How Long Should You Breastfeed? What the Guidance and Evidence Say

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Few questions about a baby's first year attract so many opinions from people who were never asked: the mother-in-law, the neighbour, the online forum at two in the morning. Ultimately, however, only you and your child can give the answer.

This article will not make that decision for you. Instead, it breaks the question down. What do the recommendations actually say, and where do the figures come from? What is the significance of the six-month mark, and what really happens if you breastfeed for more or less time? What does each additional month offer, and when do the gains begin to diminish? What does breast milk still provide in a child's second year? And how can you tell when the time is right for both of you?

There is no single right answer for everyone. There is, however, reliable evidence – considerably more than the usual debate would suggest. Knowing it may not change your eventual decision, but it can help you make that decision more calmly and without feeling that you have done something wrong.

The short answer: the WHO recommends exclusive breastfeeding for six months, followed by continued breastfeeding until the age of two or beyond. Swiss professional bodies recommend four to six months of exclusive breastfeeding and deliberately leave the duration thereafter open – for as long as mother and child wish.

1. How Long Should You Breastfeed? Recommendations at a Glance

The WHO recommends exclusive breastfeeding for six months, followed by complementary foods alongside continued breastfeeding until at least the age of two. Paediatrics Switzerland and the Swiss Society for Nutrition recommend four to six months of exclusive breastfeeding, with complementary foods introduced between the beginning of the fifth and the beginning of the seventh month.

Different figures for the same question can be confusing and are often taken to mean that experts disagree. That is not the case. The recommendations differ because they were written for different contexts.

The WHO issues guidance for the whole world, including regions without safe drinking water, a reliable cold chain or regulated infant formula. In those circumstances, exclusive breastfeeding is not merely less expensive; it saves lives, because any complementary food prepared with contaminated water carries a risk of infection. The six-month recommendation is therefore first and foremost a global public-health recommendation.

Swiss and European professional bodies issue guidance for countries with safe water supplies, strictly regulated infant formula and comprehensive paediatric care. Their recommendations are therefore more flexible – not because they value breastfeeding less, but because the balance of risks is different.

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The right-hand column is particularly revealing. No Swiss or European professional body gives an end date for breastfeeding after complementary foods have been introduced. The wording is essentially the same throughout: continue for as long as it works for both mother and child. The WHO describes two years as a minimum, not a maximum.

The Sentence in the Recommendations That Is Rarely Quoted

Alongside the figures, the official Swiss documents make another point that is quoted far less often. Both the Federal Nutrition Commission's report on the first 1,000 days and the recommendations from Paediatrics Switzerland explicitly acknowledge that some mothers cannot or do not wish to follow this guidance. They, too, should receive support so that their child is fed as well as possible.

This is not a footnote; it is part of the recommendation. Breastfeeding duration is a population-level guideline, not a target for every household. Paediatrics Switzerland states that this is precisely why its recommendations are deliberately open and flexible.

2. Why Six Months? The Evidence Behind the Figure

The six-month recommendation is based on a systematic review by Kramer and Kakuma. It found that babies exclusively breastfed for six months had fewer gastrointestinal infections than those who began partial breastfeeding after three to four months, with no difference in growth.

This review formed the basis of the World Health Assembly's 2001 recommendation. It has since been updated several times and is one of the most widely discussed studies in infant nutrition. Its findings are worth examining closely, particularly because they are more nuanced than the recommendation might suggest.

What the Review Shows

The review compared two groups: babies exclusively breastfed for six months, and babies exclusively breastfed for three to four months and then partially breastfed until six months. Its main findings were:

• Fewer gastrointestinal infections in the six-month group. This is the clearest and most robust finding in the entire review.
• No adverse effect on growth. There were no deficits in weight or length in either high-income or developing countries; the long-feared risk of inadequate nutrition did not materialise.
• Benefits for the mother: longer lactational amenorrhoea – in other words, a later return of menstruation – and, in two studies, faster weight loss after birth.
• One caveat: in regions where newborn babies often have inadequate iron stores, exclusive breastfeeding for six months without iron supplementation may adversely affect iron status. This is not a typical scenario in Switzerland, but it is one reason not to postpone complementary foods indefinitely.

What the Review Does Not Show

This is where the findings become particularly interesting, yet this part is almost never quoted. The largest randomised study included in the review was conducted in Belarus and followed children until the age of 6.5. It found that six months of exclusive breastfeeding offered no advantage over three months followed by partial breastfeeding in terms of height, weight, body mass index, dental caries, cognitive ability or behaviour.

