Weaning
Weaning is the end of the breastfeeding journey and can occur at any time.
Did you know weaning doesn’t always happen all at once?
The timeline for weaning is unique to each family, and unique to each breastfeeding dyad (an individual breastfeeding parent and child) within a family.
Each breastfeeding relationship is unique, and the circumstances of life that surround each relationship will influence the timing right for the dyad to wean. This may mean that a dyad weans before the timeline deemed ideal or after that timeline has been exceeded.
There is no right or wrong time to wean, if it is what is right for your family.
We can actually break down weaning into two pieces, some of which happen simultaneously for some dyads, while for others these are two separate processes.
The weaning process can be understood as:
The ending of the nursing relationship
and/or
The cessation of milk production
Be sure to define your goals in relation to this, and to make sure your plan for weaning meets these goals!
Weaning Emotional Considerations
Post-weaning depression and depressive symptoms are common, but they are not discussed frequently enough. Weaning is a time of change to the physical relationship you share with your baby, and a time of hormonal shifts.
Normal symptoms associated with weaning:
Feeling tearful or sad
Showing signs of depression
Feeling Irritable
Feeling Anxious
Mood Swings
These symptoms are typically fairly mild, do not impede quality of life, and resolve within a few weeks. If your symptoms are severe or persistent please contact your Health Care Provider to discuss options for treatment.
Who is most at risk for emotional distress with weaning?
Those who abruptly wean
Those who did not meet their original goals for breastfeeding, or feel pressured to wean at a time they would not independently choose.
Those with a history of depression.
Why are the hormonal shifts during weaning associated with depressive symptoms? Weaning causes a dramatic drop in prolactin and oxytocin, both of which are associated with feelings of well being, calmness, and relaxation. Dropping levels of prolactin and oxytocin during rapid weaning are more likely to contribute to emotional distress than a slower weaning process that allows for gradual hormonal shifts.
It is important to understand that these feelings are completely normal, and while weaning changes your physical relationship with your baby, you will find a new normal together. Your hormones will settle out, you will establish a new routine, and things will be alright.
Reasons you might want to consider temporarily postponing weaning:
Baby or mother is sick or hospitalized
Family is traveling, during holiday periods or other period of unusual stress
Baby is teething
Mother has mastitis
Baby is in a growth spurt
Weaning during these times is much more likely to feel traumatic for mother and baby, and contributes to negative child reactions to weaning and maternal depression associated with weaning.
A common concern about weaning is the impact of weaning on a child emotionally, and negative behaviors that may arise in a baby during the weaning process. The cause of these negative behaviors is the change in routine and feelings of loss the child may feel about their breastfeeding relationship. In order to help alleviate these negative feelings about weaning, be sure to substitute other means of physical contact and comfort. Ideas include baby wearing, extra snuggling or lap time, and introducing a comfort item such as a soft toy or lovey for the child.
There are 3 Types of Weaning from Breastfeeding
- Parent-Led Weaning
- Parent-Led weaning occurs when the parent determines the time for breastfeeding to end has come.
Parent-Led weaning may occur at any point in the breastfeeding journey.
Strategies will depend on the age of the baby and the reasons for weaning.
Parents need support during parent-led weaning to develop a plan that respects their desired time frame to wean, as well as respects their baby’s nutritional and emotional needs.
- Child-Led Weaning
- Child-Led Weaning occurs in babies over the age of 12 months at a minimum.
This is typically a gradual process where a child stops being offered to nurse, but is allowed to breastfed as they request.
If a child stops breastfeeding under the age of 12 months this is often a nursing strike, not true child led weaning.
- Society-Led Weaning
- Society-Led Weaning is weaning dictated on a time schedule by society as a whole.
This has been described by anthropologists as occurring between 2- 7 years of age. Typically the weaning process is marked by rituals and celebration.
This type of weaning can be seen within individual families to some degree, with babies nursing for a specified timeframe before the family dictates it is time to mark the end of the breastfeeding journey.
Typically this is associated with milestones such as 6 months, 12 months or 2 years.
