How do I wean?

Recently a mother called for advice about weaning. Her baby was approaching his first birthday and mom had achieved her breastfeeding goals. She was calling for advice about the weaning process. A big CONGRATULATIONS! to this mother for achieving what many do not: reaching her breastfeeding goals.

Her question inspired me to write about the weaning process. This blog will be the first of four to explore this important step in the breastfeeding journey.

Part 1: PREPARATION

Role of Breastfeeding in Mother’s and Baby’s Life
Weaning is a unique experience for each mother-baby couplet.

  • Nutrition: Certainly weaning is a change in the baby’s source of nutrition.
  • Comfort: Breastfeeding has also served as a source of comfort, as a bonding time for mother and baby.
  • Sleep: And, often breastfeeding is the means by which a baby falls asleep.

The process of weaning is the least traumatic for both mother and baby (and the rest of the household) when weaning is gradual and addresses all three components: nutrition, comfort and sleep.

Is baby’s behavior confusing mother?
Sometimes a mother notices changes in the baby’s behavior and worries he is beginning to wean too soon. Research has shown that a frequent reason that mothers give up breastfeeding before reaching their goal is misinterpreting normal developmental changes as a sign that baby is beginning to wean. [1]  Dr. T. Berry Brazelton has described Touchpoints, or predictable times in a baby’s life as he is approaching a surge in development, when his behavior will disorganize for a few days.[2]  As the baby approaches a Touchpoint, mothers may worry that their breast milk is no longer satisfying the baby. [3]  Jan Tedder, FNP-BC, IBCLC, has developed the Roadmap to Breastfeeding Success as a component of the HUG Your Baby program[4]  and includes strategies for each Touchpoint.[5]

When it’s time to wean
From the mother’s point of view, weaning is the decreasing and discontinuation of breast milk production. Every woman’s experience is unique. At one end of the spectrum is the mother who continues to breast feed one child through her next pregnancy, followed by tandem nursing both infant and toddler. Sometimes a woman will intend to continue nursing. But with the hormonal changes of pregnancy, particularly the rise in progesterone, it is not uncommon for her milk supply to decrease dramatically at mid pregnancy. Baby may continue to comfort nurse, or may lose interest and turn more to bottle or cup feeding stored expressed breast milk or formula.

Sometimes weaning can be abrupt due to a health issue of mother or baby, or separation such as military active duty. More commonly baby will begin to skip a nursing session here or there until no longer nursing at the breast. Some mothers largely wean but continue one nursing an evening for comfort and closeness. Or the mother may elect to wean. And other mothers feel encouraged (even pressured) to wean when THEY are not ready.

Many breastfeeding mothers return to work by choice, by necessity or both. This can be the first change in her breastfeeding relationship with her baby. Watch for another blog to address planning and coping with the return to work.

The American Academy of Pediatrics recommends only breast milk for the first 6 months of life.[6]  At times it may be necessary to include formula for adequate nutrition or due to family circumstances. The first steps of weaning are taken when ‘solid food’ is introduced. A baby is ready for complementary foods when she has good head and trunk control, the normal reflex to thrust her tongue forward is subsiding and she is showing an interest in or reaching for food when at the table with her parents.

Analyze breastfeeding roles and patterns
As you consider weaning, notice the roles breastfeeding plays in your baby’s daily life. While you may be feeding on demand, look for patterns in times of day that your baby is hungry or sleepy. When your baby is fussy can other family members amuse or comfort him or is the breast everyone’s ‘go to’? When it is time for nap or bed, does baby always nurse until deeply asleep, or are there other options that work, such as rocking until calm and drowsy, then putting baby down to finish falling asleep in the bassinet or crib. Perhaps your baby is accustomed to nursing several times during the night. These considerations influence your planning and strategies for preparing to wean.

Watch for more blogs discussing the weaning process:
* Helping Your Baby Sleep without Nursing
* Meeting Your Baby’s Nutritional Needs While Weaning
And a companion blog:  * Return to Work

[1] http://www.uptodate.com/contents/starting-solid-foods-during-infancy-beyond-the-basics
[2] https://www.brazeltontouchpoints.org/family-resources/touchpoints-your-baby/
[3] http://givethehug.blogspot.com.es/2009/08/dr-t-berry-brazeltons-touchpoints.html
[4] http://givethehug.blogspot.com/search/label/Roadmap
[5] http://givethehug.blogspot.com/search/label/Touchpoints
[6] https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/HALF-Implementation-Guide/Age-Specific-Content/Pages/Infant-Food-and-Feeding.aspx


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