Ina May's Guide to Breastfeeding

13
Weaning

There is no “best” age to wean a baby. Women in different cultures wean their babies at different times, usually according to what is best for the babies in view of the local food supply. In many countries where poverty is rampant and food is scarce, children are nursed by their mothers and grandmothers until they are three or four or even older. A long nursing period helps make an easier, healthier transition between the diet available to the toddler and that eaten by adults. There is no reason, however, why a mother living in a country where food is plentiful must automatically wait to wean until her toddler refuses the breast. At the same time, if your baby is gaining and developing well, and both you and your baby are still enjoying nursing, there is no good reason why you should stop.

Do I sound like a moderate on this issue? I hope so, because I do think there is a middle course between obligatory weaning by a certain age, which is chosen by someone besides you and your baby, and nursing for as long as your toddler wants, even when she is inflicting real damage on your body. What do I mean by damage? I’m talking about cracked, bleeding nipples caused not by a young baby who hasn’t got the latch right yet but by someone with teeth who could be chewing food instead of chewing on you. I’m talking about bruises to your arms and legs caused by your toddler kicking you in anger because you didn’t teach her nursing manners at a younger age.

At the risk of being accused of promoting parental cruelty, I do want to point out that all mammals eventually wean their young. In some species, the weaning process has much to do with the size of the baby. A young elephant, for instance, will reach a size when it would have to get on its knees to gain access to mother’s milk. Once young pigs get fat enough (and it’s not unusual for a sow to give birth to twelve in a litter), the litter is no longer able to fit into nursing position at once. In addition, once the adult teeth start appearing, most mammalian mothers no longer find joy in continuing to nurture their whopping offspring, so mother-led weaning is the norm. Please understand, though, that I am an advocate of continuing to nurse your human baby through teething and beyond—as long as it is the best for both of you.

One of my midwife friends nursed her three children until they were each six or seven years old. Her decision to nurse this long did not stem from a parenting philosophy that everyone should do this but rather from the fact that her husband suffered from a variety of very serious allergies. She worried that their children might inherit this tendency from him and so decided that they would benefit from as long a nursing period as possible. All were gentle nursers, she told me, so she never had to deal with biting or other problems having to do with nursing an older child. When her oldest child, a daughter, was six years old, my friend began asking her if she didn’t think she was old enough now to think of weaning. “But, Mom,” her daughter said, “you’re always talking on the phone to women about how good breast milk is. Don’t you think it’s good for me too?” Certainly in this case, and I’m sure in many others, child-led weaning was the best strategy for the family. Not long after this conversation, my friend’s daughter decided that she was ready to give up nursing.

Some children can be quite tenacious—and creative—in clinging to nursing when their mother is ready to wean. I know of a case in which the mother had made several attempts to wean her robust two-and-a-half-year-old boy, without success. Finally, her husband convinced her that if she went away with her girlfriends for a weekend, the transition could be made. The night after she left, he was surprised to find that his enterprising little son had joined the litter of puppies nursing on their mother on the front porch. I laughed so hard hearing that one that I forgot to ask when and how the dog weaned him.

Another tenacious lad was the one that Mary Breckinridge, founder of the famous Frontier Nursing Service, described in her fascinating autobiography, Wide Neighborhoods. When asked about the health of the Appalachian babies the Frontier Nursing Service midwives delivered, she said, “We will find it hard to cope with our babies if they become any more mentally and physically abusive than many of them are now. Not so long ago, a woman with an eighteen-month-old boy came to our hospital outpatient clinic at Hyden Hospital and sat down to nurse him. The Medical Director said to her, ‘Don’t you think it is time to wean your baby?’

“‘Yes, I know, Doc,’ she replied, ‘I know, but every time I try to, he throws rocks at me.’ “

One of my favorite weaning stories comes from a midwife who remembers her grandmother, who lived on a midwestern farm in the 1940s. The women of the family were exchanging weaning stories, and the grandmother began telling how she weaned her youngest son after he was old enough to be rough with her. Anticipating that he would want a drink soon, she went over to the woodstove, covered her hand with the soot that had accumulated inside the stove lid, unbuttoned her dress, and rubbed the soot on her breasts. Her son toddled in and she opened her dress top. Horrified at the sight of her blackened breasts, he cried, “What happened?”

“Pigs got ’em,” she replied. He never wanted to nurse again.

