Approaches to Weaning

Weaning is one of the few experiences all breastfeeding mothers have in common. It begins when the baby takes food or drink other than mother’s milk and ends with the last nursing. Although weaning is often thought of as an event, it is actually a process. Depending on the approach the mother uses, weaning may be abrupt or gradual. It may takes days, weeks, or sometimes months.

The word “wean” is derived from a word meaning “satisfaction” or “fulfillment.” During most of history, weaning was considered a natural stage of growth, an indication that the child had finally had his fill. Today, however, rather than a natural process to be celebrated, many mothers dread weaning as a time of deprivation and unhappiness. The approach a mother takes can make a tremendous difference in the physical and emotional comfort of both her and her baby. A rigid and abrupt approach makes weaning unnecessarily painful and difficult. But this does not have to be. There are ways to wean that are as gentle and loving as the way breastfeeding began. Weaning gradually and with love–with consideration given to the feelings and preferences of both mother and baby–can make it the positive experience it was meant to be.

TRY TO AVOID ABRUPT WEANING

Abrupt weaning is the most difficult for both mother and baby and should be avoided if at all possible. Abrupt weaning has several serious drawbacks. One is the physical discomfort and potential health complications for the mother. Even though a mother stops nursing, her breasts continue to produce milk. If some of the milk is not removed, her breasts will become overly full and painfully engorged, which may lead to a breast infection or a breast abscess. Abrupt weaning also contributes to depression due to a sudden drop in a mother’s level of prolactin, the hormone released during breastfeeding associated with feelings of well-being. Mothers with a history of depression are especially at risk and should always be encouraged to wean gradually.

There are also drawbacks for the baby. Because breastfeeding is a source of comfort and closeness, as well as food, an abrupt weaning may be emotionally traumatic, leaving the baby feeling as though his mother has withdrawn her love as well as her breast. A gradual weaning is a much better alternative because it allows a mother to gradually substitute other kinds of attention and affection to compensate for the loss of nursing.

Even when abrupt weaning is recommended for medical reasons, there are usually other options. If a mother tells her doctor that she’d like to continue nursing or be given time to wean gradually, alternatives can usually be found. For example, if a drug that is prescribed for a mother is found to be one of the few drugs that are incompatible with breastfeeding, the doctor may be able to substitute another drug if he knows the mother wants to continue nursing. Mothers can contact their local La Leche League Leaders for information on the compatibility of specific drugs with breastfeeding. Even when a mother must take a drug that is incompatible with breastfeeding, she still has the option of temporarily weaning, continuing to express her milk, and returning to breastfeeding later. Many mothers have nursed through medical problems, even surgery. With good information and support, abrupt weaning can usually be avoided.

In the rare cases when abrupt weaning cannot be avoided, for example, the mother with cancer who must begin chemotherapy without delay, physical discomforts in the mother can be minimized. The following suggestions can help: wearing a firm bra for support–one size larger than usual may be necessary–reducing salt intake, not restricting fluids, and regularly expressing just enough milk to relieve discomfort. By gradually expressing her milk less and less often, the mother’s milk supply will slowly decrease. Binding the breasts–which is sometimes still recommended–is an outdated practice that can intensify a mother’s discomfort and cause plugged ducts.

The baby also has special needs during an abrupt weaning. The baby’s doctor should be consulted about what foods to substitute for mother’s milk, which may vary depending on the baby’s age. The baby will also need lots of extra holding and focused attention. Although many mothers feel the urge to distance themselves from their babies while weaning for fear the child will insist on nursing, what a baby needs most during weaning is reassurance that he is still loved.

PLANNED WEANING OF A YOUNGER BABY

If a mother wants to wean her baby before he is ready to wean on his own, a planned, gradual weaning is a much better choice than an abrupt weaning. Eliminating one daily feeding no more often than every two or three days allows the mother’s milk supply to decrease slowly, without fullness and discomfort. It also gives the mother time to make sure her baby is adjusting well to the change and to give her baby the extra loving attention as a substitute for the closeness they shared while nursing. Because some babies have a strong need to suck, they may find another outlet, such as thumbsucking, during or after weaning. If the mother prefers that her child use a bottle or pacifier, she can offer this instead.

The practical details of a planned weaning will depend upon the age of the child. For the younger baby, weaning involves first consulting the baby’s doctor about appropriate substitutes for mother’s milk and then replacing breastfeeding with bottles. If the baby is close to a year old and is drinking well from a cup and eating other foods, after first consulting the baby’s doctor, the mother may be able to substitute other foods and drinks for breastfeeding, forgoing the bottle and going directly to a cup.

For the younger baby, the first concern during weaning is nutrition, since breastfeeding is first and foremost a method of feeding that also provides closeness and comfort. In order to gradually wean a young baby, substitute a bottle for one daily feeding every two to three days. In about two weeks, the baby will be down to nursing just once or twice a day. If there is no rush to wean completely, you can continue these nursings for another week or two. Your breasts will continue to produce enough milk for these feedings as long as your baby continues to nurse.

PLANNED WEANING OF AN OLDER BABY OR TODDLER

Although the health and nutritional benefits of breastfeeding continue for as long as the child nurses, the emotional side of nursing becomes more important as the child grows. The older baby or toddler may develop strong preferences about nursing, as he does about all aspects of his routine, so these need to be considered during weaning.

