Weaning takes time, particularly when a baby has been breast-fed for an extended period.
The following strategies can help both a mother and her baby adjust to a new feeding routine and manage any stress or discomfort that this transition may cause.
1. Know when to stop
Weaning can be a long and challenging process, for both mother and child. It is important to have a strategy in place in order to wean properly.
Women do not need to stop breast-feeding if they are not ready, and do not need to continue breastfeeding if they have had enough.
Nevertheless, a few simple guidelines can help mothers determine whether they want to continue breast-feeding their baby.
The American Academy of Pediatrics recommend that infants be exclusively breast-fed for the first 6 months of their life. Solid foods may be introduced around 6 months. After that, breast-feeding can continue for 1 year, or as long as the mother and baby wish to continue.
Infants over a year old primarily use breast milk as a supplemental food, a source of comfort, and to support the immune system.
Women sometimes consider stopping breast-feeding because of pain, breast engorgement, social pressure, or fear that the baby is not getting enough milk. Women who want to continue breastfeeding, but who are concerned about these issues, should speak with their doctor or a breast-feeding specialist.
2. Ensure adequate nutrition
Women weaning infants less than 1 year old must replace breast milk with infant formula or donor breast milk.
Babies older than 6 months still need formula or donor breast milk, but can also transition to age-appropriate solid foods. Children less than 1 year old should never be given cow's milk, soya milk, or other similar products.
Infants who eat solid foods need adequate protein, iron, and other nutrients. If worried, parents can consult a pediatrician about the right balance of nutrients and ideal daily caloric intake.
Some babies may need a multivitamin or other supplement, particularly if they do not get enough iron or vitamin D.
3. Eliminate stressors
If a woman is unsure, a medical professional can offer advice on when it is appropriate to start weaning.
Some infants wean easily, while others protest. Planning for a difficult transition can help make the weaning process easier. Going slowly can also help prevent stress for the mother and the baby.
A woman can try to choose a time when there are no other significant stressors, such as a deadline at work or a pending vacation.
If possible, it is helpful to spend extra time with the baby, as they are sometimes anxious or clingy during weaning.
Parents should plan on the weaning process taking a few weeks. If the baby needs to be weaned by a particular date, it is a good idea to start the process early.
4. Wean at night
When they are between 6 months and 1 year old, most babies feed less often during the night. This process, known as night weaning, can help mothers get some much-needed rest.
It may also mean that women can sustain breast-feeding for longer, as fewer nighttime feedings can help mothers nurse comfortably during the day.
5. Reduce breast-feeding sessions slowly
It may be tempting to quit breast-feeding in one go, but doing so can cause engorgement, nipple pain, and psychological distress to both the mother and infant.
An easier strategy is to reduce breast-feeding sessions slowly over several weeks.
Start with the session that seems least important to the baby or the one in which the baby eats the least. Give the baby a few days to adjust before stopping the next feeding session. Repeat the process to eliminate each feeding session, up to the last.
The last remaining feeding session, usually an early morning or evening feed, is often the most difficult to give up. Women should allow time for the baby and themselves to adjust. Some women choose to keep this final feeding session going for several additional months.
6. Use a pump
Using a breast pump can help to alleviate discomfort while weaning. It is best to pump only a small amount, to avoid more milk being produced.
Breast-feeding operates according to supply and demand. When a baby drinks more milk, or a woman pumps regularly, her body will keep producing milk.
A women's supply of breast milk tends to taper off as the baby eats less. However, many women experience engorgement and generalized discomfort during this time.
One way to alleviate discomfort is by pumping a small quantity of breast milk. Avoid pumping lots of milk, as that can increase supply. Instead, try pumping for 2-3 minutes, or until any pain has gone.
Women who are weaning their baby can give this pumped milk to the infant at a later feeding session. This pumped milk means that a woman will not have to breast-feed the baby at the later session, which will help the woman's milk supply shrink faster.
7. Manage engorgement
If pumping for a few minutes does not help, breast-feeding women can find other ways to manage discomfort.
Both pumping and breast-feeding can increase the supply of breast milk, which may prolong discomfort and slow the weaning process.
Some strategies that may reduce discomfort include:
- Applying cabbage leaves to the breast. Chilling the leaves may help with swelling.
- Taking a non-steroidal anti-inflammatory drug (NSAID) for pain.
- Applying warm compresses to the breasts before feeding, or taking a hot bath.
- Applying cold compresses (such as bags of frozen peas) after feeding.
- Discussing birth control pills with a doctor. Some women find that taking birth control reduces breast milk supply, which reduces the discomfort of weaning.
- Massaging the breasts to reduce the risk of plugged ducts.
- Wearing a supportive bra, as the breasts may feel heavier. Tight clothing and binding can make pain worse and may even cause a breast infection.
8. Know the signs of trouble
Weaning can be stressful but is rarely dangerous. The two primary risks of weaning are a breast infection and malnourishment in the baby.
Contact a doctor if:
- the mother develops a fever
- the breasts are swollen, red, or hot
- there is green or foul-smelling discharge from the breasts
- the mother has symptoms of depression or anxiety
- the mother no longer feels bonded to the baby
- the baby has less frequent wet or soiled diapers
- the baby experiences a significant change in sleep patterns that last longer than a week or two
9. Comfort the infant
Breast milk is more than a source of nutrition. Breast-feeding also offers babies comfort when they are stressed or afraid. Many babies fall asleep while feeding.
Strategies for comforting an infant during weaning include:
- holding baby in skin-to-skin contact
- offering a pacifier
- distracting a baby who wants to nurse by playing, singing songs, or going for a walk
- rocking the baby
- giving the baby a teething ring chilled in the freezer if they are teething
- establishing a new bedtime ritual that helps the baby fall asleep
Having another parent or caregiver comfort the baby can also help. Infants in the process of weaning may aggressively try to feed. Allowing someone else to comfort or feed the baby can significantly reduce stress for the mother and baby.
Suppressing breast milk
Once your infant has been weaned off breast milk, you will want to stimulate the body to stop producing it, or "drying it up."
Firmly supporting the breasts and reducing the amount of milk expressed from them can help to gradually reduce milk secretion.
This can be a painful process, and milk can back up and cause swelling and aching.
Breast pads can be used in a bra to soak up any leaking milk. Painkilling medication and cold or gel packs inserted into the bra can help to resolve discomfort or pain. Cold cabbage leaves also have a soothing effect on the breasts, but be sure to store them in a refrigerator and change them when they become limp.
If you experience pain in the breasts while lying down, sleep with a pillow supporting the breast area. Those who sleep on their front can use a pillow under the stomach and hips to support the breasts.
Mothers should be patient with infants who do not want to wean. The baby may temporarily regress to an earlier stage of development, be anxious or clingy, or cry more frequently than usual. After several weeks, these issues will improve.