NURSING
MOTHERS, INC.
Weaning
Factsheet 7
Weaning is the process by which a baby stops depending on her mother's milk for nourishment. You actually begin the weaning process the first time you give your baby anything other than breastmilk, although final weaning may be months or years away.
When to Wean
There is no "right" time to wean: every family's decision is unique. Weaning is a personal decision for each nursing couple, based on your baby's needs and attitudes, your feelings and the circumstances of your family.
Current guidelines of the American Academy of Pediatrics (AAP) recommends exclusive breastfeeding (meaning only breastmilk: no formula, juice, cow’s milk, or solids) for the first six months of the baby’s life. Most breastfeeding mothers find they begin weaning somewhere between the sixth and ninth month, when they start introducing solid food into their babies' diets. Final weaning may be delayed until the baby drinks from a cup, becomes disinterested in nursing, or when you decide it is time to stop breastfeeding. The AAP recommends nursing for at least one year and thereafter for as long as desired by both mother and child.
While there are no right times to wean, there are definitely some wrong times, especially the following:
· When you have a breast infection. Most experts on nursing agree that weaning during a breast infection or mastitis, actually increases the chance for complications from the infection and adds time to the recovery process.
· When your family is adjusting to other situations such as the baby's teething, moving, illness, etc. These times are already difficult for everyone. This is not the time to add the additional stress of new routines.
· When you think you don't have enough milk, simply because the baby is going through a growth spurt. This is a common, needless time to wean a baby because of feelings of inadequacy. To increase your milk supply, you should nurse your baby more frequently.
· When there is social or family pressure to quit for no good reason. People may offer you unwanted "advice." "Your baby is getting too old to nurse," or "If you keep nursing, your baby will become too dependent on you." Accept their advice with a smile, examine your own feelings, and make your own decisions. There is no one else who knows your baby better than you do. Don't be pressured into doing something that feels wrong. Your Nursing Mothers counselor can help you cope with unwanted criticism.
Types of Weaning
There are three types of weaning, distinguished by who makes the decision to wean:
· Mother-led weaning You decide it is time to stop nursing, although your baby may not show any desire to quit. Gradually you substitute a bottle-feeding or cup feeding for the breast when you feel the time is right. Consider this decision carefully. While the decision to reverse the weaning process is probably not irreversible early on, relactation at a later date may be difficult.
· Baby- or child-led weaning You let the baby wean herself at her own pace, dropping feedings as she indicates she is no longer interested. You may notice during a feeding that your baby nurses a few minutes, stops, and is not interested in resuming. Or there may be times during the day when she totally rejects the breast in favor of other activities. The earliest age for a baby-led weaning is about 9 months (when they first begin attempts to walk), with other common times around 14 and 18 months.
When babies are 3 to 4 months old, they often display seeming disinterest in breastfeeding, playing with the nipple and looking all around. This is the age when babies "wake up" to the world around them. Don't mistake their curiosity and playfulness for a desire to wean. Other nursing strategies will often get you through this period (nurse in a quiet, dark place, nurse when the baby just wakes up, etc.) Rejection of the breast may also signal a nursing strike. A nursing strike may lead to weaning, but it does not have to. Carefully evaluate your situation before deciding your baby is definitely showing interest in weaning.
· Joint or cooperative weaning You help guide your baby to final weaning, adjusting the pace according to your child's needs and desires at a particular time. This may include stepping up nursing during a stressful time. There is much give and take in this type of weaning. It usually happens at a slower pace than either mother-led or child-led weaning.
How to Wean
The best way to wean is gradually and sympathetically. Steps in a gradual mother-led weaning, also applicable to joint weaning, are as follows:
· Determine which feeding your baby is least interested in and eliminate it first. You may decide to substitute a bottle or cup for this feeding. If your baby is older, you may choose to substitute play, reading or a snack. You should always discuss with your baby's doctor whether you can substitute formula or whole cow's milk for your breastmilk.
· After a week or more, eliminate the next lightest feeding, repeating this method until you reach the desired number of feedings or eliminate breastfeeding altogether.
