Weaning a baby

How do I wean my baby?

To wean a baby, first make sure the baby will still receive all the required nutrients. A baby being weaned needs to be given an appropriate type of milk, generally infant formula if the baby is less than a year old and cow’s milk if the baby is older. The milk needs to be safe, available, and affordable. There are different ways to wean a baby: Mothers can let the baby self-wean, they can gradually increase the number of non-breast milk feeds and decrease the number of breastfeeds, or they can suddenly stop breastfeeding and express just enough to keep their breasts comfortable. In each case, the breasts gradually stop making milk. The expressed milk can be fed to the baby along with other milk or stored in case the baby does not tolerate other milk. Weaning too quickly can cause problems, including mastitis and abscesses. Older children may be harder to wean but there are some tools that can make it more acceptable to them.

A) How to wean

Mothers who decide to wean have several options:

  1. Allowing the baby to wean at their own pace (self-wean).
  2. Gradually increasing the number of replacement feeds that do not use breast milk and decreasing the number of breastfeeds, while expressing just enough milk to keep the breasts comfortable.
  3. Weaning suddenly and stopping milk production (drying up) by expressing just enough to keep the breasts comfortable.

Each of these processes involves removing less and less milk. With no demand for the milk, the breast will slow down and then stop milk production.  

B) Weaning safely

Whatever weaning process is chosen should be acceptable and safe to both mother and baby (Grueger 2013). There are times when weaning is not safe or necessary.

Before weaning, mothers must be sure that weaning will not compromise the baby’s nutrition. A baby being weaned needs to be fed in a way that is affordable, sustainable, and safe. They need to be given an appropriate type of milk, generally infant formula if the baby is less than a year old and cow’s milk if the baby is older.

Weaning too quickly and having overfull breasts can result in painful difficulties for the mother including:

Mothers should avoid unsafe dry-up tools.

C) Weaning by self-weaning

Self-weaning is allowing a child, usually a toddler or older child, to decide when and how to stop breastfeeding. It is relatively rare in babies less than a year old without a reason and usually happens at between two and four years old. Self-weaning is often the easiest and safest way to wean.

D) Weaning by using replacement feeds

One way to wean is to gradually increase the number of replacement feeds, with each one replacing a breastfeeding session. A typical approach may be to give one more replacement feed each day. In this way, the breasts have a chance to gradually slow the production of milk.

For example, on the first day the baby breastfeeds seven times and is bottled for one feed. On the second day the baby breastfeeds six times and is bottled for two feeds and so forth.

If you are overfull, slow down the process or express enough milk to be comfortable but not so much that you empty the breast. Emptying the breasts encourages them to keep making milk. Breast massage and cool cabbage leaf compresses are used to treat breast engorgement and can also be used to treat breast tenderness. 

E) Weaning by expressing less and less

Another method of weaning is to express less and less milk. With this method, the baby does not breastfeed at all. Instead, a small amount of milk is regularly expressed for every breastfeed the baby misses. If only enough milk is removed each time to make the breasts comfortable, the breasts will gradually dry up until expressing is no longer needed. The expressed milk can be fed to the baby along with the other milk the baby is receiving or it can be stored for later use in case the baby does not tolerate infant formula.

Again, mothers should not proceed too quickly.

F) Weaning toddlers and older children

Toddlers and older children may be less willing to be weaned than babies.

If the child is allowed to wean at his or her own pace (self-wean), there is no conflict. If it is a mother’s decision to wean, she must consider the child’s normal emotional dependence on breastfeeding.

If a mother wants or needs to wean a child and allowing the child to set the pace is not an option, she can follow the steps used for weaning a baby described above. She may also need to help the child through this possible traumatic transition. Some of the ways to do this are to:

  • Minimize breastfeeding:
    • Delay or distract the child.
    • Offer another healthy drink or snack.
    • Keep breastfeeds short.
  • Talk about weaning:
    • Read to the child from a children’s book about weaning.
    • Set a date.
    • Choose a different feeding tool such as a “special big-girl or big-boy cup.”
  • Change bedtime routines:
    • Have another family member care for the child at bedtime.
    • Cuddle and read to the child in a different place from where you typically breastfeed.

References

Grueger B; Canadian Paediatric Society, Community Paediatrics Committee. Weaning from the breast. Paediatr Child Health 2013;18(4):210