Weaning from the Breast

In my previous blog post, we examined the variety of reasons mothers wean from the breast. In this blog post I will talk more on the practicalities of weaning at a variety of ages.

Babies under 6 months of age

Babies of this age are fully milk fed, so weaning from the breast will need to come with the introduction of an appropriate infant formula. If you’ve been fully breastfeeding until now then the weaning process should be introduced slowly, both to reduce the chance of you getting mastitis, and also for your baby’s tummy to adapt to a new food. These are the steps for weaning:

1. Pick your least favourite day feed and replace with a formula feed. I start with a day feed as you will be giving your baby a new food and I prefer to do anything new during the day so I can watch for any adverse reactions. (see my blogs for baby led bottle feeding and getting a breastfed baby to take a bottle for help with this)

2. You will probably feel pretty full at the time you would normally give this feed. Don’t pump as this will encourage production, but rather hand express small volumes just to the point of comfort.

3. Keep just this feed dropped for a few days until you no longer feel ‘full’ at the skipped feed.

4. Consider if dropping this feed was enough to make the breastfeeding relationship sustainable, if yes – then continue at this balance, if no – then move to step 5

5. Drop one more feed (not immediately before or after the feed you previously dropped) and go back to step 2

At the end of this process you will have either found a combination feeding balance that works for you and baby or will have fully weaned from the breast. Some women find that step 3 lasts anything up to a week before they are able to move on, while others find their body adapts in just a couple of days – go at a pace that is comfortable for you.

Babies aged 6 – 12 months

Babies of this age are starting to explore solids and so you may find (depending on how well they are eating) that you can replace some feeds with solid meals and others with milk feeds. A baby who is one year old no longer requires formula, so if you are weaning from the breast at the upper range of this age group then consider biasing the feed replacements more towards solid foods.

The practical steps for weaning are the same as those above, with some feeds being replaced by solids rather than formula.

Younger toddlers

Although at this point about 70% of your child’s calories (energy requirements) come from solid foods, there are still significant nutritional needs being met by breastfeeding. In the second year of life 448ml of breastmilk provides:

• 29% of energy requirements

• 43% of protein requirements

• 36% of calcium requirements

• 75% of vitamin A requirements

• 76% of folate requirements

• 94% of vitamin B12 requirements

• 60% of vitamin C requirements

— Dewey 2001

In light of this, we need to make sure that we focus on encouraging a varied and healthy diet as we wean from the breast. Your toddler will also find great comfort in the breast and if you’re not needing to wean in a hurry, it is worth taking the time to introduce a comfort item while feeding for your child to connect with. This comfort item (and lots of cuddles!) can help your child make the emotional transition away from breastfeeding.

How frequently they are currently feeding will influence how quickly you can wean from the breast, but in general, the advice of one feed at a time still holds. There is no need to introduce any alternative milk feeds at this age, just increase the number of meals / healthy snacks in line with their hunger.

Older toddlers / children

Children of this age will require some emotional support and preparation for weaning from the breast. It has been a source of love and comfort their whole lives, and while it is absolutely your right to choose to wean, we also must respect their natural feelings of distress at the end of the relationship.

Often our instincts is to try to convince the child that they are now a ‘big boy/girl’ and don’t need the breast any longer. In my experience, this is more likely to result in regressive behaviours as they try to convince you (and themselves!) that they are still little and absolutely need the breast.

I prefer to frame it as the milk has ‘all gone’ rather than mum has decided to stop providing it. This allows for you both to be sad together that the breastfeeding relationship has ended, while being able to offer comfort in other ways.

Every child is different, and some react better to the ‘all gone’ method where there is consistency in the weaning process, while others find it easier to slowly transition away from breastfeeding one feed at a time.

If you are slowly transitioning, one method is ‘don’t offer, don’t refuse’ – whereby you no longer suggest feeding, but don’t refuse if asked for it. This method tends to work best when the child is close to natural term weaning.

Another gentle method is to introduce a ‘breastfeeding chair’ where you only feed when sat together in that chair. Then you only sit in the chair at times where you are happy to feed – once that boundary is in place it becomes easier to reduce feeds by simply not sitting there outside of feeding times.

If you gradually wean from the breast you won’t need to do any active management of your supply, but if you decide to go with ‘all gone’ then you may need to do some pumping/hand expressing to manage any engorgement.