Breastfeeding

Managing weaning including thoughts and feelings

In 2001, the World Health Organisation issued a global public health recommendation that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond. Exclusive breastfeeding from birth is normally physiologically possible except for a few medical conditions, and unrestricted exclusive breastfeeding results in ample milk production.

Weaning is the process of stopping breastfeeding. It is generally thought to begin with the introduction of solid foods (see 'Introducing solid foods') or infant formula, especially if a baby has been exclusively breastfed, and may take weeks, months or even years from then to the point of completion when the baby is no longer receiving any breastfeeds. It is a complex process related to the age of the baby and his/her readiness to accept other foods, whether weaning needs to be fast (in case of sickness or family crisis, for instance), or can be done at a more leisurely pace.

For the women we talked to, weaning from the breast took a variety of forms. For some women it was gradual, flexible, baby-led and usually mutually agreeable for them and their baby. They talked about it being natural, non-traumatic and something that just happened. For these women, weaning usually occurred when their baby was older and suckling more for comfort than nutrition (see Interview 48 below) and having only one or a very few breastfeeds in a day, such as early in the morning and at night time before bed. Sometimes their baby indicated that he/she did not want to breastfeed anymore and sometimes the women gently reduced the number of breastfeeds and encouraged their baby away from their breast by offering other distractions and substitutes or setting up special bed time routines such as a drink or supper, a cuddle and a story. Several women said that their baby weaned when they became pregnant again, perhaps because of a change in the taste of breast milk. Some women with older babies were able to talk to and reason with them about stopping breastfeeding.

Some women said that they thought that their baby was aware of their presence (and perhaps the smell of their milk) which made him/her reluctant to give up that last breastfeed. At this point several women went away for the weekend or longer leaving their baby in the care of relatives and their absence marked the end of breastfeeding. However, a few came back and began breastfeeding again.

For others, because of circumstances (such as the mother's return to work or unsatisfactory breastfeeding for one reason or another) weaning from the breast was more abrupt, structured and sometimes traumatic for either mother or baby or both. This was particularly the case if their baby was young, being weaned onto infant formula and was reluctant to take a bottle (see 'Variations of the breastfeeding experience'). For some of these women, however, the transition to infant formula was a relief from the anxiety produced by a lack of confidence in breastfeeding (see 'Monitoring baby's growth').

Of those women who had not yet reached the weaning stage, some were thinking about it and planning how they might achieve it without discomfort or upset for themselves or their baby. One woman thought that it would be “the biggest challenge in our breastfeeding career”. A few young women were planning to breastfeed exclusively for six months, as recommended, and then wean their baby onto infant formula so that they could go out again. However, others who had already reached that stage had changed their minds, deciding that their baby's needs were more important and that going out could wait until later. Flexibility appeared to be the overwhelming issue for most women as thoughts, feelings and situations with regard to weaning were constantly changing.

Even when weaning went smoothly, women talked about it being a difficult time of heightened emotions and anxiety. It included feelings of sadness and even devastation as something so pleasurable was coming to an end. Some women who weaned prematurely talked about regret, feeling guilty and as though they had failed. Some women, especially the longer-term breastfeeders, spoke about beginning to feel tied, resentful and a bit claustrophobic so that weaning came as a relief (see 'Changing family relationships with a breastfed baby' and 'Breastfeeding an older baby'). Some spoke about wanting their body back. On the other hand, some women never felt like this. One woman decided to embrace weaning as another stage in her daughter's development.

Some women talked about resisting pressure, from family, friends and health professionals, to wean their baby from the breast and “get back to normal” (see 'Breastfeeding an older baby').

Some women acknowledged their sadness at finishing breastfeeding, particularly if it was their last baby, while others spoke of overcoming that sadness with the thought of being able to have more children. One woman had breastfed almost non-stop for nine years and was sad that her breastfeeding days were coming to an end because it had been such a big part of her life.

One woman said that she was “frightened” of weaning her daughter from breast milk and repeating a family history of inappropriate eating.

*Footnote: A small percentage of at-risk babies will develop dental caries in spite of breastfeeding not because of it. Good dietary and oral hygiene practices will help with prevention. A dentist should be consulted about treatment.

Last reviewed September 2015

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