At some point in your breastfeeding relationship the topic of weaning will come up. Well-intentioned family and friends will ask and even you yourself will question the when and how of the process.
The American Academy of Pediatrics (AAP) recommends that, “Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.” Babies very rarely self-wean before 18-24 months. If your baby has suddenly stopped nursing or is acting fussy at the breast before this time period, he or she is probably not self-weaning and it is possible that you are experiencing a nursing strike. The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of life, and the introduction of appropriate solid foods at 6 months together with continued breastfeeding up to 2 years of age or beyond.
There is no one right or “natural” time in your or your child’s life to wean. Every baby is different, not every mother has the same breastfeeding goals, and not everyone weans at the same time. Nursing can be a tremendous logistical, emotional, and physical challenge, and there are many factors which may contribute to a situation in which breastfeeding is no longer appropriate for you. We understand weaning from breastfeeding is a very personal decision for each mother. Only you know when it is the right time for your nursing relationship to end, and we support all mothers making their own decisions about when to stop nursing. No matter what age weaning occurs, it is going to be an emotional process for you and your child. Even if you are fully ready to wean, once the process is over you will probably find yourself feeling sad and depressed. Know that this is very normal and common.
Weaning Before Age 1
Before age 1 the primary source of nutrition for your baby is either breastmilk or formula. If you choose to begin the weaning process before your baby is 1 year old, this means that you will need to offer frozen breastmilk, donor milk, or formula in place of each missed nursing session.
When weaning, the key is to take things slowly. You don’t want to abruptly go from nursing 6 – 8 times a day down to 0 nursing sessions a day: this can create problems such as painful clogged ducts or mastitis. Slow and steady is the key. Aim to drop one nursing session a week. Start by picking your LOs least favorite nursing session and offer a bottle instead. For example, if you normally nurse right after an afternoon nap every day, for one week you can offer a bottle and a cuddle after the afternoon nap instead. Choose a different session to drop the next week, and continue this process until you have dropped all nursing sessions. If at any point you start getting clogged ducts, it’s a sign you are moving too fast. Your body will need time to adjust. During the period of adjustment after dropping a nursing session you will notice some engorgement. Try to limit pumping, as pumping tells your body to keep making milk. Instead, try hand expressing just a little a bit for comfort, using cold compresses, and wearing loose-fitting clothing. Your body will soon learn that making milk at that time is no longer necessary, and the engorgement will subside.
How your baby reacts to the process varies very much from baby to baby. If your baby is used to nursing overnight you may experience a sleep regression, and your baby may be extra clingy. If you have been nursing your baby overnight regularly, continue to offer bottles overnight in place of those nursing sessions.
Some women decide they want to wean their babies completely by 12 months. Before 12 months remember that you can not drop nursing sessions without replacing that missed breastmilk with either frozen milk, donor milk, or formula.
Weaning After Age 1
After age 1, weaning changes. A one year old may be offered more solids and alternative milks in place of nursing sessions.
That being said, a little food for thought: Babies develop interest in solid food at different times. While at 12 months some babies may be eating 3 meals a day plus snacks with no problems, others may still only be eating a little solid food and getting the majority of their nutrients or calories from nursing. Abruptly stopping nursing at this point and switching to an alternative milk may not be in your baby’s best interest. While after age 1 you can offer cow’s milk in place of breastmilk, large quantities of cow’s milk are not recommended for toddlers. Too much cows milk can cause anemia. While there are other alternative milks now (soy, coconut, almond, etc), these contain additives and lack the fat and protein that a growing toddler needs. These milks can be a great occasional snack, but they are not adequate to replace breastmilk. If your baby is still not interested in lots of solid food and you want to wean, you may want to consider talking to your doctor about a toddler formula to use instead of cow’s milk.
So, with that being said, after age 1 weaning is different. As with babies, you will want to wean your toddler slowly. Start with the least favorite nursing session and drop one a week. You can either offer a snack or a cup of milk in replace of the nursing session, depending on how often your toddler is nursing and how much milk your child needs.
Expect your toddler to be upset and extra clingy during this process. They do not understand why they can not nurse anymore. Offer comfort and reassurance as well as distractions. Finding activities to do that will keep you busy can help. If you are on the move and doing things, it can be easier to distract a toddler from melting down. If you are in the middle of the weaning process, set a time your toddler can nurse. Say “milk before bed” and reinforce that over and over when your child wants to nurse. Again, it’s going to be difficult for your child so be sure to reassure them often.
The big picture here to take weaning slow and steady. Don’t rush and abruptly go from nursing on demand or nursing 3 times a day to nothing. This will only end in clogged ducts, breast infections, and meltdowns. Understand it will be emotional for you, and that’s okay. Its normal!
Emergency Weaning
In some circumstances, there is a need to wean rapidly: acute medical needs like chemotherapy required for cancer treatment, for example. Weaning in a rush means both that there is no opportunity to gradually taper nursing sessions and that there is no time to prepare emotionally for the weaning process.
If you abruptly stop nursing, your breasts will become engorged. If at all possible, pump and gradually taper down the pumping sessions to reduce the risk of clogged ducts or mastitis. Full breasts signal the body to stop producing milk; removing milk signals your body to continue producing it. Hand expressing small quantities, using cold compresses, and wearing loose-fitting bras or other clothing can help to make you more comfortable. Some measures may also help to more rapidly dry you up: cold cabbage leaves applied to your breasts, strong peppermint tea, and foods with sage added are commonly cited among them. These, along with any medications which have been said to reduce milk supply, should be taken only after consultation with your healthcare provider.
For many women, not being able to respond to your child’s need to cuddle at the breast, or grappling with your own emotional need to connect, may be the hardest part of the weaning process. You may be angry at the need to wean, or overwhelmed by a sudden feeling of separation. It’s normal to feel sad, anxious, or frustrated. Nursing can be a comfort measure for moms and babies both; if you cannot nurse, you may look for other ways to connect and comfort both yourself and your child. If you have a support network, this is a time you may want to lean on it: talk about your feelings. Whether you have a personal support network or not, there are many wonderful community groups and programs for mothers. Be sure to reach out if you are struggling.
