Thinking About Weaning?

by Norma Ritter, IBCLC, RLC

NOTE: This is the third and last of a series of articles about weaning.
You may want to read the previous articles first:
"When is the best time to start my baby on foods other than breast milk?”

"Good Foods for Babies"

Kendra was confused.
"Before I had Jason, everyone was after me to breastfeed. They said it would be good for the baby. So why do they now keep asking me when I am going to wean him? Even some of the articles I read say that there is no reason to keep nursing after the first few weeks. Is this true?”

Tanya had a similar question.
”When I was still pregnant with Davy,” said Tanya, “I thought I would only nurse him for a few weeks before switching to formula. But now I have come to realize how much we both love breastfeeding, and I feel sad when I think about stopping. Davy is 9 months old and eating all kinds of other foods as well as nursing. When am I supposed to wean him?”

There is good news for both of these mothers:
 - Human milk does not suddenly turn to water after a certain length of time!
 - Mothers can nurse their babies for as long as both they and their children wish to continue.
 - Children will wean all by themselves when they are developmentally ready to do so.

Your milk continues to provide both food and health benefits, even after your baby has begun to eat other foods. In fact, it continues to be the most important part of your baby's diet until heis a year old.

Did you know that the American Academy of Pediatrics (AAP) recommends that babies continue to nurse until they are at least a year old, and that the World Health Organization (WHO) recommends continuing to nurse for at least two years?

Why do so many mothers worry about weaning?

I'll bet you have never heard a mother say, “I will make him walk by the time he is xxx,” or “I will make him talk by the time he is xxx.” We KNOW that you cannot make a baby walk or talk before they are ready to do so! All babies are different and there is no reason to set an exact date. The same goes for weaning; children wean when they are ready.

What can I say to people who ask when I am going to wean?
It depends who is asking....

For example, you could:
 - Explain that breastfeeding is the healthy option.
 - Make a joke, like, “Until she goes to an out of state college!”
 - Tell them that your doctor recommends natural weaning.
 - Share that natural weaning is a family tradition.
And if all else fails, ask why they need to know!

Weaning is a process, not an event!

As he gets older, your baby will gradually eat more table foods. You will notice that he needs to nurse less frequently, or for shorter periods of time. However, babies nurse for many reasons besides food. Even when he becomes a toddler, your baby may still  need to nurse to sleep, or when he gets up, or has a boo-boo.

There will also be days when she needs to nurse more than usual, perhaps when she is teething, or coming down with a cold. Nursing can help hercope with these upsets. In fact, many mothers say they could not imagine getting through the toddler stage without nursing to smooth the way. All too soon, your little one will be too busy exploring the world to nurse and that is how babies wean - easily and naturally.

But what if I want a night out with my partner or friends, or to go to the gym?

 - You can pump or hand express some milk to leave for your baby while    you are away.
 - Be sure to nurse immediately before leaving, so that you both will feel comfortable.

What if I have to go back to school or work?

 - You do not have to wean completely from the breast!
 - You can nurse when you are home and pump when you are away, and your sitter can give your baby your pumped milk.
 - Even if you decide to use formula while you are away, you can still nurse when you are home. This is called partial weaning. Even a little milk is important to your baby's health!
(Coming soon: new articles about nursing and working, and choosing a pump.)

What if I get sick and need to take medicine?

Most meds are safe to use when breastfeeding. For those that are not safe, there is almost always another, safer drug available. Your health care provider can look up the meds online at Lactmed, a free government service, before writing a prescription.
Remember, you can always get a second opinion!

What if I want to have an alcoholic drink?

Here are some things you will want to know:
 - Only a very small proportion of the alcohol will go into your milk.
 - Nurse the baby before having your drink.
 - There is no need to pump and dump, because the alcohol will pass out of your milk in the same way it passes out of your blood.
 - It takes about an hour for the effects of one drink to go away.
 - If you are fit to drive then you are fit to nurse.
If you are planning on drinking a lot, pump ahead of time so that your baby will have milk to drink until you are sober. Be sure to have somebody else care for your baby until you are able to do so safely. Do not sleep in the same bed as your baby if you are not sober.

