Nighttime Weaning

Written by Anna Choi, IBCLC

A few months ago, when my youngest daughter was between 15 and 18 months old, I found myself hitting a rough patch in terms of sleep deprivation. After almost a year and half of waking up throughout the night to nurse her back to sleep, I was exhausted and frustrated. “It’s time to night wean,” I told my husband. I had been hoping and hoping she would start sleeping through the night on her own after her first birthday, but it hadn’t happened yet and I was at the end of my rope. I loved the amazing breastfeeding relationship we had built and was nervous to make a change, but knew it was needed.

Talking with a good friend whose breastfed daughter was the same age as my little one, and also not sleeping through the night, reassured me that there was nothing “wrong” about our situation. We agreed though that we were ready for more consistent sleep stretches and began researching gentle night-weaning strategies, thinking we might approach this next big step together so we could support one another through the ups and downs. We spent two months researching and delaying [trying to choose the best time to start – when the littles were not sick or teething, we had a few days off work, not during a trip out of town, etc], and then, as luck would have it, both of our girls began sleeping through the night on their own around 18 months old. How’s that for irony?

Even though I ended up not needing to move forward with a night-weaning strategy, I thought it would be helpful to share what I learned with my fellow sleep-deprived mamas of toddlers, as well as answer some of the most common questions we get as Lactation Consultants regarding nighttime breastfeeding of a toddler over 12 months old.

Why is my 1-2 year old waking at night?

It’s important to remember that there are a variety of reasons your little one may continue to wake throughout the night. These reasons can include hunger, a need for comfort, pain from teething/illness, and external factors such as noise, just to name a few. Even though you may be using breastfeeding as the primary means to settle your toddler back to sleep, it may not be the reason your little one is waking in the first place. If you are able to pinpoint a cause for the night waking [such as your little one being too hot/cold], then you can oftentimes make a simple change [adjust the temperature of their room by using a fan/space heater] to decrease nighttime wake-ups.

What are some options for approaching nighttime weaning?

Once you have addressed outside variables such as room temperature, teething, etc, and feel as though baby primarily needs comfort and assistance transitioning back to sleep during nighttime wake-ups, there are several choices for how to move away from using breastfeeding as the means to settling your toddler back to sleep. These are a few of the gentle nighttime weaning methods and links to more detailed information about each one:

Jay Gordon Technique

This method uses gentle behavior modification by slowly reducing the total time spent breastfeeding at night, while replacing the nighttime nursing sessions with another comfort measure.

http://drjaygordon.com/attachment/sleeppattern.html    

Cues For “Bye-Bye Milk”

Depending on the age of your toddler and their understanding of verbal cues, some mothers find that using a verbal cue [and possibly ASL sign] for the end of a nursing session can help transition baby off the breast more smoothly. Many toddlers already use a sign or word to ask for milk, and this idea flips that routine to the ending of the nursing session. Once your toddler responds well to mommy saying, “bye-bye milk” or “all done milk,” or another phrase that works for you, this technique can usually be transitioned into explaining that when it’s dark, or nighttime, mama’s milk goes night-night too.

http://www.mommypotamus.com/so-you-want-to-night-wean-your-toddler/    

Will my milk supply decrease if I choose to night wean?

The short answer is, yes it probably will. However, for most breastfeeding mothers, the dip in supply will not be drastic enough to cause any adverse effects on the breastfeeding relationship. Now that your little one is a toddler and should be eating plenty of solid foods throughout the day, the small dip in supply will likely go unnoticed. As long as your toddler continues to nurse during the day, you will continue to produce breastmilk for him/her.

General tips for approaching nighttime weaning:

1. Enlist the help of a support person. No matter which path you take, nighttime weaning will involve providing comfort for your toddler in another way besides breastfeeding. Having another adult, whether this is your partner, a grandparent, your best friend, or a postpartum doula, available at night to help provide this comfort and/or support you through this change will be immensely helpful.

2. Create a bedtime routine and stick with it. If you haven’t already, I highly recommend you come up with a simple bedtime routine that you do with your toddler each night. Consistency is important for helping to establish boundaries and teach your little one what to expect during the night. Bedtime routines do not have to be elaborate. Something basic such as: bath, pajamas, story or song time, breastfeeding, toddler laid down in their sleep space, is all it takes.