· Be prepared to be flexible. Your baby may need the emotional support of nursing during stressful periods when he is ill, extremely tired, or teething. In the big picture, this "backsliding" is only temporary.
Additional suggestions to encourage your child to cut down on nursing include:
· Nurse after feeding solids to the baby rather than before.
· Shorten the feeding sessions, or nurse only on one side at each session.
· Give your baby some food, a drink, a bottle or cup at regular intervals instead of waiting for the baby to ask for a nursing.
· Distract your baby to delay a feeding.
· Give your baby more attention in other ways: play together, read, sing, rock in a rocking chair, plan an outing. In other words, find ways to reassure the child that cutting down on nursing is not your way of rejecting her.
· Change your routine. For example, if you normally sit in a particular chair together to nurse, avoid that place at the time you are eliminating that feeding.
If your baby is weaned slowly in this manner, you should not experience any discomfort from excess milk in your breasts. If you find it necessary, express only enough milk to relieve the fullness. The goal is to convince your body to stop producing milk at this time. Your body accepts this process gradually; you will probably have some milk for weeks after the final weaning. This is typically not uncomfortable and is no cause for concern.
Guideline for Sudden Weaning
Some women must mean their babies very suddenly. They may have a serious illness, or may need to be separated from their babies for extended periods. We encourage you not to wean suddenly unless it is absolutely necessary. Abrupt weaning can be very difficult for both you and your baby. You will run the increased risk of engorgement, plugged ducts or breast infections if you wean abruptly. Your baby may experience emotional upset. Carefully examine your alternatives before proceeding with sudden weaning. Could you pump or manually express your breasts until you can nurse again? You can decide to use a pump to help you wean as the baby normally would.
If you must wean suddenly, you will experience some breast discomfort or pain for several days. You can help relieve this by expressing a little milk until you are comfortable, or using an ice pack. Consult your doctor about taking any pain medication. If you develop a fever or experience any flu like symptoms, contact your doctor immediately.
Temporary Weaning
Sometimes women may require a period of temporary weaning, possibly for medical reasons such as contraindicated medications (these are few), hospitalization or a baby's nursing strike. Sometimes doctors ask a mother temporarily to stop breastfeeding to diagnose late onset jaundice. During temporary weaning, you fully expect to resume nursing. You will need to express milk as often as your baby would normally nurse to maintain your milk supply. Your Nursing Mothers counselor can help you arrange for a pump. Depending on the reason for the temporary weaning, you may be able to give your expressed breastmilk to your baby.
Resuming nursing after an extended temporary weaning may be difficult. Sometimes the baby has gotten used to a bottle or formula (this is more common in older babies.) Perhaps your milk supply has substantially decreased. Most women feel it is worthwhile to at least try to reestablish breastfeeding after a temporary weaning, even though they recognize the weaning may become permanent.
You can minimize the difficulty of reestablishing the breastfeeding relationship by considering alternatives to bottle-feeding for the period you must supplement. Other ways to feed a baby include finger feeding with a supplemental nursing system, cup feeding (even newborns can feed from cups!), spoon feeding, or using an eyedropper or oral syringe. Your baby's doctor best knows the medical history of your child and can offer a recommendation of which method would be appropriate.
If you need to reestablish your milk supply, increase the frequency of nursings for several days. Offer your breast to your baby on demand, as you would if he were a newborn. Within 24 to 48 hours, you should see a substantial increase in the amount of milk you produce.
Summary
Weaning is a personal decision. No two situations or nursing couples are exactly alike, so no two weaning experiences are exactly alike. Being sensitive to your needs, your family's needs and particularly your baby's needs will help you choose the right time and the right weaning style for you.
Keep in mind that no matter how long your baby nurses, whether it is for two weeks, two months, two years or longer, you have given your child the best possible start in life.
Related Factsheets
Nursing
the Newborn Who Has Difficulty Grasping the Nipple or Shows Nipple
Preference
Breast Infections
and Plugged Ducts - Dr. Newman’s Breastfeeding
Handouts
Nursing the Older Baby
Increasing Your Milk
Supply
Revised: 1/92, 2/95 Lisa Davis; 01/03
Megan Allen
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