That is a remarkably sober result, and it puts the debate into perspective. The difference between three and six months of exclusive breastfeeding concerns infections during the first year, not long-term development. The review's authors therefore worded their conclusion cautiously: there were no apparent risks in recommending six months of exclusive breastfeeding as general policy. This is the language of a public-health recommendation, not an instruction for every individual.

3. How Long Do Mothers in Switzerland Actually Breastfeed?

According to the 2024 Swiss Infant Feeding Study, 97 per cent of mothers breastfeed immediately after birth. More than half of babies are exclusively breastfed for at least 17.4 weeks, and 53 per cent of babies under ten months are still breastfed.

SWIFS is the fourth national survey of infant feeding since 1993 and was commissioned by the Federal Food Safety and Veterinary Office. It is the most reliable evidence available on what actually happens in Swiss families, and it presents a considerably more positive picture than public debate often suggests.

The factors associated with breastfeeding duration are revealing. A longer total duration was statistically associated with the mother's income, a higher birth weight and – notably – a supportive attitude among those close to the mother: her partner, family and friends. Smoking, a BMI above 30 and health problems affecting the baby were associated with a shorter duration.

The influence of other people's attitudes deserves comment because it is easy to misinterpret. It does not mean that you should breastfeed for longer because the people around you approve. It shows that practical support makes a difference. Mothers who get help at night, do not constantly have to justify themselves and are given a cooked meal instead of advice breastfeed for longer on average. It is therefore worth explaining early on what kind of support you need. For some mothers that means encouragement; for others, it means being left in peace.

The study also identifies knowledge of breastfeeding mothers' rights and workplace culture as areas requiring greater attention, despite improvements since 2014. In Switzerland, then, breastfeeding is less often curtailed by a lack of knowledge than by the conditions mothers face afterwards.

4. What Each Additional Month Offers

The benefits of breastfeeding increase with duration, but not at a constant rate. The gains are steepest during the first weeks and months, after which the curve levels off. The benefits do not disappear, but the difference between ten and twelve months is smaller than the difference between one and eight weeks.

This is the heart of the question ‘how long should I breastfeed?’, yet it is rarely answered in these terms. The usual message – breastfeeding is good, therefore more is better – is not especially helpful when making a specific decision. What matters is where the greatest gains occur over time.

The First Few Days: The Steepest Part of the Curve

Colostrum, the first milk produced after birth, is breast milk in its most concentrated form. The quantities are small – only a few millilitres per feed – but concentrations of antibodies, immune cells and growth factors are at their highest. It also helps establish protective gut bacteria and acts as a mild laxative that helps the baby pass meconium.

In practical terms, if you are unsure whether breastfeeding is right for you, the first few days offer the greatest benefit relative to the effort involved. Even breastfeeding for just one week gives your baby something that cannot be provided later.

The First Few Weeks: Protection from Infection and Establishing Breastfeeding

Milk production becomes established during the first few weeks. Protection from infection matters particularly at this stage because the baby's immune system has not yet developed much defence of its own. In the Lancet meta-analysis by Victora and colleagues, protection against gastrointestinal and respiratory infections and middle-ear infections was the best-supported benefit of all.

At the same time, the first six weeks are when most mothers who stop breastfeeding do so – often because of problems that could have been resolved with professional support: sore nipples, positioning and attachment, feeding too infrequently or an undiagnosed tongue-tie. If you want to breastfeed, early lactation support is the single most effective intervention. It often has more influence on duration than any prior intention.

Months Two to Six: The Recommended Window

This is the period at the centre of professional debate. Kramer and Kakuma's review tells us that the difference between three and six months of exclusive breastfeeding is seen in gastrointestinal infections, not in growth or long-term development.

In practice, if you introduce complementary foods at four months because you are returning to work or your baby shows clear signs of readiness, you remain within the Swiss recommendations.

Months Six to Twelve: Milk Remains the Main Source of Nutrition

A common misconception is that milk becomes secondary once complementary foods begin. The opposite is true: throughout the second half of a baby's first year, milk remains the most important source of energy and nutrients. Complementary foods are just that – complementary. They add to milk rather than replacing it. At first, puréed meals often provide less energy than the milk they displace.

All professional bodies therefore recommend continued breastfeeding alongside complementary foods. The number of breastfeeds varies greatly from one baby to another and depends largely on how readily the baby accepts other foods.

From Twelve Months: The Period with Few Clear Figures

From this point, the evidence becomes thinner – not because the effects end, but because very little research has been conducted. In high-income countries, so few women breastfeed beyond the first year that studies often lack sufficiently large samples. The next section examines what is known.

