by Amy Spangler
September 29, 2011

When to wean and how are among the many questions parents ask about breastfeeding.

The short answers are when you and your baby decide you’re ready and gradually. But short answers don’t begin to address the myriad of circumstances in which weaning occurs.

Weaning is one of the most misunderstood practices—in part, because it’s not a specific event. A baby doesn’t fully breastfeed one day and stop breastfeeding the next, except in rare cases. Weaning typically occurs over time. It begins when solid foods or other liquids are introduced (learn more about introducing solids here), and ends with a final nursing—one that is seldom planned, but becomes the last, simply because no more follow.

When to wean
How long a mother chooses to breastfeed—weeks, months, or years—depends on the individual needs of a mother and her child. Some babies start to lose interest in breastfeeding between 6 and 12 months of age when solid foods are introduced. Others, eager to explore the world around them, are less content to cuddle at the breast once they learn to walk and run. Sometimes mothers and babies are separated due to illness and weaning is necessary. Other mothers stop breastfeeding in anticipation of returning to work or school, unaware that the two (breastfeeding and work/school) can be combined. Quite often, social or cultural pressures prompt mothers to wean. In cultures where independence is valued, a baby’s first tooth or first step can be seen as a sign that it is time to wean. Mothers in Western cultures tend to wean sooner than their non-Western counterparts. Nonetheless, the average age for weaning worldwide is 2–4 years, and in some cultures children breastfeed for 5–7 years. In reality, the right time to wean is when your child, your partner, or you decide that the time is right.

The American Academy of Pediatrics (AAP), the World Health Organization (WHO), and the United Nations Children’s Fund (UNICEF) all recommend breastfeeding for at least 1–2 years, and the introduction of complementary foods around 6 months of age. But despite these recommendations, few mothers in Western cultures breastfeed beyond the first year (less than 1 in 4 U.S. babies born between 1999–2007 were breastfed for 12 months). And those who do practice what has become known as “extended breastfeeding” often find themselves the target of disapproving looks and critical comments. If you are concerned about the reaction of family and friends to your plan to breastfeed until your child decides to stop, talk with them early on about your decision, letting them know how much you need their support.

How to wean
Weaning is easiest when both parties (mother and child) are willing participants, but more often than not, one leads the way, while the other reluctantly follows. Given enough time, all children will wean themselves (child-led weaning). But quite often mothers choose to wean (mother-led weaning) before their child is ready to stop. If you live in a culture where few mothers breastfeed more than a year, you may be reluctant to follow your child’s lead, but more important than who takes the lead is that the process be gradual. Mothers who wean suddenly are more likely to experience feelings of sadness or guilt, in addition to physical symptoms such as leaking, swelling, or pain.

Tips for weaning gradually

• Drop one feeding at a time. Replace one daily breastfeeding at a time with solids or liquids, depending on your baby’s age and ability. Begin with the breastfeedings your child is least likely to miss. Early morning, naptime, and bedtime feedings are often the last to go. If your baby refuses to give up a particular feeding, continue to breastfeed, but try shortening the length of the feeding.

• Enlist help. Babies often refuse foods (especially bottles) offered by their mother, but will accept the bottle from another family member. Breastfeed when you are around and save the bottle-feedings for when you are not present.

• Use a cup. Even newborns can learn to cup-feed, so you may want to use a cup and avoid bottles and nipples altogether. If you, or your caregiver, prefer to use a bottle, try different nipple shapes until you find one that your baby will accept. A slow-flow nipple may make the transition from breast to bottle easier. If your baby is able to hold a cup and feed herself, you might want to use a cup with two handles and a snap-on lid to minimize spills.

• Use formula before age 1. If your baby is under 1 year of age, use iron-fortified formula rather than whole cow’s milk for replacement feedings. Whole cow’s milk can be given to 1–2 year-olds. Low-fat or skim milk can be given to children 2 years and older. Some mothers choose to never introduce cow’s milk; read more about this here.

• Keep iron levels up. If your baby shows signs that she is ready for solid foods, usually around 6 months of age, iron-rich foods such as meats and iron-fortified cereals will meet her need for iron.

• Cuddle more. Your baby needs to know that separation from the breast does not mean separation from you. Hugs and kisses will let your child know that your love and affection continue even after breastfeeding stops.

• Provide distractions. Outdoor play, storytelling, and games are a good way to distract your active and curious toddler.

Tips for weaning suddenly

• Relieve fullness. Managing sudden weaning is a balancing act—much like walking a tightrope. Remove too much milk and you tell the breasts to keep making the same amount. Remove too little milk and you increase the risk of engorgement, plugged ducts, and infection. Ideally, you want to hand express or pump just enough milk to relieve fullness and prevent engorgement. Soaking the breasts in warm water—shower, bath, washcloth—can make milk removal easier. Remove only enough milk to relieve fullness. The more milk you remove from the breasts, the more milk you will make.

• Apply ice packs. If your breasts become swollen and hard, cold packs, bags of frozen peas wrapped in a wet washcloth, or cold, rinsed cabbage leaves can be used to reduce the swelling.

• Take pain medicine. Acetaminophen or ibuprofen can be taken for pain.

• Wear a bra. A snug bra can provide comfort and support.

Many mothers continue to produce milk for days, weeks, or even months after weaning is complete. Leaking is unlikely to occur if there are only small amounts. But if leaking becomes an issue, breast pads can provide short term protection. As long as the breasts are comfortable, milk expression should be avoided. If the breasts become hard or lumpy, mothers are urged to express only enough milk to relieve the hardness and remove the lumps. The less milk you remove from the breasts, the less milk you will make.

Occasionally a mother weans and then decides days or weeks later, when her child unexpectedly becomes ill, to resume breastfeeding. Reestablishing a milk supply that has disappeared, or nearly so, is known as relactation. A mother’s ability to relactate depends, in part, on how long it has been since she last breastfed. Click here for more information on relactation from La Leche League International.