Weaning... What's normal?

“If baby is thriving, but Mom is completely burned out… something has to change.” - William Sears

The true definition of weaning means the moment a baby is eating anything other than mother’s milk - the weaning process has begun.

Weaning means changing the relationship a mother has with her child. Weaning will not immediately help a child sleep through the night, nor decrease night waking. If a mother has been breastfeeding the baby back to sleep it may mean that someone will have to walk or rock the baby back to sleep and that may mean a partner can help. Breastfeeding is definitely not egalitarian, only the mama can do it.

If a mother is feeling ambivalent about weaning she might try asking herself if stopping breastfeeding will make her life harder or easier. If the idea of weaning makes a mother feel sad, she may not be ready to wean. If the baby is resistant, it may help to delay weaning and try again in a few weeks.

Once the mother has decided the time is right, and really because the work of breastfeeding is solely the mother’s work, the decision to wean is hers to make. In our culture, few women are able to meet the AAP and WHO recommendation of breastfeeding exclusively until 6 months and then continuing to breastfeed until age one and as long as is mutually desirable. Breastfeeding is incredibly challenging, and a mother should be applauded for any amount of breastfeeding. If a mother successfully breastfeeds until the baby is 6 months old, breastfeeding is usually the easiest part of her parenting relationship. We also need to remember that breastfeeding is not the only way to bond. A parent holding their baby skin to skin is bonding. It is the place that bonds not the milk. Lack of societal understanding of the importance of breastfeeding means that women are frequently convinced that breastfeeding is a bad habit that needs to be given up. Often, people look at how hard a mother is working and suggest that she should stop breastfeeding to make her life easier. This may or may not be true - it can also be a powerful tool in a mother’s parenting toolkit. For example, breastfeeding contains melatonin and can quickly get the baby back to sleep, ensuring everyone is getting as much rest as possible. It is also a comforting way for a baby or toddler to reconnect after being away from its mother.

If there is a situation where a mother must wean abruptly for medical reasons, then she should continue to pump or hand express enough to keep her breasts comfortable but not enough to empty the breasts. The mother should know that depression is much more common with abrupt weaning and that if the depression is persistent, she should seek help from her doctor. It is easiest on the mother’s body and mood to slowly decrease the number of times per day she is breastfeeding. Weaning too rapidly can cause a rapid shift in the hormones prolactin and oxytocin which can lead to depression.

One myth is that there is no benefit to breastfeeding beyond a year. That is silly, the body doesn’t know how old the baby is and the antibodies and the perfect nutrient content are present as long as a mother continues to breastfeed. Ideally, the decision to wean is made by both the mother and baby.

Most babies, if given access to the breast or pumped milk do not self-wean before age one. It is also normal for babies to need to nurse during the night through the first year of life. The baby’s blood sugar starts to drop in the early morning hours and those are the feedings that are usually non-negotiable. If a tired mama has a partner willing to give a bottle during those hours that may be a way to get a stretch of uninterrupted sleep. Babies fall back asleep more easily at the breast than with a bottle and research shows that breastfeeding mothers get more sleep than bottle feeding parents. Breastfeeding to get the baby to sleep is not the wrong thing to do, it is how we parented for millennia.

Weaning before age one will mean replacing dropped feedings with formula. If a baby is close to a year and loves solids, it may be possible to replace the calories with heart-healthy fats and nutrient dense food. Some examples would be avocado, nut butters, coconut oil on vegetables and meat especially dark meat which is a good source of zinc and iron.

A mother should decide which feeding the toddler cares least about and drop that feeding. A mother can also shorten the length of the feeding by telling the toddler that they will nurse while the mother sings a song and then they are done with that feeding.

When nursing a toddler, the conventional advice is to not offer the breast and to allow the toddler to nurse when requested. A mother can try delaying by saying “Yes, we will nurse after (we get home, we finish this game, we have lunch etc.) If the toddler becomes upset, it means the child was asking to breastfeed because breastfeeding reboots the baby’s mood when their world becomes too frustrating.

Most mothers who have nursed into toddlerhood at some point become frustrated by night feedings. It is easier to wean at night when the child is over 18 months and they can understand concrete concepts. One method is to put a nightlight on a timer and set it for a reasonable time in the early morning. Telling the toddler, “we will nurse when the night light is on and you can have some water if you need something when the light is off”.

A mother should not be made to feel guilty for weaning when she has made the decision to wean. No mother needs to be given permission to quit breastfeeding. It is her body and baby and her decision to make. It is up to health care providers to help solve feeding challenges and support the mother to meet her feeding goals.

Amanda Ogden RN, BSN, IBCLC