“Weaning should be considered if breastfeeding is no longer mutually desired by either the mother or child,” says Reames. “Many women choose to wean when they return to work or after their baby’s first birthday. At this age, babies are starting to walk, talk, drink whole milk and eat more solid foods so they may naturally lose interest in nursing.”
According to the American Academy of Pediatrics, exclusive breastfeeding should occur for the first six months of a baby's life, followed by breastfeeding in combination with solid foods until at least 12 months of age. The World Health Organization also recommends that moms breastfeed exclusively for the first six months, but that a combination of breastfeeding and solid foods can continue until the child is 2 years old.
However, a mother may need to wean if there are medical conditions. These include if she is HIV-positive, uses street drugs, has active tuberculosis or is receiving chemotherapy for cancer, or if the baby has a rare condition called galactosemia, which affects how the body processes a simple sugar called galactose.
What is the process for weaning?
When possible, weaning should be done gradually so the mother and infant can adjust to the physical and emotional changes.
Reames offers the following strategies:
- Don’t offer it, but don’t refuse it is a gentle approach. This works well for older children, but it can take longer than other methods.
- Skip one feeding each week and replace it with a bottle or cup of breastmilk, formula or cow’s milk (if your child is at least 1 year old). Continue to reduce a feeding session each week until your child is using only a bottle or cup.
- Decrease the amount of time you are nursing. If your child usually nurses for 10 minutes, try five minutes.
- Try distracting and postponing feeding, especially if your child is older. If your child wants to nurse, explain that they need to wait until bedtime. Ask your partner to help with distractions.
- Avoid sitting in your nursing spot and plan a fun activity during the time your child would normally nurse.
- Try to avoid weaning during other major changes, such as teething, illness, a new day care, etc.
If you are weaning slowly, your body should adjust and your supply will decrease accordingly.
If you are weaning off the pump, try to shorten each session by a minute or two every few days or cut out a nursing session every two to three days.
What should I do about engorgement?
If your breasts feel full and uncomfortable, hand express or pump to relieve the fullness but not to empty them. The less milk you remove, the quicker your body will stop producing it.
Ibuprofen and cabbage leaf compresses may provide comfort during this process. Gradual weaning will decrease the likelihood of plugged ducts or mastitis.
How might my body change after weaning?
Once you have completely weaned, your breasts may feel less full, but you may continue to produce small amounts of milk for some time.
With the increase of estrogen post weaning, your period may begin again and be heavier. Consider your birth control options.
How do I prepare emotionally for weaning?
Many mothers have mixed emotions when they decide to wean. On one hand, there is flexibility and freedom that comes with weaning. On the other hand, nursing provides an intimate bond with your child.
Deciding to wean can be very emotional. Find someone you can talk to without feeling any judgement. “You are not a bad mother if you have some resentment toward breastfeeding,” says Reames. “Enlist your support system prior to weaning. Watch closely for signs of depression, which could be triggered by the decrease in oxytocin and prolactin. Know who to call if you need help.”
Try to remember that there are other ways to comfort your child. Be proud of your breastfeeding experience, and consider celebrating it by writing down your breastfeeding story or marking the transition in another way.