3. Remember, it doesn’t have to be all or nothing. If your little one is waking multiple times throughout the night, you may wish to focus on eliminating one nighttime breastfeeding session at a time. Taking this slower approach can be helpful for avoiding engorgement as well.

4. If at any time during the night weaning process you have second thoughts or feel as though this isn’t the best decision for you and your family, then stop. You aren’t signing a contract when you embark down this path, and it’s okay to stop the process and wait to start again in a few weeks or a few months. Trust your gut and your mama instincts.

Help a Mama Out: Weaning a Toddler

‘Help a Mama Out’ Topic of the Week: Tips for Weaning a Toddler

Kelly: Take it slow and take cues from your toddler.  We haven’t completely weaned yet, but in order for ME to keep our breastfeeding relationship in a good place, I had to take is down to 3x a day.  While I wanted to distract and push away when the little one wanted to breastfeed, what he really needed was a few minutes of cuddling before he was on to the next thing.  Once I figured that out, taking it down to 3x a day was a breeze and I feel like I could do this forever now (or at least until HE wants.)

Heather: Honestly, let the toddler decide when to wean.  That is what I plan on doing with my daughter.  She is 18 months and still nursing strong!

Heidi: Sit them down and have a little heart-to-heart – worked with both of mine!  It’s incredible how much they really ‘get it.’

Lolis: I got pregnant!  Just cut out feedings by distracting her.  Nursing is a two-way relationship and if you don’t want to do it anymore, then your feelings should be respected, too.  I thought I would end up tandem nursing, but she weaned when I was 30 weeks pregnant and has tried a few times since then, but I just distracted her to take her mind off of it.  I’ve said ‘no’ a few times, too.  Try to also offer a drink when they are trying to nurse because sometimes they are just thirsty.  I also wear shirts that make the boobies inaccessible.  We made it to 21 months and I’m completely ok with that.

Theresa: When my daughter was a little over 2 years old I became pregnant and nursing was suddenly very uncomfortable for me.  We took weaning very slowly and gradually, cutting it back to naptime and before bed.  We had lots of honest talks about how mommy’s body was changing and that nursing was uncomfortable for me (not that she hurt me) because of those changes.  I incorporated giving her a cup of unsweetened coconut milk before going to bed as ‘big girl milk.’  I really emphasized how special our snuggle time was to me and reassured her that it wouldn’t stop just because she wasn’t having mommy milk anymore.  It took several months and, to be honest, a few teary times for both of us.  She breastfed for the last time when she was 32 months and started referring to it as ‘baby milk’ instead of ‘mommy milk.’  Also, once I stopped nursing, I switched from wearing nursing tanks to a bra and T-shirt.  It seemed to make it easier for her to accept a gentle ‘I can’t.  Mommy is not wearing the right type of shirt,’ on the random times when she still wanted to try.

Susan: Just finished weaning my 15 month old and low supply played the biggest role.  Once those first few days of sadness was over (for me), it was a relief to know she was happy as a clam getting a full 6-8 oz of non-dairy milk and I felt great knowing she is healthy and thriving.  I’ve realized we all take a different path in this motherhood and nursing thing and we all do what we can for the well-being of our children.  I totally agree with Lolis that nursing must be a mutual two-way enjoyable experience and if mommy is done that must be respected as well.

Adrienne: Having specific times of the day for nursing helped us.  We loved first thing in the morning, naptime, and bedtime.  Then I could say ‘not now, but we can nurse at naptime.’ This made her actually ask to go to bed.  Of course, there were exceptions for major physical and emotional injuries, but this worked for us.  Distraction, staying busy, avoiding places that reminded her of nursing, offering something else instead (like a book, snack, drink, cuddle, etc.) also helped.

Donna: I use distraction as much as possible and tell him that they are empty when they are.  Eventually they forget and nursing is replaced by cuddles J

Kathy: ‘Don’t offer, don’t refuse’ worked best for me and my son.  Shortly after his second birthday, he just stopped asking one day.  Seems like a lifetime ago and I miss it!