What if I get pregnant?
 - It is usually safe to nurse through a pregnancy, unless there is a history of early miscarriage or some other medical reason to wean.
 - Many women continue to nurse while pregnant.
- During early pregnancy your milk production will probably go down as the milk changes back to colostrum. Your baby may not like the taste and wean on his own.
- Some mothers develop sore nipples when they become pregnant. If this happens to you, you can think about offering shorter nursing sessions rather than completely weaning.
- It will not hurt the new baby if the older child also nurses.
 - A mother who is “tandem nursing” makes enough milk for both children, just as if they were twins.

But people tell me that weaning will make life easier!
 - As a general rule, babies who are weaning need MORE attention, holding and comforting!
 - Breastfeeding is much more than food. It is comfort and medicine too.
 - Your baby will still need to be held and cuddled when feeding. A propped bottle is a choking hazard, and there is a serious risk of inhalation pneumonia.
 - Although some partners start off by doing the night feeds, most don't continue for long, and then it will be YOU getting out of bed every night to heat a bottle when your baby cries.
 - Your baby is more likely to get sick if she is not getting antibodies from your milk, so you may be spending more time at the doctor's office, and need more time off work.

If you need to wean before your baby is ready...

Do what feels right for you and your family. Each mother's circumstances are different!

 - If your baby is under a year old, talk to your doctor about which formula to use, and mention any allergies that run in the family.
 - If your baby is over a year old, ask your doctor about using other milks instead of formula. You may be able to go straight to a cup.

Go slowly!
- Each time you are ready to drop another nursing, for the first couple of days let your baby nurse briefly at that feeding before offering the bottle. This will help him get used to the bottle more gradually. It will also help to prevent you from becoming over full and maybe developing mastitis. If you still feel uncomfortable, pump JUST ENOUGH to feel better.
- Let another person be the one to feed her the bottle if you will be only partially weaning. You will want your baby to associate you only with breastfeeding.
- Be prepared to backtrack. There will be days when your baby is not feeling well and needs to nurse. It is NEVER wrong to listen to your baby! Two steps forward and one step backwards is quite normal.

Bottle feed as much like breastfeeding as possible.
 - Use a slow flow soft bottle nipple that has a wide base and a shorter, round nipple (not the flatter, orthodontic kind.)
 - Start by resting the tip of the nipple on your baby's upper lip, and allowing him to take it into his mouth himself, just as if he was nursing.
 - Keep the bottle only slightly tilted, so that she has to work to get the milk out. If you hold the bottle straight down the milk will come out too fast, and she may feel as if she is drowning.

Start by substituting a bottle for one nursing a day for about a week.
 - The second week, change another feeding to a bottle at the opposite time of day: for example, 10am and 10pm.
 - The next week, change the feeding that is half way between those times, say about 6pm.
 - The next week, change the 6am feeding.
Continue this way until you have completely weaned your baby from the breast.
(If you will be partially weaning, of course you will only need to change to a bottle a few times a day.)

Remember:

You know your baby best, and you know what is best for your family.

                          Trust your instincts and you won't go far wrong.


Want to know more about weaning?

Here is a great book:

How Weaning Happens by Diane Bengson

Here are some articles you may find helpful:

A Natural Age of Weaning by Katherine Dettwyler, PhD

Breastfeeding Past Infancy: Fact Sheet

Comfort measures for mom during weaning

Paced Bottle Feeding-as much like breastfeeding as possible

How much expressed milk will my baby need?

World Health Organization (WHO)
"WHO recommends mothers worldwide to exclusively breastfeed infants for the child's first six months to achieve optimal growth, development and health. Thereafter, they should be given nutritious complementary foods and continue breastfeeding up to the age of two years or beyond. “

The American Academy of Pediatrics (AAP)
"Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother, especially in delaying return of fertility (thereby promoting optimal intervals between births). There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer. Infants weaned before 12 months of age should not receive cow's milk but should receive iron-fortified infant formula."