3 Parent-Led Weaning Strategies
Parent-led weaning can be done in several ways, depending on your baby’s age, your timeframe for weaning, and your baby’s temperament.
If your baby is under the age of 1, your baby will need to have expressed breastmilk or infant formula in place of nursing in order to meet their nutritional needs. Infants will likely need bottles to meet their needs, but over the age of six months some children happily wean to a sippy cup. Over a year sippy cups should be used instead of bottles, and you should consult with your child’s health care provider to determine what replacement milk to use with your baby.
Replace Nursing Sessions 1 by 1
With this strategy you start by choosing the least favorite nursing session of the child, and therefore the least likely to cause distress, and substitute either an alternative feeding or a distracting activity.
An easy way to accomplish this with an older infant or toddler is to drop the post-nap nursing session in favor of a snack or meal. With this process you drop a session and wait a few days to a week, allowing your body to slowly adjust to less milk production.
After this time passes you can repeat with the next favorite nursing session, and continue repeating until nursing has ended. Some baby’s after 2-3 cycles of dropping a session will stop nursing of their own volition.
Trial Weaning
With a younger infant a strategy that works for many parents is to separate the end of nursing from the end of milk production.
With this strategy you switch the baby from breastfeeding to bottle feeding expressed milk or formula, while pumping for a week or two to make sure the transition away from breastfeeding is successful, then work on dropping the milk supply.
This provides a clear avenue back to the breast should the parent decide weaning did not address the problem it was intended to address.
Stop Trying to Make Breastfeeding Work
With this strategy weaning is not necessarily the intent, but rather the likely outcome of stopping measures in place to preserve breastfeeding in a difficult situation.
With this strategy the parent stops pumping, taking supplements or medications supporting milk production, and while they continue to allow the baby to nurse they don’t necessarily encourage it.
Bottles or sippy cups are given in order to meet the nutritional needs of the baby. This is often an emotional process, but may be the easiest way to address the needs of the parent who has been struggling.
Child-Led Weaning Strategies and Considerations
The biological norm for children to self-wean is between 2-2.5 years, with true self-weaning rarely occuring before 1 year of age.
Babies Under 1 Year
Children younger than a year exhibiting behavior that can be perceived as weaning are often having nursing strikes, which are temporary disruptions to the breastfeeding relationship that, with active management, do not have to result in weaning.
Some parents make a decision during a nursing strike to allow it to be the end of the relationship and that is totally acceptable.
This is particularly common at around the one year mark, which is a goal for many parents, so the nursing strike can bring them close enough to their goal to allow them to peacefully transition to life after breastfeeding.
Toddlers
Younger toddlers are rarely trying to wean themselves, but are at a time developmentally where changing nursing from something the parents offers to something only provided when the child can request it will likely result in reduced nursing sessions and ultimately lead to weaning.
Children at this age are rapidly changing developmentally and often become distracted enough that this process happens fairly easily.
This same strategy, when inadvertently used by a parent not intending to wean their child, may result in premature weaning.
Self-Weaning
Self-weaning is a GRADUAL process occuring over a minimum of several weeks.
This occurs when the child no longer needs the breastmilk to meet nutritional needs (and is past the point of needing a supplemental milk to replace the breastmilk), and they have developed the independence and confidence to move on from the comfort nursing can provide.
NURSING STRIKES
Nursing strikes can be an incredibly frustrating experience, with active management to protect the milk supply, detective work to figure out what has caused the baby to stop nursing, and creativity to coax the baby back to the breast. With younger infants they are normally short lived, but with older infants and young toddlers, they can last for over a week or more, and it can be very stressful on the whole family.
The key to outlasting the nursing strike is to protect the milk supply during this time by pumping or hand expressing so that at the resolution of the nursing strike there are not supply issues to contend with.
Common Causes
Stuffy nose
Teething
Sore throat
Ear pain/infection
Bottle preference reaction to mother’s response to biting
Stress related to sleep training/being left to cry it out
Family stress
Separation from nursing parent
Strategies to End Strikes
Identify the cause and resolve the issues
Lots of snuggles and supportive parenting
Skin to skin contact
Make the breast available but don’t force anything
Offer the breast to a sleeping baby
Remove other options for the baby to satisfy their innate need to suck (using cups or syringes to feed the baby to meet their needs).
