Weaning from the Breast…When and How?
As a new parent, you want to give your child the very best. And since research over the past 20+ years has established that breast milk is perfectly suited to nourish your infant and protect him from illness, you may have chosen to breastfeed. Now, you and your infant are reaping the many benefits that breastfeeding has to offer. However, you will eventually have to wean him from the breast as he grows and his nutritional needs change. You may experience mixed emotions about weaning your baby, from enjoyment of your newly found freedom to mourning the passing of a very intimate phase in your relationship with your child. As you enter this uncharted territory, use the following information as your guide.
When to wean
There is no magical age or stage of life when you should wean your child from breastfeeding. However, the American Academy of Pediatrics offers the following recommendations:
- A child should receive breast milk as a sole source of nutrition for the first 6 months of life, followed by a gradual introduction of solid foods from 6-12 months.
- Continue breastfeeding for first 12 months of life.
- Beyond 12 months, continue breastfeeding as long as both baby and mom want to.
With the above recommendations in mind, you decide when you and your baby are ready to wean.
Be knowledgeable about nutrition
When contemplating weaning, it may help to know some basics about the nutrient content of breast milk at the different stages of your infant's life. Iron stores from birth begin to diminish around 6 months of age, at which point it is appropriate to offer iron-containing foods, such as infant cereal. Around one year of age, breast milk no longer supplies enough protein for the infant, so additional protein sources such as meat, fish, eggs, beans, or cheese are necessary. At this point, it may make sense to begin weaning your child from breast milk to make room for important nutrient-rich foods and avoid nutrient deficiencies. One study following infants weaned at an older age (12-18 months) reported that these children ingested less than the recommended level of fat, iron, vitamin E, and zinc.1 Consumption of grains and whole milk dairy products is a simple way for your child to receive these necessary nutrients.
How to wean
Make sure you have at least two weeks to dedicate to the weaning process. Taking a gradual approach will make it easier on you and your baby. Avoid sudden weaning if at all possible. Follow these guidelines for a smooth weaning experience.
Substitute the least favorite feeding: Choose your child's least favorite feeding, if he has one, and offer a bottle or a cup instead. If he does not have a least favorite, choose a mid-day feeding. He may refuse initially, and is more likely to accept the feeding from the other parent or another caregiver. The use of pumped breast milk, formula, or cow's milk for that feeding, as well as the type of cup or bottle used, will depend on the age of your child. Discuss this with your pediatrician prior to beginning the weaning process.
Express milk to relieve fullness: You may have some discomfort from breast fullness at first, in which case you should express just enough milk to provide relief and minimize the risk of plugged ducts. After a few days, you will no longer need to express milk at the eliminated feeding time. However, don't express a whole feeding's worth of milk or your body will not slow its milk production.
Resist the urge to encourage finishing the bottle or cup: Keep in mind that you don't know how much your child is drinking while breastfeeding. That is good because then he can eat only as much as he needs. Let him do the same when drinking from a cup or bottle, and avoid forcing him to finish his bottle if he is giving you signs he is full.
Continue substituting feedings one at a time: A second substitute feeding can be given when your baby is accepting the cup or bottle well. While this often happens within a few days, it can take up to a few weeks. Continue substituting feedings at a pace that works for you and your child, until he is taking most feedings from a bottle or cup. The nighttime feeding is usually the last feeding to go and is often the most difficult. Create a bedtime routine that is not centered around breastfeeding to help ease the transition.
Give extra love and attention: It is normal for you and your child to have some trouble with this transition. Keep him distracted and stimulated with fun activities. Show him affection by spending quality time together, hugging, and cuddling him.
- Huggins K, Ziedrich L (1994). The Nursing Mother's Guide to Weaning. Boston: Harvard Common Press.
- Picciano MF, Smiciklas-Wright H, Birch LL, et al. Nutritional guidance is needed during dietary transition in early childhood. Pediatrics 2000;106:109-14.
- Samour, PQ & King, K (2005). Handbook of Pediatric Nutrition (3rd ed). Boston: Jones and Bartlett Publishers.