How Duration Affects the Mother's Health

Less widely known, but well supported and particularly relevant to duration, is the dose-dependent association with maternal health. Here, what matters is not simply whether breastfeeding began, but the cumulative time a woman breastfeeds over her lifetime.

A pooled analysis of 47 epidemiological studies from 30 countries, including more than 50,000 women with breast cancer, found that breast-cancer risk fell with each additional year of cumulative breastfeeding. Similar, though weaker, associations exist for ovarian cancer and type 2 diabetes. Breastfeeding three children for eight months each adds up to two years – a duration at which the effect is already measurable in these analyses.

The caveat above applies here too. Equally important, these findings support enabling women to breastfeed, not requiring them to do so.

5. What Breast Milk Provides at Different Ages

The composition of breast milk changes continually. It does not deteriorate; it adapts. After 18 months, fat and protein levels rise again relative to the first year, while levels of immune components also increase during the second year.

The claim that ‘there is nothing left in breast milk after a year’ is one of the most persistent myths about breastfeeding. It has been thoroughly disproved, and the data are surprisingly specific.

An Israeli study compared the milk of 34 mothers who had been breastfeeding for 12 to 39 months with that of 27 mothers between two and six months into breastfeeding. Average fat content was around 11 per cent in the longer-duration group, compared with just over 7 per cent, and energy content was correspondingly higher. A 48-month Polish longitudinal study confirmed the pattern: beyond 18 months, fat and protein levels rose significantly while carbohydrate levels fell. The values remained stable from 24 months onwards.

Immune components follow an equally counter-intuitive pattern. Lactoferrin, a protein with broad antibacterial activity, is at its highest in colostrum and falls to its lowest level between months one and twelve. It then rises markedly between months 13 and 24, reaching almost the level found in colostrum.

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6. Breastfeeding Beyond the First Year

Worldwide, the average age at weaning is between two and four years. Breastfeeding during the second year is less common in Switzerland and may therefore seem unusual, but there is no medical reason against it, and the WHO explicitly describes two years as a minimum.

A mother breastfeeding a one-year-old in Switzerland belongs to a statistical minority and is likely to notice this in everyday life. That is a cultural observation, not a medical one. It is worth keeping the two separate, because comments from others often present themselves as medical concerns.

The Case for Breastfeeding for Longer

As described above, the nutritional contribution is not negligible: fat levels actually rise, and immune protection increases again during the second year. There is also a practical benefit that many parents recognise. Toddlers who are unwell and refuse food and drink will often still breastfeed. During gastrointestinal infections, this can help maintain fluid intake.

A third consideration is emotional regulation. Breastfeeding can calm a two-year-old very quickly after a fall, a fright or sensory overload. That is neither indulgence nor dependence; it is simply an effective tool – although not an essential one if other ways of soothing the child are well established.

The Honest Case Against It

The most common concern relates to teeth, and the evidence here is genuinely mixed. Several systematic reviews suggest that breastfeeding protects against early childhood caries during the first year, while an increased risk has been reported beyond twelve months, particularly with night feeds.

At the same time, those reviews note that the studies are heavily influenced by other factors: oral hygiene, sugar intake, frequency of feeds, falling asleep at the breast and social context. Professional bodies do not conclude that mothers should wean earlier. They continue to recommend breastfeeding for up to two years, combined with thorough toothbrushing and reduced sugar intake.

A second point is rarely voiced: breastfeeding for longer creates practical constraints. A child who can fall asleep only at the breast limits the extent to which other caregivers can take over. For some families that is not a problem; for others it matters considerably. It is not a medical argument, but it is a legitimate one.

The Myth of the Dependent Child

There is no reliable evidence that children breastfed for longer become clingier, less independent or less able to soothe themselves. Attachment research shows the opposite pattern: children whose needs receive a consistent response explore more, not less. A secure attachment is the base from which a child gains the confidence to venture out.

What can be observed is something different: a two-year-old who is still breastfed stands out. In everyday life, being statistically unusual can quickly be mistaken for something unusual about the child.

7. How to Tell When the Time Has Come

There is no medically correct time to stop breastfeeding. Signals from both sides can guide you: waning interest from the child, shorter feeds and falling asleep more easily without the breast – and, on your side, exhaustion, aversion or the feeling that you are merely functioning.

So far, this article has focused on data. This section addresses the question that the data cannot answer, which makes clear practical indicators all the more valuable.

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Two qualifications are important when interpreting this table.

