To Wean or Not to Wean
As a postpartum doula, I love my role in supporting those whose goal is to breastfeed/chest feed. We know all the wonderful benefits that come with starting your little one off on breastmilk, both for baby and parent. But deciding when and how to stop can come down to personal preference, circumstances, and the baby’s willingness to give it up.
There really is no "right" time to wean. The World Health Organization recommends exclusive breastfeeding until six months of age with continued breastfeeding along with appropriate complementary foods up to 2 years of age or longer. The American Academy of Pediatrics adds the recommendation to nurse for as long as mutually desired by the parent and the child. For many families, the circumstances surrounding their ability and desire to breastfeed differ.
When a parent makes the decision to wean baby from the breast/chest, they may struggle with feelings of sadness and guilt, imagining that their baby will lose out on all the benefits of breast/chest feeding and their breastmilk.
I'm currently supporting a breastfeeding mother who exclusively breastfed her first child for 9 months and is considering weaning her 3 month old sooner than she expected. She imagined that she would do for this baby what she did for her older daughter.
My client thought that, by telling me, I would try and talk her out of it. Instead, I asked, "How is that making you feel?"
"I feel guilty, and at the same time, thinking of weaning brings me a sense of relief".
I could share with you why she is looking to wean her baby, but I won't. I won't because I think that, as a society, we should acknowledge that there are many reasons for weaning, and that any reason is valid if it's a reason that resonates with the parent and that fits in with their current circumstances.
Why Wean?
Here are some reasons parents choose to wean from breast/chestfeeding:
Breast/chestfeeding is uncomfortable even after working on latch and positioning.
You are feeling "touched out”--that is, being tapped to the max which causes you to feel irritable as a result of missing out on your own autonomy. It is often referred to as “burnout” and is more common than breastfeeding/chestfeeding parents want to acknowledge.
Breast/chestfeeding may exacerbate anxiety or mental health issues.
It may be tough to balance working, pumping, and feeding. Some parents may receive little support in the workplace.
You may have trouble producing a full supply of milk, and breast/chestfeeding and supplementing is tiring.
Breastfeeding can trigger past experiences with sexual abuse or trauma.
Some parents need to wean because a medication is contraindicated for breastfeeding (most medications are safe to take while breastfeeding).
If you have to undergo cancer treatment, breastfeeding is contraindicated.
If you are going to be separated from your baby for an extended period of time, it may affect milk supply.
And sometimes a baby stops breastfeeding on their own. This can sometimes happen after a child is a year old.
Making the Weaning Process as Smooth as Possible
The best way to wean is to do it gradually. It gives your baby time to get used to the new feeding method and your body time to adjust.
If you wean abruptly, you risk engorgement, clogged ducts, or mastitis, as well as an abrupt change is your hormone levels which can lead to depression. If you do need to wean abruptly due to an unforeseen event or medical emergency, you can pump or hand express just enough to relieve pressure or full feeling in the breast, and do that over a period of a few days. You can apply a cold compress to relieve swelling or consult with your doctor for recommendations on herbs or medications that can help decrease your supply.
Ideally, you would have introduced the bottle before weaning so that your baby is comfortable taking milk from a new feeding method. Babies under 6 months of age are 100% reliant on a milk-based diet. So, if you were exclusively breastfeeding, you would need to replace all of your breastmilk with formula. You can speak with your pediatrician about formula options that will best fit your baby's needs. You may find that your baby does not like the taste of formula, and you may need to try more than one brand.
How to Wean?
Since the best method is to wean gradually, one way to do this would be to drop one feeding every few days. You could try the following:
Choose a feeding that you will replace with a bottle of formula.
You can decrease the time feeding at the breast and offer a bottle of formula to complete the feed until the feeding goes away and it replaced with a bottle of formula.
You could stretch the time between feeds until one of the feedings naturally drops.
If you are exclusively pumping, you can drop one pumping session every few days or decrease the number of minutes you pump or the number of ounces you are pumping. Be cognizant of how your body is feeling to avoid engorgement, clogged ducts, or mastitis.
You also may decide that partial breastfeeding fits your lifestyle. You may choose to breastfeed in the morning and at night and offer formula throughout the day. As long as you breastfeed regularly, your body will adjust and keep up with the supply your baby needs.
Weaning and Mental Health
Like my breastfeeding client I mentioned earlier, some parents worry about feeling guilty or sad when deciding to wean. Others have felt that breastfeeding was so taxing and stressful, that only once they stopped breastfeeding could they truly bond with their baby. There is no right way to feel. There is only what is right for you, your baby, and your family.
Keep your health care provider and pediatrician informed about your desire to wean and when you start weaning, especially if part of the reason for weaning is due to anxiety and depression or another perinatal mood and anxiety disorder. Postpartum depression can last through the first year or more after you have had your baby, and the process of weaning can intensify postpartum moods. You do not have to navigate the challenging feelings that go along with weaning alone--it is always best to reach out to a professional or seek support from a postpartum doula with lactation experience. You deserve compassionate care.
Breastfeeding is a relationship that is shared between you and your baby. Even if you feel confident and comfortable with your decision to wean, you may still find yourself feeling sad. That is a normal feeling but is also due to a hormonal shift, which can cause heightened emotions.
Breastfeeding does create a close bond between parent and baby. But bonding can happen outside of breast/chestfeeding. Bottle-feeding also provides occasions to snuggle, gaze lovingly into your baby's eyes, and just soak in this time which truly is short.
You'll have many opportunities to bond with your baby as they grow, and as life circumstances change, we adapt with them, but we don't allow that to make us lose our connection. We find other things or common interests to bond over. So, while you are weaning, be gentle with yourself and know that your special bond is not broken when breast/chestfeeding ends.