Don't miss our Boob Group podcast episode: Breastfeeding Toddlers: Night Nursing and Weaning

Here are a few more articles on weaning and toddlers on our blog:

Gentle Weaning: What is the Process? 

Gentle Weaning: Techniques and Resources 

Toddler Nursing Part II: Toddler vs. Breastfeeding 

Toddler Nursing Part III: Super Breastfed Baby!

A Farewell to Na-Na: When It's Time to Wean

Written by guest blogger, Jessica Lang Kosa

My youngest is weaning. Most people assume she has long since stopped nursing, since she goes to preschool, eats everything, and has sleepovers with the grandparents.   She still usually nurses at bedtime, but sometimes forgets to ask.  Occasionally she'll drift off, and then bolt up, announcing "bedtime nana!"  She seems to be on roughly the same timetable as her older brother and sister, so I suspect she'll forget more and more often, and be weaned altogether in a few months.

Mostly, I'll be glad. My milk supply is now very low, so nursing can feel annoying sometimes. And in our household, weaning is a right of passage marked by a family celebration…. with balloons and favorite foods.  It's kind of her first graduation party.

Like all my kids' milestones, it will also be bittersweet.  I will miss the potent mothering tool that toddler nursing has been, and I will miss this part of her life.

I'll miss the magic ability to calm an overtired kiddo and stop a tantrum; from meltdown to melting-in-my-lap with the flip of a breast.

I’ll miss the intense physicality of the nursing connection, and the way it relaxes both of us.  Coming home from work used to trigger a demand of “nana on couch!” I’d sit right down on the sofa to nurse her, reconnecting first thing, rather than getting swept into the flurry of household activity.

I’ll miss nana-as-medicine.  'Tis the season for colds and bugs.  Preschool germs have been so much more manageable since I could nurse her through them when she didn't feel like eating or drinking.

I won't particularly miss some of the boundary negotiations, but I'm glad we had them. Learning as a toddler that it’s not OK to strip-search mommy is a great introduction to personal space.  It's been a opportunity to teach that critical concept: other people, even mommy, have feelings.  Someday, when she's a young woman in a relationship, I hope her subconscious will remember my gentle limit-setting and guide her towards taking care of herself while loving someone else.

Since she's my third, I know how fast they grow up.  At preschool, she has friends her own age and a cubby and art projects with her name on them.  She helps make her own lunch, and proudly packs it in her backpack. As she discovers the outside world, with all its glory and its hazards, I will cheer her on, but miss the simplicity of her time as a baby.  She’s a long way from the tiny infant I used to tote around with me, but nursing allowed me to see and feed the baby inside her.  Watching her outgrow nursing in her own time has been a privilege.  Weaning has been a microcosm of holding on while letting go.

Jessica Lang Kosa is an IBCLC, providing in-home lactation consulting for families in Greater Boston, and breastfeeding education for professionals around New England.  

Connect with her at:

http://motherfeeding.com

http://www.facebook.com/motherfeeding

Gentle Weaning: Techniques and Resources

In this third article in our Gentle Weaning series, we will start the conversation about different techniques you can try to gently wean your baby.  If you are wondering about how to pace the weaning process, check out our last article, Gentle Weaning: What is the Process?

Every breastfeeding mother eventually weans her child.  It is part of the evolutionary process.  Whether your baby is a few months old or a preschool-age child, there comes a time when the act of breastfeeding no longer occurs.   When the time is right for both you and your child to wean, there are quite a few techniques you can use to help make the process go more smoothly. 

 I have searched books and the Internet to find some of the best resources out there.  I would love if you would please share your own resources and experiences, as well, so that we can all benefit from them!

 Techniques for Gently Weaning your Breastfed Child

Choose one feeding per day to replace with something else.  If your child is not on solid foods yet, then this would have to be some other nutritionally-based liquid.  Consider using previously pumped milk, or donor milk, in a bottle or cup.  If you child is eating solids, replace this breastfeeding session with fruits, vegetables, protein, grains, etc.  Fill a cup with water, pumped milk, or another nutritional liquid to help keep your child hydrated.

