In Western countries extended breastfeeding usually means breastfeeding after the age of 12 to 24 months, depending on the culture. Health benefits and Psychological effects Health benefits Longitudinal research shows breastfed toddlers aged over 12 months have fewer illnesses and lower mortality rates. Milk composition in the second year of breastfeeding contains significantly higher concentrations of lactoferrin, lysozyme, and Immunoglobulin. These have been shown to support the child's immune system's antibodies. The World Health Organization recommends breastfeeding “up to two years of age or beyond”. The American Academy of Family Physicians (AAFP) states that "[h]ealth outcomes for mothers and babies are best when breastfeeding continues for at least two years. The American Academy of Pediatrics (AAP) recommends "continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant". Psychological effects In A Time to Wean, Katherine Dettwyler 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 "A mother in my practice who breastfed 2 children until 2 years of age explained that she would slow down and give 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 counters that the child is the one who chooses when they are weaned,