The planned weaning of an older baby and toddler may require several weeks or months of concentrated time and attention to help a child wean with a minimum of unhappiness before he is developmentally ready. As Dr. William Sears, pediatrician and father of seven, says, “A wise baby who enjoys a happy nursing relationship is not likely to give it up willingly unless some other form of emotional nourishment is provided that is equally attractive or at least interestingly different.” Many mothers have found that the following ideas make the process easier.

Offer regular meals, snacks, and drinks to minimize the child’s hunger and thirst. Also, keep in mind some of the other reasons a child may want to nurse: closeness, the urge to suck, comfort (if hurt, ill, or upset), boredom (nothing else to do), habit, and to fall asleep.

Don’t offer, don’t refuse means breastfeeding when the child asks but not offering to nurse at other times. When used with the following suggestions, it can help accelerate the weaning process.

Try changing daily routines to eliminate nursings without tears. Most children have certain times and places they ask to nurse. Start by thinking about when the child asks to nurse and how to change the daily routine so that he will be reminded to nurse less frequently. For example, if he usually asks to nurse when the mother sits in her favorite chair, she might avoid that chair while she is weaning him.

Encourage the baby’s father to play an active role in weaning. If the child typically asks to nurse upon waking in the morning, the father can be the one to get the child up and bring him to breakfast. Fathers can also help a child get back to sleep when he wakes at night and provide special daytime outings together.

Anticipate nursings and offer substitutes and distractions. This is another time-tested way to make a planned weaning more positive for the child. Think about possible substitutes for nursing and consider again the daily routine and the child’s reasons for nursing. Offer substitutes before the child asks to nurse. (Once a child has asked to nurse, he may feel rejected if a substitute is offered instead.) For example, if the mother has a general idea of her child’s nursing pattern, she might offer a special snack and drink right before a usual nursing time and then take the child out to his favorite place, such as a playground or a friend’s house, as a further distraction. If food is used as a substitute, be sure to offer healthy, nutritious foods, not candy or sweets.

Be attentive to the child’s reactions and respect his preferences. One of these ideas may be more effective than another. For example, the child may be unhappy with postponing nursing but do well with distraction and substitution. Also, certain nursings may be more important to the child than others. If so, the mother can continue those until the end and allow the child to give them up last. If the child clings to these nursings even after he has given up the others, the mother has the option of continuing to nurse him at those times for a while. For example, some children react strongly to giving up their naptime or bedtime nursing. The mother may decide to continue nursing the child to sleep until he is more comfortable giving up those last breastfeedings.

One benefit of a gradual, planned weaning is that the mother can be flexible when unusual situations arise. When a child is ill, for example, he may want to nurse more often for comfort. The mother can then go back to nursing more often until he is feeling better, knowing that weaning can always be resumed then. There is no advantage to rushing weaning, as weaning is a big change for both mother and child and it takes time to adjust to change.

NATURAL WEANING

Although it is more common in our society for babies to be weaned within their first year, through most of human history and in most parts of the world, babies have breastfed for years rather than months, with two to four years being the average. It is likely, in fact, that when the human race is viewed as a whole natural weaning, the third basic approach, is the one most commonly used. Some mothers choose natural weaning because it feels right to them; others choose it because it is the least work.

Many mothers fear that if they don’t initiate weaning that their child will “nurse forever.” Actually, children do outgrow nursing on their own, just as they outgrow other babyish behavior. How long does this take? Just as there is a wide variation in the ages at which children learn to walk, get their first tooth, and learn to use the toilet, the same is true for natural weaning. One child may wean naturally at age one or two while another may be going strong at age three. Reasons one child may nurse longer than another include a strong sucking urge, a great need for closeness and body contact, and an unrecognized allergy or other physical problem. Natural weaning allows for differences in children by letting them grow at their own pace, giving up breastfeeding according to their own timetable. Only one thing is known for sure: all children eventually wean.

BABY’S NEEDS AND MOTHER’S FEELINGS

Although the approach is important, the baby’s needs and the mother’s feelings about weaning will also be factors in how weaning goes. Even at the same age, some children will be more ready than others to take this step. If the child becomes upset and cries or insists upon nursing even when the mother tries to distract or comfort him in others ways, this may mean that weaning is going too fast for the child or that different strategies would be more effective. Other signs that weaning may be moving too fast are changes or regressions in behavior, such as stuttering, night-waking, an increase in clinginess, a new or increased fear of separation, or biting, when it has never occurred before, as well as physical symptoms such as stomach upsets and constipation.

The child will also be influenced by his mother’s feelings. If a mother gives of herself lovingly to her child and feels comfortable and confident in her decision, her child is less likely to have difficulties with weaning. On the other hand, if a mother feels guilty about weaning or about pushing weaning too hard, she may find it more difficult to be loving with her child, which may make the child anxious and increase his desire to nurse.

Although weaning itself is universal among nursing mothers and babies, every weaning is unique. The best advice for making weaning a positive celebration of growth is for the mother to listen to her heart and be sensitive to her baby’s cues. Because breastfeeding is more than milk, weaning is best done gradually and with love.

For more information about nursing beyond the first year, order the book Mothering Your Nursing Toddler by Norma Jane Bumgarner from The Art of Breastfeeding. The cost is $8.95 and you can find it under Books in our Educational Resources section.