… with as few tears as possible
Firstly, well done for every single drop of milk that you’ve made and fed to your little one! Every day, week, month and year matters to the long term health and wellbeing of your child, so you deserve to feel rightly proud.
There are so many reasons why you may need to stop breastfeeding – I don’t judge you for any of them! I have worked with women who are returning to a very demanding job where it is not practical to express. I have worked with women who need to wean from the breast to start chemotherapy. I have worked with women who want to stop breastfeeding to allow their fertility to return so that they can have another baby. And, of course, I also work with women who want to stop just simply because they have decided that the breastfeeding journey has run its course and must come to an end. I support all these women with compassion, practicality and sensible information. Here I am going to try to summarise some of my favourite suggestions for how to gently stop breastfeeding, whether your little one is a few weeks, months or years old.
Firstly, have you considered whether partial breastfeeding might be an option for you? Especially if your little one is under a year, reserving your two favourite feeds per day could be an option. Many women maintain a morning and evening feed for several months, and it’s a lovely way to connect with your baby after a long day at work.
If you decide to wean, be prepared for some hormonal changes, and the return of your periods (if they haven’t already!). Make sure you sort out your contraception, because you may have a surprise otherwise! Also, many women find that they feel quite teary, emotional and a bit low. Some also find that they are more vulnerable to illnesses after they stop breastfeeding. Look after yourself. Take a good multivitamin, plan some lovely activities, get your favourite food in the house ready for those wobbly moments, and have someone you can talk to honestly on speed-dial!
If your baby is very young (less than 6 months) then you’ll probably need to get them used to accepting a bottle. There is SO much information out there about how to get a breastfed baby to accept a bottle – I don’t really want to re-invent the wheel, but try these tips:
- Warm the teat
- Try a narrow teat (NOT the wide teat ‘closer to nature’ types)
- Try varying the temperature of the milk
- Bottle feed cheek to breast
- Start on the breast and move to the bottle
- Try feeding when your baby is just waking up
- Try wearing a silicone nipple shield, so your breast feels like a bottle
- Try natural rubber teats, or latex ones, rather than silicone (they are softer)
- Try feeding whilst walking around
- Get someone else to try to feed the baby (after you’ve made the switch, it should be YOU who does most of the feeds though!)
It’s also REALLY important how you bottle feed. Check out my blog on bottle feeding if you’re new to this and don’t panic – your baby will get there in the end. Allow plenty of time and don’t let on to your baby how desperate you are – he will sense your stress levels and will react badly! I often suggest introducing formula one feed at a time, but continue to pump (you’ll see why in a second!). Introduce one formula feed instead of a breastfeed every couple of days, or when your baby has accepted the change. If they reject the taste, try mixing half breast milk and half formula, and slowly increase the amount of formula.
Now, all those breastfeeds you’ve been expressing – the reason for this is to leave the door to returning to breastfeeding open should there be a major problem with the formula. If your baby develops a reaction or allergy, you have maintained your supply and can easily return to full breastfeeding. Once you are happy with the way your baby has adapted to the change in milk, you can begin to reduce the amount you pump. Your breasts will become full and hard, which I’m afraid you will need to put up with to some extent – the fullness is the trigger for your body to reduce your milk supply. Stay comfortable, hand express for comfort, and use warm compresses or take a hot bath. Anti-inflammatory medicines are also fine to take.
And what to do with all that expressed milk? Well, you could feed it to your baby, or freeze it and save it for if your baby ever gets a sickness bug and can’t tolerate formula.
For older babies, you may be able to reduce the number of breastfeeds and substitute with solid food. Opt for high nutrient foods with plenty of protein, calories, natural fat and vitamins. Think about avocado, chicken, tofu, pitta bread and home made humous. Peas have extremely high vitamin C content and are great for trying out the new pincer grip of an 8-10 month old! Broccoli is very high in calcium and iron. Play around and see if partial breastfeeding plus solids is an option. If not, then formula in a cup could work. Older babies are often reluctant to accept a bottle if they have not used one before, but they will often use a cup. I like free flow cups for breastfed babies – valved cups are basically bottles in disguise, as babies have to suck hard on them, which is not what they do on the breast. You could wean in the same way as I have described above.