First: a temporary loss of interest is not a sign that a child is ready to wean. Nursing strikes occur regularly between three and eight months, when a baby suddenly refuses the breast, often for several days. Teething, illness, a change in surroundings or a painful experience during a feed are common triggers. These phases pass if they are not interpreted as the end of breastfeeding.

Second: your signals matter just as much. ‘For as long as mother and child wish’ genuinely means both. It is not a failure to wean while your child would still like to breastfeed. A mother who is completely depleted has less to give her child than one who has found a way to recover.

There is also an emotional aspect that is rarely discussed. Prolactin and oxytocin levels fall during weaning. Some women experience sadness or a vague sense of loss at this stage even when they are entirely comfortable with their decision. This is a recognised, temporary effect and does not mean the decision was wrong. Gradual weaning makes the transition noticeably gentler than stopping abruptly.

8. The Most Common Myths About Breastfeeding Duration

Four false assumptions are particularly likely to shorten breastfeeding: that breast milk has no value after a year, that weaning improves sleep, that soft breasts mean an inadequate milk supply, and that complementary foods replace milk.

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9. Breastfeeding and Returning to Work

Maternity leave in Switzerland lasts 14 weeks. During the baby's first year, mothers who return to work are entitled to paid breastfeeding breaks of at least 30, 60 or 90 minutes per day, depending on their working hours. Expressing milk has the same legal status as breastfeeding.

For many mothers in Switzerland, returning to work is the real turning point. Fourteen weeks is early in relation to the recommendations, and the question becomes less ‘how long should I breastfeed?’ than ‘how can I make this continue?’ This is precisely why the SWIFS study identifies workplace breastfeeding culture as an area requiring action.

In practice, there are three main approaches. None is inherently better than the others; they suit different jobs, commutes and personalities.

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Many mothers find it reassuring that the body adapts. If there is no breastfeeding or expressing during the day, milk production falls at those times; morning and evening feeds are usually unaffected and can continue for months. For many families, partial breastfeeding is not merely a transitional stage before weaning but a stable arrangement well into the child's second year.

How Childcare Can Help

Whether breastfeeding continues after a mother returns to work depends not only on her employer but also on the nursery. In everyday life, there is a significant difference between a setting that treats expressed milk as an exception and one with an established procedure for handling it.

Some providers have developed a dedicated approach. Little Star Day School, for example, supports breastfeeding mothers through the transition with its Bottle Bridge© programme. Specially trained baby-care practitioners follow the baby's established feeding routine, use set procedures for handling expressed milk and, when needed, provide a private space for breastfeeding at the nursery. A mother who works nearby can therefore breastfeed her baby on site rather than relying on bottles.

What is particularly notable about this approach is what it does not do: it does not prescribe a direction. Support explicitly covers breast milk, formula or both, and the decision remains with the mother. That is what matters – childcare with an informed approach to breastfeeding, not an opinion about it.

10. When Breastfeeding Does Not Work – or Is Not Right for You

There are many legitimate reasons not to breastfeed or to stop sooner: medical conditions, medication, pain, inadequate milk production, psychological strain, work circumstances or a personal decision. Infant formula is strictly regulated and safe in Switzerland.

Breastfeeding is a biological process, and biological processes do not work in the same way for everyone. Anatomical differences, hormonal causes, previous breast surgery, certain medicines, severe pain or a genuine disorder affecting milk production are real; they are not a matter of effort or willpower.

There are also situations in which breastfeeding may be possible but comes at too high a cost: severe exhaustion, a traumatic birth or mental-health difficulties after delivery. A mother who switches to a bottle and is consequently able to sleep, eat and connect with her child is making a sound decision for that child. This is exactly what the official Swiss recommendations mean when they say that these mothers, too, should be supported.

If you want to breastfeed and it is not going as hoped, early professional support is the most effective intervention – far more effective than advice from those around you. In Switzerland, you can turn to your midwife, an IBCLC-certified lactation consultant, your municipality's parent advisory service or your paediatrician. And if you feel under pressure, that too is a reason to speak to someone.

11. Frequently Asked Questions About Breastfeeding Duration

Is there a minimum length of time for which I should breastfeed?

There is no mandatory minimum. Colostrum provides the greatest benefit per feed during the first few days, when concentrations of antibodies and immune cells are at their highest. Even a short period of breastfeeding is therefore worthwhile.

Why does the WHO recommend six months while Switzerland recommends four to six?

The WHO issues global guidance, including for regions without safe drinking water. For high-income countries, ESPGHAN finds no evidence that introducing complementary foods in the fifth or sixth month is less beneficial than introducing them in the seventh.

Does six months of exclusive breastfeeding offer more benefit than three?

