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.

Breastfeeding the Older Baby: 12-18 Months

Written by Anna Choi, BS, IBCLC

Thank you for joining us for our third and final article in our blog series, Breastfeeding the Older Baby – What to Expect and How to Adjust. I’ve enjoyed writing these articles, as we have explored the evolving breastfeeding relationship between mama and baby, and I hope to have provided some insight for you about what this evolution might look like for you and your little one. In this final article, we will look at months 12 through 18 of your toddler’s life.

PHOTO CREDIT CHRIS WOJDAK

How often do toddlers breastfeed?

This answer varies greatly from one toddler to the next. Some mothers and nurslings have slowly decreased the number of breastfeeding sessions they have each day and may find that at this age, their toddler is breastfeeding as little as once or twice a day. Others may have a toddler who nurses like a newborn and goes to breast frequently throughout the day, nursing as many as 10 or more times in 24 hours. What’s important to remember is that there is no one “right” way to nurse a toddler and no magic number for how many times each day your toddler should or shouldn’t nurse. As long as mama and baby are happy with their nursing relationship and have found a rhythm and balance that works for them, then breastfeeding is going well.

Now that my little one has celebrated his/her first birthday, do I need to introduce cow’s milk or another milk alternative?

Such a great question – and one that we find ourselves answering frequently! In order to provide you with the most educated answer to this question, I enlisted the help of one of San Diego Breastfeeding Center’s favorite Registered Dieticians, Rachel Rothman. Here is what Rachel had to say:

Cow's milk is a good source of fat, protein, calcium and vitamin D, though it is not the only potential source of such nutrition. As infants become toddlers, many pediatricians make the recommendation to start baby on cow’s milk in order to meet baby’s specific nutrient needs.   If your baby is consuming a sufficient amount of these nutrients (in other forms), there is no reason he/she needs cow's milk or an alternate milk source.   One note I always give to my patients is that for children up to at least 2 years of age it’s advisable to give them full-fat / whole milk dairy products (cheese, yogurt, or milk) to ensure they receive enough fat to satisfy their needs. Keep in mind -  breast milk is an excellent source of fat and other nutrients.

- Rachel Rothman, MS. RD

If you find yourself having further questions about your little one’s diet, I encourage you to reach out to Rachel, as she possesses a wonderful wealth of information on nutrition {http://rachelrothman.com}.

I’ve reached my goal of breastfeeding for one year and I am ready to wean, what is the best method?

Congratulations on reaching your goal! If you are ready to wean from breastfeeding, there are several methods to choose from. Weaning gradually often makes for the smoothest transition for you and your little one {and your breasts!}. To start the weaning process, choose one breastfeeding session and replace it with something else {such as previously pumped breastmilk, water, solid food, etc}. After a few days, you’ll choose another breastfeeding session to replace with something else, and so on. Usually the nursing sessions before naps and bedtime are the hardest to wean from, and therefore the last to go. Your little one will appreciate extra snuggles as they adjust to this big change in their life. Depending on the temperament of your child, and how often they are currently nursing, the weaning process may take a few weeks or a few months. If you’d like more information on weaning, check out this link to a previous blog series all aboutweaning an older child

Can I stop pumping at work and continue to breastfeed when I’m with my toddler?

Absolutely! As a working mom myself, I was eager to put away the pump after my little one turned one year old. I knew I’d miss that lovely womp womp womp sound and getting undressed and redressed in the middle of my workday, but figured I’d somehow survive. How soon you can stop pumping at work will depend on your work schedule, baby’s solid food intake, and what you have decided baby will consume in place of the pumped breastmilk you’ve been supplying. If you stop pumping at work and continue to breastfeed your toddler when you are with them, your supply should adjust to meet the needs of this new routine. Some moms find that their supply decreases as a result, but this usually isn’t a huge concern since your toddler should be eating plenty of table foods at this point. If you decide to stop pumping at work, remember to drop pumping sessions and reduce the amount of time spent pumping gradually, to reduce your risk of engorgement and plugged ducts.

 

How do I handle unsolicited advice about my toddler being “too old to breastfeed?”

The short answer is, don’t feel the need to defend yourself. When someone makes a comment about your toddler breastfeeding, simply say, “We are doing what’s best for our family. Thank you.” And then, walk away.

If you’d like to get a little more detailed with your response, or perhaps provide some breastfeeding education to the person, you can reference the American Academy of Pediatrics and the World Health Organization’s recommendations, which advocate continued breastfeeding past twelve months of age. You can also let them know that nursing toddlers are generally sick less often and have fewer allergies than non-breastfeeding toddlers.

What did breastfeeding look like for YOU during months 12-18?