptive, surrogate, or foster family.

In many cases, medical specialists and lactation experts can find ways to help. Pumping, hand-expressing, or using banked breast milk can provide many of the same benefits when traditional breastfeeding isn’t a good option. You can also check out these resources for gender-diverse parents.

What about working parents?

Many parents work outside the home. Juggling work and breastfeeding can be difficult, especially when parents hope to breastfeed for 2 years or more. 

Some workplaces have found healthy ways to support breastfeeding. But many parents still report facing awkward or discriminatory situations at work. This is especially likely when employers and coworkers don’t understand the value of breastfeeding. 

An important part of the new breastfeeding guidelines is that they clearly state the health benefits of breastfeeding — including breastfeeding through the second birthday. They also support policies that protect breastfeeding in public and insurance policies that cover lactation support. Working parents who choose to breastfeed can use the guidelines to challenge workplace practices that make breastfeeding difficult.

What should you do if you can’t breastfeed?

One drawback to sweeping guidelines like these is the effect they have on parents who can’t — or decide not to — breastfeed. 

When it comes to feeding a baby, the most important factors are the health of the baby, the health of the parents, and the bond that develops between them. Both mental and physical health are important. 

If the stress of breastfeeding is getting in the way of bonding, or if it is creating mental health challenges, breastfeeding might not be the healthiest choice for the family.

Alternatives to breastfeeding

Although the new guidelines promote the idea of breastfeeding only, the fact is that most babies who don’t breastfeed grow up to be perfectly healthy. 

No matter how you choose to feed your baby, keep in mind these feeding basics:

• When you can’t give breast milk, a cow's milk-based formula with iron is the right choice for most babies less than 12 months old.

• After about 6 months, nearly all babies can add a variety of healthy pureed table foods to their diet — in addition to breast milk or formula.

• Baby formula isn’t needed after the first birthday. When you can’t give breast milk, regular cow’s milk is just fine for babies older than 12 months. 

Does combination feeding have the same benefits as breastfeeding?

A combination of breast milk and formula offers most of the same health benefits as breastfeeding alone. But when babies receive formula, they eat less breast milk overall. This gives the breast milk less of a chance to have a positive effect. Over time, it can also lower the parent’s breast milk supply.

Why trust our experts?

Written by:

Kerry R. McGee, MD, FAAP

Kerry McGee, MD, FAAP, has over a decade of experience caring for babies, children, and teenagers as a primary care pediatrician. She has a special interest in adolescent health, particularly in adolescent mental health.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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