For gastrointestinal infections, yes. However, the largest randomised study found no difference at age 6.5 in height, weight, BMI, dental caries, cognitive ability or behaviour compared with three months of exclusive breastfeeding followed by partial breastfeeding.

Is breastfeeding after the first year still beneficial?

Yes. Breast milk does not lose its value. After 18 months, fat and protein levels are actually higher than during the first year, while lactoferrin increases markedly again during the second year.

Is it true that breast milk eventually becomes ‘watery’?

No. Studies of breastfeeding beyond twelve months show higher fat and energy levels than during the early months. The composition adapts; it does not become depleted.

How long do mothers in Switzerland breastfeed on average?

According to SWIFS 2024, 53 per cent of babies under ten months are still breastfed, while more than half are exclusively breastfed for at least 17.4 weeks. In the 2014 survey, the median total breastfeeding duration was 31 weeks.

Does prolonged breastfeeding increase the risk of tooth decay?

The evidence is mixed. Breastfeeding appears to be protective during the first year, while several studies report an increased risk thereafter, strongly influenced by oral hygiene and sugar intake. Professional bodies continue to recommend breastfeeding for up to two years alongside thorough toothbrushing.

Will my child sleep better if I stop breastfeeding?

Usually not. Night waking depends on a child's developmental stage, not the type of milk they receive. After weaning, many families find that the waking continues; only the quickest way of settling the child back to sleep has gone.

Do children who are breastfed for longer become less independent?

There is no reliable evidence for this. Attachment research shows the opposite pattern: children whose needs receive a consistent response tend to explore their surroundings more, not less.

My child suddenly refuses the breast – is that the end?

Usually not. Nursing strikes are common between three and eight months and can be triggered by teething, illness or changes in the baby's surroundings. They often last only a few days.

Can I continue breastfeeding if I work?

Yes. During your baby's first year, you are entitled to at least 30 to 90 minutes of paid breastfeeding time each day, depending on your working hours. Expressing milk has the same legal status as breastfeeding, and the breaks may be divided.

Will my milk supply disappear if I stop breastfeeding during the day?

Milk production adapts to the times at which milk is removed. Supply falls during the day, while morning and evening feeds usually remain stable and can continue for months. Partial breastfeeding can be maintained long term.

When can I introduce complementary foods?

Swiss professional bodies recommend starting between the beginning of the fifth and the beginning of the seventh month, but not earlier. Developmental readiness matters more than age alone: sitting upright, showing interest in food and a diminishing tongue-thrust reflex.

How can I wean without developing engorgement?

Proceed gradually by replacing one breastfeed every three to five days. If your breasts feel uncomfortably full, express only enough milk to feel comfortable. Contact your midwife or doctor if you develop redness, a hard area or a fever.

Is infant formula worse than breast milk?

Infant formula is strictly regulated by law in Switzerland and fully covers nutritional requirements. Breast milk also contains antibodies and living cells that cannot be replicated. A healthy child thrives on both.

Conclusion: There Is No Single Right Answer – and That Is a Good Thing

How long should you breastfeed? The recommendations are clear, yet more open than they are often presented. Six months exclusively, followed by continued breastfeeding for as long as it works for both mother and child: that is the international consensus. Swiss professional bodies recommend four to six months of exclusive breastfeeding and deliberately leave the duration thereafter open.

The evidence can be summarised in three sentences. The benefits are greatest at the beginning and level off over time. The difference between three and six months of exclusive breastfeeding concerns mainly gastrointestinal infections, not long-term development. And breast milk does not lose its value during a child's second year; it is simply less well studied at that stage.

The remaining question is what to do with this information. Three thoughts may help.

Think in stages, not targets. Resolving to ‘make it through a year’ creates pressure on every difficult day. Deciding to ‘see how things are next week’ works better and often takes you further than expected.

Separate the decision from any judgement of yourself. Whether you breastfeed for six weeks, six months or two years says nothing about how good a mother you are. It reflects your circumstances: your body, work, health, energy and child.

Seek support before things become unmanageable. Most mothers who stop breastfeeding do so not because they lacked the desire, but because a solvable problem remained unresolved during the first few weeks. Lactation support in week two is more effective than any resolution made in advance.

And if you ultimately take a different path from the one you planned, that is a decision, not a failure. Your child needs a mother who is well enough to be present. How the milk reaches your child is secondary.

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This article is not a substitute for individual medical advice. If you have questions about your health or your child's health, medicines during breastfeeding or any symptoms, contact your midwife, doctor, an IBCLC-certified lactation consultant or your municipality's parent advisory service. Information correct as at September 2026.