by Star Rodriguez, IBCLC for The Leaky Boob
this post made possible by the generous support of Fairhaven Health.
In my practice, I do prenatal consults. During these, almost 100% of the time, people ask me, “So, how long am I supposed to do this, anyway?” I typically tell pregnant moms and their families that the American Academy of Pediatrics recommends that you exclusively nurse for 6 months, continuing until at least a year once complimentary foods are introduced. The World Health Organization recommends nursing until two years of age. However, I always caution my families that breastfeeding is a very personal thing between a mother and baby dyad and that people typically have an idea of when they are done nursing. This may vary from what you thought it would be while pregnant, or what it was during other breastfeeding relationships.
There are two different types of weaning. Baby initiated weaning and mother initiated weaning. Baby initiated weaning is probably the easiest way to do it. The baby generally gradually starts nursing less and less until baby just eventually stops. It’s easy for baby and easy for mom. Well, mostly. With either baby initiated weaning or mother initiated, there can be some sad feelings when the breastfeeding relationship ends. Check out the post on weaning ceremonies to find ways to celebrate the nursing relationship.
A word of caution: some babies exhibit behaviors that we call nursing strikes. Nursing strikes are not cues to wean. They are when a baby who is normally fine with breastfeeding, or happy at the breast, will suddenly refuse it and become fussy, often in the first year. This is typically not a baby signaling intent to wean. It is usually linked to something like illness, teething, an increase in social behavior, or something like that. True baby initiated weaning is not usually accompanied by an unhappy baby.
With mother initiated weaning the mother decides, for some reason, to cease breastfeeding. This is a little harder on most babies, because typical breastfed babies like to nurse. It is not, however, as hard as some people make it out to be. I have had patients tell me that they cannot possibly nurse their babies because it will be a very difficult endeavor to wean them. Trust that if you decide you are done breastfeeding, at any age you can stop, and you will probably not have to spend millions in therapy because of it.
I rarely recommend weaning cold turkey (where you just stop weaning, with no gradual step down.) There are a few reasons why this is a bad plan in most circumstances. First, babies don’t often take well to this. If you suddenly stop breastfeeding and give babies just bottles, most of them will be a little confused and a lot upset. Secondly, it’s not great for Mom, either. Moms that wean suddenly often experience engorgement (again!) and can experience plugged ducts and infections. It’s just not a lot of fun.
There are, however, some medical reasons that you may need to wean cold turkey. First, make sure that this isn’t something that will only interrupt breastfeeding short term. If it is, you may be able to pump and dump during that time and resume nursing after if you would like. If it is a long term thing, though, try not to feel guilty or upset. Many of these reasons for needing to wean are serious emergencies to one’s mental or physical health, and in those circumstances, do not worry about the short term effects to your baby. No, it is not ideal. But your baby will not benefit as much from gradual diminishment of breastfeeding as they will from a healthy parent. If you are in pain from sudden weaning, you can express a little milk when you are uncomfortable until your milk begins to dry up. You may be able to use other things to help your milk dry up faster, but if you have weaned for a medical reason, you should always check with your medical provider first.
In lieu of needing to wean immediately, most in the breastfeeding community favor the gradual approach. In this, you replace one feeding, beginning with the least favorite, with something else. For a baby that is nursing as a form of primary nourishment, such as those that are under a year, you will have to replace that feeding with an equal source of nourishment. For most babies, this will be formula or expressed breastmilk. Hopefully, your baby will accept another method of feeding already, but, if not, be sure to keep an open mind. You may offer the new type of feeding; someone else may offer it; and you can think of various different ways to give your baby nourishment (bottle, cup, sippy cup, syringe, etc., depending on age.) If you have an older child who is receiving her primary nourishment from other foods, like most nursing toddlers, you can offer things like water (or another liquid) from a cup, a snack, or some kind of redirection. You can also explain to your child – “We aren’t going to nurse right now, so we’re going to do (whatever) instead.” Older children may not ask for it, and, if that happens, it is probably better to just not say anything at all.
After you have taken out that first, least important feeding, wait a few days or weeks (base this on the comfort of you and your baby – if your breasts are feeling overfull, or your child is not handling the transition well, you should wait a little longer until you adjust) and remove the next feeding. That should be the new least important one. (When I discuss the least important feedings, I mean the one the baby is the least attached to. For example, often, the most important feeding is right before bedtime, and the least is during the day at some point. Your mileage may vary, though.) Again, wait until your breasts and baby have adjusted, and then repeat as needed. You may find that partial weaning, where you remove some feedings while still allowing others, may be an option, too, if you are weaning for non-medical reasons.
During the time that you are weaning your baby, remember to be gentle on them – and you! As I stated before, weaning can be an emotional experience for everyone, and the emotions may vary, a lot. Some people feel happy and disappointed all at once. Whatever you feel is ok. Give your child lots of cuddles and kisses during this time. You will both benefit from this and it will ease the transition. When it is time to wean, whenever that is for you and your child, many moms discover that the relationship they have with their child changes some and while it is normal to miss what you had, new ways of bonding and sharing time together will emerge for you both to enjoy.
_________________________
How old was your baby when you weaned? How did you feel?
_________________________
