Weaning After Breastfeeding

When the woman is ready to initiate weaning, one option is to gradually eliminate one breastfeeding session every two to five days. Other ways to wean include shortening nursing sessions slowly or lengthening the time between nursing sessions.

It may be possible to wean a child from nursing during the day and to continue breastfeeding at night; this may be a good option for women who are unable to pump breast milk while working. The midday feeding may be a good time to start as children tend to be most interested in nursing at the first and last feedings of the day, when their need for comfort is greater. Pre-bedtime or nighttime feedings are usually the last to go.

However weaning occurs, mothers should watch their breasts carefully for any sign of pain, redness, or tenderness. These can be signs of plugged ducts or mastitis.

Stopping breastfeeding “cold turkey” is not recommended because the breasts will become engorged, painful, and may develop an infection (mastitis). If breastfeeding must be stopped immediately for medical or other reasons, it may help to hand-express or pump milk a few times per day until the breasts feel comfortable (not empty) and the milk production slows, usually over a few days. Do not wait to express milk until the breasts are painful or very full. Wearing a well-fitting, supportive bra can be helpful. Hand expression is discussed in detail separately.

Bottle or cup? — An infant can be weaned to a bottle then a cup, or directly to a cup, depending upon the child’s age. Children under 6 months of age may use a bottle while children older than 12 months can usually use a cup. Children between 6 and 12 months may use either a cup or a bottle. Weaning directly to a cup avoids the problems associated with bottle feeding. A trainer cup with two handles and a snap-on lid with a spout may be easiest to manage.

When introducing a bottle, it helps if the baby is not extremely hungry, so that he or she may be more patient. It also helps if another caregiver introduces the bottle; some babies initially refuse a bottle if the mother is near.

Initial feedings from a bottle/cup may be easier if the bottle/cup contains expressed breast milk. Breast milk is sweeter than formula. Infants may be more willing to accept the bottle or cup if the taste of the milk is familiar. If the child is older than 12 months, cow’s milk may be given instead of formula.

The child should not be left with a bottle of milk or formula while sleeping. Falling asleep while bottle feeding can lead to “baby bottle tooth decay” and is not recommended.

When partially breastfeeding, try to offer the breast before the baby is hungry and impatient. After bottle-feedings have started, some babies get frustrated with breastfeeding because milk flow is not as fast from the breast as from a bottle. This may be prevented by selecting a bottle nipple with slow flow. Another suggestion is to pace the infant with the bottle so that a feeding takes at least 10 to 15 minutes, similar to a nursing session.