Peer Pressure
This is my personal favorite…
Babies love to mimic what they see, and jealousy is an emotion they are incredibly well acquainted with.
Many nursing strikes can be ended by taking the baby to a breastfeeding support group or play group where older babies are openly nursing.
Sometimes the act of seeing another baby nursing is enough to inspire the nursing-striker to come back to the breast happily.
Night Weaning
There is a lot of emphasis on babies sleeping through the night despite night wakings being normal well through toddlerhood. Nighttime nursing continues to function to stimulate milk supply and to meet the nutritional needs of a growing baby, who can consume almost a quarter of their milk intake at night. The decision to night wean should be based on balancing breastfeeding and the family’s overall needs, not on outside pressures making a normal childhood behavior seem pathological.
Night weaning is appropriate for babies over 6 months of age who are consistently gaining weight well IF the family is disrupted by the night wakings. Night weaning can be done in a variety of ways, but there are consistent principles that allow you to help support your baby’s needs while changing the nursing pattern. Common strategies include:
Providing more opportunities for milk and food intake during the day to help meet the baby’s nutritional needs without the need for nighttime nursings
Having the non-breastfeeding parent comfort the child during night wakings to help break the pattern of needing to nurse to fall back asleep
Using clothing or sleeping spaces to make night nursing less convenient for the child to gently discourage it
Substituting other comfort measures for nursing during night wakings
Explaining that nursing is unavailable at night to an older toddler (at least 15-18 months of age).
If night weaning is not working for a family, but the sleep disruptions are too much, it might be worth considering changing sleep routines to allow for the nighttime nursing to take place in a safe sleep environment to allow for more rest for the breastfeeding parent.
Click here for more nighttime weaning resources.
Weaning from the Pump
Much of the discussion about weaning surrounds the nursing relationship, but what about mothers who are exclusively pumping, or pumping to reduce supply after an abrupt end to nursing?
What about the practical matters of weaning off the pump? When weaning from the pump, the goal is to reduce and space out the number of pumps until the milk supply is reduced, while pumping only enough to be comfortable without engorgement.
We want there to be milk remaining in the breast while weaning in order to signal to the body that less milk is desired.
You want to avoid pumping between 11pm and 5am if at all possible as the higher prolactin levels at that time will extend the time required to wean. See The Pumping Weaning Schedule below.
PTC = Pumping to Comfort (not to empty) | √ = Regular Pumping Session
Schedule is based on someone pumping 8 times per day and allowing 6-8 weeks to dry up the milk supply (slower is better to control the hormonal shift)
So, is it always this simple? I wish the answer was yes, but honestly, each person responds to weaning differently, and the desired timeline is different. The best way to make sure you wean comfortably is to do a weaning consultation where we can discuss your current pumping/nursing routine, your milk supply, history of issues with clogged ducts, mastitis, and your desired timeline.
Weaning comfortably can be complicated, but getting this support can really help improve your experiences.
Drying up the Milk Supply
So how long does it take to dry up the milk supply? There is unfortunately no set answer for this, each person's body responds differently to weaning, and some will lose their milk supply rapidly but others take much longer. Typically, it takes a few weeks to bring milk production to an end, but it can be done more rapidly. If you need to wean rapidly, you would greatly benefit from a weaning consultation to make sure you are able to help avoid clogs, mastitis, and manage the engorgement that will occur with rapid weaning. Often times, if rapid weaning is medically indicated, a health care provider will be consulted to help with the medicinal options for drying up the milk supply.
Here are some basic strategies to assist your body in reducing your milk supply:
Just as there are foods and herbs that support healthy lactation, there are foods and herbs that reduce milk supply and assist in the weaning process of drying up the milk supply.