When you replace this feeding session, don’t stimulate your breasts at that time.  Skipping this nursing session should help to slowly decrease your milk supply, without the discomfort of engorgement.  After a week or two of skipping that nursing session once a day, choose another feeding to drop.  Continue this process until you have completed weaned.  This process may take weeks or months…. It is completely up to you. 

Don’t offer, don’t refuse.  This gentle weaning technique is more appropriate for an older child, rather than an infant.  What it means is that you don’t offer to nurse your child unless he/she asks to nurse.  This process may take longer than the other, as your child is never denied a chance to nurse if he/she needs to or wants to breastfeed. 

Save naptime and bedtime as the last feeding sessions to wean.  Bedtime and naptime are often the most difficult nursing sessions to end for both emotional and convenience reasons.  Save these for last.  Attempt to drop all of the other feedings first before you attempt those associated with naptime and bedtime. 

Create a new routine.  If you and your child like to nurse before a nap or bedtime, replace this nursing session with another routine.  Here are a few ideas:

Have your partner put your child to bed

Read your child a story

Sing to your child and relax in a rocking chair or bed (somewhere that is a different location than where you nursed before.)

If your child is old enough, ask him/her to choose what he/she would like to do instead.

Distract your child or offer something else.  If you can anticipate that your child is going to want to nurse at a certain time, offer him/her something else to do.  Kellymom.com recommends distracting with a favorite snack, a playdate with a friend, playing outside, or reading a favorite book as a few ideas.

Attempt nighttime weaning and daytime weaning at different times.  Trying to daytime wean and nighttime wean at the same time can be extremely overwhelming.  It’s best to choose one or the other and start there.  Kellymom.com has some terrific suggestions for ways to nighttime wean.

Celebrate your breastfeeding accomplishments at the end.  Weaning can be a very emotional process for both mother and child.  I remember my last nursing session with my son like it was yesterday.  We had this cozy, green rocking chair in his bedroom and I just sat there, rocking his soundly sleeping body in my arms, for about an hour after he finished nursing that last time.  I reflected upon the breastfeeding challenges we had overcome and the joy it had brought to the both of us.   I felt so blessed to have shared those moments with my sweet boy.

Now, this is NOT an exhaustive list of techniques to help you gently wean your child…not in the least.  Here are a few of my favorite blog posts about this topic:

Natural Parents Network: Gently Weaning a Preschooler

PhD in Parenting: A Different Kind of Baby-Led Weaning

San Diego Breastfeeding Center: Our Breastfeeding Memoirs, Chapter Two

What is Weaning and When Should I Wean my Baby?

Weaning is a very personal and emotional topic for all breastfeeding moms.  My personal experience with weaning my two boys was not what I expected nor anticipated.  As my milk started to dwindle when my boys turned three months, I didn’t have the breastfeeding support or knowledge I needed to ramp up my supply.  At that time, I was not a lactation consultant.  Instead I was a full-time working mom, breastfeeding while with my son and pumping, 2 times a day, while at work. 

I was devastated that my milk supply was ‘failing’ me, but I did the best I could to eek it out as long as I could.  I made it to 7 months with my first son and to 8 months with my second son.  I had hoped to breastfeed until my boys were at least a year, but my body had another plan in mind.  I weaned as slowly as I could, for I didn’t want to let go of breastfeeding completely.  The emotional tie was too great for me to let go of.

So, what is weaning?  What does it really mean?

Some women feel that anytime the baby is sucking on something other than a breast, it is considered weaning (i.e., pacifier, bottle, complementary foods starting after 6 months).  However, in the United States, I would say that most women consider weaning to be when a mother begins to breastfeed less, with the end result being that she is no longer breastfeeding.

How do you know when to start weaning?  Is there a right time to wean?