Your older baby should not have cows milk as a main drink under the age of about 1 year. This is because it is very low in iron. Formula is based on cows milk, but is fortified with iron. There is nothing very magic about the age of 1 – there has to be a cut-off somewhere and it is generally assumed that by 1, most babies are on a range of family foods which are high in iron, so they can get away with drinking ordinary cows milk.
If you are using formula – remember to use a first milk for the first year. There is no need for hungry formulas, and follow-on milk is not recommended by the World Health Organisation. Just move on to cows milk around your child’s first birthday. Also try to stop bottles after the age of one, or even before – they can cause problems with overfeeding, poor dental development and dental caries.
Finally, remember to check whether your child needs vitamin D. If they are having less than 500ml of formula a day they need a 7-8.5mcg vitamin D supplement until the age of 5 years.
For toddlers, stopping breastfeeding is usually more of emotional task! This is really best handled with a lot of time, patience and compassion. Here is my usual approach to stopping breastfeeding a toddler.
- First, consider which of the feeds your toddler has seem to be least significant to him – start by trying to cut these ones! Strategies I like to use include offering a snack instead, or a cuddle, or simply being busy and offering a really fun alternative.
- Consider which of the feeds you find the most difficult. Sometimes, if you eliminate this/these feed(s) then you find you don’t actually want to give up all of the others. So, if your toddler still feeds a night, maybe consider gently night weaning and maintain the day feeds a bit longer. Try setting a timer a feed for only a specified amount of time. Reduce the time on the timer by a minute (or 30 seconds if it’s very short!) every couple of days. Keep your toddler close and offer cuddles, stroking, and soothing instead while they fall back to sleep in your arms. For older toddlers who can comprehend the concept, I love this book which aims to prepare your toddler for stopping feeding at night (for what it’s worth I recently used it to eliminate night feeds in my 32 month old toddler with absolutely NO TEARS at all. Winner.
- Try being less flexible about where you will breastfeed. So, pick only one location. Make it somewhere you don’t already feel very used to breastfeeding in, so it has less of a cosy feel! Do not restrict breastfeeds at this point, just the location. So, no breastfeeds when out and about, only at home, in the chair. If you go away for a few days, find a temporary location, and explain that this will be the feeding chair while you stay there.
- Once your toddler has accepted that level of restriction in their breastfeeding habits, start to place limits on when you will breastfeed. Its up to you how you do this, and it might depend on how many feeds there are. Perhaps just morning, lunchtime and evening? Or only after meals? You decide!
- Then, start to plan to be out during those designated times. Your toddler will probably just ‘forget’. When you return home, if he asks for a feed, patiently say when the next feed will be, and offer an alternative.
- It really helps if you can be somewhere SUPER fun during the expected feed times – swimming, or the playground, or soft play, or with friends in the park – or whatever.
- Try not to be out for more than one of the feeds per day, but consider changing around which feed you will miss, so your toddler doesn’t always miss the same one.
- When you get down to one or two per day, offer a snack instead, and a cuddle. See if they will accept a cup of water, or a fruit smoothie, or a milkshake. It may have to be a fairly rewarding drink to compensate for the fact that it’s not mummy milk!
- You may find it useful to express if you become full. It will feel much harder to do if you’re uncomfortable, and your little one will know that you have plenty of milk. It’s more authentic if you’re well-drained!
I hope that helps to give you some ideas for how to wean as gently as possible. This is sometimes hard on mums and babies/children, but be kind to yourself, and patient and gentle with your little one – you will both get there. Allow yourself the opportunity to grieve the loss of the breastfeeding relationship – it’s normal to feel quite sad about it. Celebrate your wonderful achievement in some way – get a photo of you breastfeeding your child; she will love to see it in years to come. Or consider a charm bracelet, breast milk pendant, or some other way of remembering the closeness and special memories. You did a great job Mama!
Lyndsey Hookway is a paediatric nurse, health visitor, IBCLC and holistic sleep and behaviour coach. She works privately at www.feedsleepbond.com as well as for the NHS and as an independent lecturer and trainer. She offers webinars and bespoke training for health professionals, childcare, sleep and maternity carers and parents. Lyndsey’s first book will be published in 2018.