Peppermint candies like Altoids (natural peppermint flavor)
Sage or jasmine tea. Begin with ½ cup tea daily and increase gradually until results are seen
Peppermint tea 2-4 cups per day until results are seen
Tea Designed for Milk Supply Reduction (Earth Mama Brand or Pink Stork get positive reviews)
Parsley, cilantro or sage in food
Apply cabbage treatment to reduce engorgement:
Wash chilled green cabbage leaves and gently score the surface of the leaf to release juices
Wrap leaves around breast & areola, Leave on 20-30 minutes, repeat 3-5 times per day
Apply cold compresses to reduce engorgement.
Medications to discuss with your doctor if other measures are ineffective in reducing milk supply:
Pseudoephedrine, Vitamin B6, and Oral Contraceptives containing estrogen.
Abrupt Ending of Breastfeeding
Gradual weaning is always the preferred means of weaning, it allows for a gradual shift in hormones, and reduces the risks of plugged ducts, mastitis, and discomfort associated with more rapid weaning. However, there are times that breastfeeding comes to an end abruptly. There may be medical situations, or personal circumstances that drive the need for abrupt weaning on the parents’ side. Sometimes the situation prohibits a family from working through a nursing strike. Abrupt ending of breastfeeding is not uncommon, but requires attention to both the emotional and physical needs of the dyad.
For the parent care needs to be given to the emotional impact of the end of a very important relationship, as well as the physical impact of rapid weaning. There is a high risk of clogged ducts, mastitis, engorgement, and physical discomfort. Active efforts to reduce milk supply quickly to alleviate the physical aspect may need to be managed.
Feelings of depression that can be a normal part of the weaning process may occur, as well as intense grief at the loss of a special relationship. Abrupt weaning often prevents the nursing parent from meeting the goals they initially established for themselves, and this can compound the grief. These feelings are completely normal, and attention to these grieving processes should be given the care they deserve.
Some parents find that they feel the opposite about the unplanned ending of breastfeeding. Breastfeeding is a lot of work, and weaning can bring about a new sense of freedom for the breastfeeding parent. If breastfeeding was difficult there may be a sense of relief at moving onto the next stage in your child’s life. Sometimes these feelings in themselves become a feeling of guilt at not grieving the loss of the relationship like other parents.
Whatever your response to an abrupt ending to breastfeeding, you should know that your feelings are normal, and not a reflection on your relationship with your child. Parental relationships are made to move past breastfeeding at some point, and while the transition can be difficult, you will find new ways to interact with and comfort your child. There will be a new normal, and this is a good thing.
How Do I Wean…
Without Getting Mastitis?
Weaning without getting mastitis requires active management of engorgement. There is a fine line between allowing controlled milk stasis to down-regulate the milk supply and engorgement which can lead to inflammation and infection.
Pumping or hand-expressing just to comfort, and comfort measures such as cold compresses and cabbage leaves can help allow the milk supply to dry up without getting mastitis.
Special caution should be taken if there is existing nipple damage or trauma at the time of weaning. This greatly increases the change of infection. It may be prudent to heal the nipples before weaning when possible to reduce this risk.
An Attached Toddler?
When weaning an attached toddler, gradual weaning while replacing nursing sessions with a different form of close parental interaction, as well as an alternative food source is the best strategy to manage the shift.
If your toddler if over 15-18 months, explaining that nursing is unavailable may help the child to understand the new routine without feeling rejected or abandoned.
A Toddler Cold Turkey?
Abrupt weaning of a toddler can be very traumatic, difficult, and should be avoided if at all possible. Sometimes, however, this is what is right for your family. You may want to have the other parent step in to take care of the child for a few days, or to allow the child to stay with friends or family to help with the worst of the transition.
Attention to the emotional needs of the child is very important during this time, and opportunities for physical comfort should be readily available. Offering favorite foods and beverages can help ensure proper intake while the child is transitioning from breastfeeding.
And Choose a New Milk?
If your baby is less than 12 months, your baby should only receive breastmilk or infant formula.
If your baby is over 12 months and eating solid foods well, your baby actually does not need a replacement milk.
The calcium, protein, and fat needs for your baby can be met by offering a well-rounded diet.