By: Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC
Knowing exactly when to wean your baby isn't always easy, but it's an inevitable event for any nursing mother. The key is doing it gradually and making sure that both you and your baby are ready for this transition.
Is this the right time?
Chances are both and your baby have enjoyed the closeness that comes with breastfeeding. In fact, you may want to continue nursing your child through toddlerhood. But your child's active temperament may cause them to be too impatient to continue to nurse.
On the other hand, your child may want to continue nursing long past his first year, particularly before bedtime and when they're in need of comfort. But you may feel the need to move on to the next phase of parenting, with more independence.
The American Academy of Pediatrics recommends continued breastfeeding beyond a baby's first birthday, as long as desired by mother and child.
The simplest, most natural time to wean is when your child starts the process. Weaning may begin naturally at six months, when solid foods rich in iron and protein should be introduced. Some infants begin to turn gradually away from breastfeeding and toward other forms of nutrition and comfort at around one year of age, when they have begun to enjoy a wide variety of solid foods and have learned to drink from a cup. Others wean themselves during the toddler years as they become more physically active and less willing to sit still to nurse.
Gradually tapering off how often you nurse—by eliminating a feeding every two or three days, or even once a week—can help the weaning process proceed smoothly. As your child becomes so busy with new experiences, they may forgets it's time to nurse.
You may, however, decide to start weaning earlier for reasons of your own. These may include the need to be away from home for longer periods, a new pregnancy, job constraints, or even a lack of desire to keep breastfeeding. (It is important to remember, though, that you can continue to breastfeed even if you have become pregnant or return to work. You can reduce the frequency of breastfeeding, for example, and start using some infant formula.)
Did you know that the nutritional content of mother's milk keeps changing beyond the first year to meet a growing baby's needs? It continues to support a baby's immune system, too. And other protective effects tied to mother's milk, such as lower risk of certain cancers in child and mother, appear strongest with breastfeeding beyond a child's first birthday.
Starting the weaning process yourself will not be as easy as following your child's lead. But with care and sensitivity, it's certainly doable. Keep in mind that you have provided the best start for your baby by breastfeeding, no matter how early or late you decide to stop. Some breastfeeding is better than none. No one but you can decide what is best for you and your infant.
A gradual parting: How to wean
The best way to wean is gradually moving toward other forms of nutrition and closeness. Ideally, the number and length of breastfeeding sessions should tapering off over weeks or even months. In this way, you and your child will have time to find other ways to maintain closeness, express and accept tenderness or comfort, and ensure proper nutritional intake before you completely stop nursing. You will also avoid the conflicts and resistance that tend to spring from more abrupt weaning and even minimize your own physical difficulties such as breast engorgement.
One of the most effective ways to begin a gradual weaning process with a child age one or older is simply not to offer a feeding and wait to see if they request it. The easiest first session to skip in this way is usually the midday breastfeeding, when your child may already have had access to a lunch of solid food and such liquids as cow's milk or water.
If your child gets used to missing the midday nursing session, take a look at skipping a second feeding in the same way. Redirect your child's attention to new activities, other food options, and sources of emotional reassurance (such as a favorite blanket or stuffed animal) to help make the transition easier.
If your child decides that they still want to nurse, offer the breast. This will reassure that you are still there for them as they continue to explore their surroundings. If they cling to one or two favorite feeding times—usually the last one before bedtime and the first one in the morning—consider continuing these sessions for as long as they want to nurse. Such quiet times rarely interfere with even the busiest family's schedule, and are a wonderful way to maintain that special closeness with your child.
If your child resists weaning
Some children strongly object to their mother's efforts to move from breast to bottle or cup, no matter how sensitively and gradually the process is approached. This can become frustrating if you want or need to wean by a specific time (for example, if you need to start back to work or school and have decided not to express your milk during separation).
Consider shortening your nursing sessions as a prelude to dropping them altogether. At the times of day when your child is used to nursing, stay away from spots where you usually nurse. Involve your baby in an interesting activity. Avoid such strong nursing cues as pulling them onto your lap, uncovering your breasts in front of them, or even sitting down.
Don't forget to offer your child even more than the usual amount of affection, hugs, and kisses, though. The emotional component of breastfeeding is powerful for the older baby and toddler, and is best replaced with other forms of physical contact and expressions of your love.
If your baby still resists weaning, consider whether you might continue breastfeeding—just less often—while offering a cup, bottle, or other foods at other times. By partially weaning (for example, initially keeping the early morning and bedtime feedings, and then gradually dropping the early morning session), you eliminate a source of conflict between your child and yourself that may turn out to be unnecessary. You also send your child the message that you are paying attention to their feelings and responding to them.
Eventually you can agree with your older child on an endpoint for nursing. In the meantime, your willingness to recognize their needs and provide for them sets an excellent pattern in your relationship for the years to come.
About Dr. Meek
Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC, is the Associate Dean for Graduate Medical Education and the Designated Institutional Official for The Florida State University College of Medicine. In these roles, she oversees The Florida State University College of Medicine sponsored residency programs. As Clerkship Director, Dr. Meek coordinates the pediatric curriculum and training of third- and fourth-year medical students at the Orlando Regional Campus.