Partial weaning begins as soon as your baby starts eating some solid foods along with nursing, usually by the age of six to eight months. Sometimes a baby about the age of ten or eleven months will wean herself completely after she has been partially weaned for a few weeks. There is no reason to fight this tendency by insisting that a baby this old continue to nurse if she clearly doesn’t want to. On the other hand, her refusal to nurse may be temporary. If she starts to nurse again in earnest, she is likely to restimulate your milk supply. In addition, your baby may want to nurse more than usual if you are traveling with her, even if she has started to wean herself.

If your baby does seem to be weaning herself, you have the choice of whether to wean her to the bottle or the cup. One disadvantage of weaning to the bottle is that there will have to be a second weaning, from the bottle to the cup. Another is that a child who depends upon taking a bottle to bed every time she takes a nap or before she goes to bed each night is more likely to develop cavities than the child who gets her drinking done in a faster manner. The slow drip of sweet liquid, including milk, promotes tooth decay.

You can wean your baby to a cup as early as the age of seven or eight months. Since cups can spill unnoticed, you will have to pay special attention to getting enough liquid into her. This means that you will have to sit down with her and help her to control the flow of liquid from the cup so she doesn’t pour her milk or juice onto the floor or up her nose. If you notice that your baby seems to get dehydrated (some symptoms are a depressed fontanel and dry-looking skin), you need to get her to take more liquid. Increase the amount she gets by either sitting patiently with her and giving her drinks from a cup or by switching her to a bottle.

It is preferable for weaning to take place when both you and your baby are feeling healthy and well rested. In the best-case scenario, it can happen so gradually that you and your baby are not at all upset by it. You may find it easiest to eliminate one feeding at a time over a several-week period. Find something interesting to do with your baby at the time of the feeding that you want to eliminate. This could range from giving her a drink from a cup to taking a walk. The idea is to break the usual routine with an interesting new activity that will distract your baby from the fact that she’s not nursing.

If you usually nurse your baby to sleep, try this instead: Give her a big hug and kiss, lie her gently down in her bed, and pat her back for a while. She is used to having long periods of physical closeness and cuddling as she nurses, so it’s good to give her plenty of physical attention during the weaning process. She needs to know that she will still get loving attention from you when she’s not nursing.

By the time you are down to one feeding a day and you’re finished with night feedings, most of the weaning process has already happened. Some babies might cling to that last feeding for a few weeks or even months after having eliminated the rest, while many others seem ready and able to wean completely.

Some mothers find that it’s quite easy for them to eliminate daytime feedings and not so easy when it comes to the nighttime feedings. It helps if you get your baby’s father to answer your baby’s cries for a nighttime feed. He can cuddle your baby and explain that Mom’s asleep now and it’s time to go back to bed. If he thinks the baby might be thirsty, he can offer a sip of water. It’s important to realize that this strategy will work only if you and your partner are convinced that you are not being cruel parents by refusing to continue nighttime feedings.

I remember one couple who both felt it was time to wean their two-year-old daughter. For four months, this toddler had wanted to nurse only at night. At first, her mother didn’t resent these nightly wake-ups, because the toddler was sweet about nursing and always went right back to sleep. By four months later, the girl began demanding to sleep in her parents’ bed. She was a finicky sleeper in the family bed, and she would wake up and scream if her mother so much as turned over. This situation needed to change, and the couple decided that their daughter should return to sleeping in her own room. And, since it was unlikely that she would wean herself if her mother kept responding to her—since her mother only reminded her of how much she wanted to nurse—the husband decided that he should be the one to respond to her nightly wake-ups. The next night, when the toddler woke up crying in her bedroom, he was the one who went to her. The first night she cried and carried on, and the second night he even had to pace the floor with her for a while so that she would calm down. By the third night, she barely whimpered, and after that, she began sleeping through the night.

Single mothers have more difficulty with weaning because it’s more difficult for them to obtain this kind of help. If you’re single, you may need to enlist the help of a dear friend whom your baby already knows to spend the night at your place and respond to baby’s nighttime food requests.

The main thing to remember about weaning is that your baby’s attitude toward weaning will be greatly affected by your own. If you are not emotionally ready for weaning, there’s a very good chance that your baby will not be ready either. If you think that weaning is going to mean a terrible loss for your baby, you might as well nurse for as long as it takes for you to be able to make a smooth transition.