This is a very personal decision – one which mom, partner, and baby need to figure out on their own.  I recommend to all of the pregnant mothers I work with to talk with their partners about what their goals are for breastfeeding, prenatally.  How long would they like to try to breastfeed for?  This is not something that should be influenced by family members, friends, in-laws, media, etc.  Everyone has an opinion about breastfeeding duration, but no one’s opinion is truly that important as the mother’s, partner’s, and the eventual baby.  Once this decision is made, this is now your minimum goal.  If you reach your goal and you and your baby want to continue, then keep going!  If you reach this goal and are ready to wean, then you can be incredibly proud of yourself that you met this wonderful goal of breastfeeding your baby. 

Sometimes, a woman’s body begins to produce less milk, as in my situation, before she and her baby are ready to wean.  This is definitely a time to seek out the help of a lactation consultant.  Knowing what I know now, there are quite a few ways that I may have been able to increase my supply, to help me meet that goal of breastfeeding my boys for a full year.  It is all about support and knowledge.

When a mother doesn’t feel pressure to wean her baby, her baby would most likely breastfeed for at least 2 years.  This is very biological.  Remember, breastfeeding is not only something that is done for the nutritional value, but also for comfort and illness protection. 

So, what is a good process for gentle weaning? 

What are some helpful techniques, which take into account the needs of you and your baby?

Gentle Weaning: What is the Process?

In this second article in our Weaning series, we will start the conversation about how to gently wean your baby and why pacing is so important in this process.  If you are wondering when you will know when to begin weaning your child, check out our last article, What is Weaning and When Should I Wean my Baby?

At what pace should you wean your child?

Very slowly.  The weaning process can take several months, as you want to make sure that both you and your child are adapting well to this new pattern of breastfeeding.  Drop one feeding at a time (for example, from 6 times a day to 5 times a day) and try this out for a week or two. This will give your breasts time to acclimate and hopefully not become too engorged.  This will also allow your child to get used to doing something else, or get his/her nutrition from another source at this time.

This process will most likely take a month to several months; depending on how many times your child is breastfeeding in a 24 hour period.  Remember, weaning can affect you and your child physically and emotionally, so it is best to take your time and wean very slowly.

What are the risks for abruptly weaning?

It is very rare that a mother would have to abruptly wean her child from breastfeeding.  The risks associated with abrupt weaning for the mother could be:

• Breast pain

• Engorgement

• Mastitis

• Breast abscess

There are also risks associated with abrupt weaning for the child.  Remember, breastfeeding is not only a source of nutrition for your child, but also a sense of comfort and bonding.  To suddenly remove this could be very confusing and scary for your child, especially if he/she is still developing his/her sense of attachment and trust.  As with all methods of parenting, it is most respectful and effective to initiate change at a slow pace.

What physical and emotional changes should a mother expect when weaning?

All rights reserved, Susanne Klein photographeAs you begin to drop a breastfeeding session during the weaning process, you may feel fullness in your breasts, which can become uncomfortable.  Here are a few tricks to relieve that fullness:

• Pump or hand express, just to relieve the fullness.  Don’t pump to drain or you just defeated the whole purpose of skipping that breastfeeding session.

• Take a hot shower, which will help you leak a little and may reduce the pressure in your breast.

• Cabbage leaf compresses – good old green cabbage wrapped around your breasts can help to reduce fullness.

• Sage tea – drink sparingly while gently weaning, as it can really tank a milk supply when consumed in large quantities.

Emotionally, your body is going to go through some hormonal changes as you begin to wean.  During the weaning process, prolactin levels begin to drop.  Prolactin not only helps to stimulate your milk supply, but it also provides a sense of relaxation and calmness.  Some mothers may even feel depression after weaning. 

I remember feeling a sense of loss, that I had a difficult time describing, as I was weaning my son.  It was somewhat temporary, but it definitely was there.  I just felt sad that this aspect of mothering and comforting my child was coming to an end.  Something that helped me adapt to this change was creating a different bedtime routine for the two of us.  Instead of nursing my son to sleep, we now read a story together in his rocking chair.  Then, I turned off the light and sang him a song as I rocked him into a state of sleepiness.  My son is now five years old.  At bedtime, we still read a story in his bed and then listen to a song on his IPod as I lie down next to him and snuggle.  It is my favorite time of the day!

Now it’s your turn to share how you paced your weaning process with your child. 

How long did it take you to wean? 

What physical and/or emotional changes did you encounter?