Expert: Sally Wendkos Olds - 3/5/2008

Question
Hello, my daughter will be turning one next month and I am ready to stop nursing. I am a full time student and its hard for me to get anything done until she goes to sleep. She wakes me up several times throughout the night. She has a cup and she takes formula when I am not around but as long as I'm in her sight, she wants breast milk. What steps should I take to begin weaning her? Also, should I try to wean her with homogenized milk? PLEASE HELP!!!

Answer
Dear Shayla,

First, congratulations for giving your daughter the best start in life by breastfeeding her!

You can certainly give her homogenized milk at this age. Introduce it gradually, a little at a time.

As far as the night-time wakings, that is a hard habit to break, especially if she is sleeping in the same room with you. I am attaching an excerpt from my book (see below) with suggestions for encouraging a baby to give up these night feedings.

I am also attaching another excerpt with suggestions for weaning. Some of these apply to an older child, but some may be helpful to you. I hope so!

Good luck!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with Laura M. Marks, M.D.
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Nighttime Nursing
If you don’t really mind getting up at night, there’s no age by which your baby has to sleep through, so you can just wait until he gives up night feedings himself—and try to catch up on your own sleep by scheduling a nap during the day.
  But if your doctor says your baby is growing well, if he is nursing often and well during the day, if he’s at least twelve weeks old, so your milk supply is well established, and if getting up with him leaves you exhausted and irritable, you may be able to encourage him to sleep for longer stretches at night. Sometimes one of the following will work:
• Try nursing later at night, maybe at midnight, to see whether this will hold your baby till morning.
• Let your baby fuss (not scream) for five or ten minutes when he wakes during the night; if he’s not too hungry, he may go back to sleep.
• If your baby sleeps separately, let your partner go to comfort the baby, maybe by rubbing her back or rocking her in her crib. From a very early age, your baby associates your looks and your smell with feeding; if you go to her side, she’ll expect to nurse. This is why the father or someone else is often more successful in getting her back to sleep.
• If your baby is on a “night shift,” sleeping during the day and up a lot at night, reorient him by waking him up and nursing him every two to three hours during the day, and keeping him awake by taking him out, bathing him, playing with him, or sitting him in an infant seat where he can see interesting things and people.
• Although some parents feed their babies solid foods in the belief that this will help them go longer between nursings at night, there’s no evidence that this does any good. You should follow the AAP recommendations and continue giving your baby breast milk alone for six or more months. (Suggestions for starting solids are given in Chapter 18.)
• Offer a pacifier, if your milk supply is well established and your baby is at least twelve weeks old.  
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Mother-Led Weaning
If you’re ready to wean, but your child hasn’t shown any sign of losing interest, you may want to start the ball rolling yourself.
  If possible, try to initiate weaning at a time when your child does not have to make other adjustments. If he’s teething or has a cold, or you’ve just gone back to work, or there’s a new baby-sitter, or you’ve just moved, or there’s some other major disruption of routine, put off the weaning for a few weeks. It’s always easier to manage only one change at a time.
  Pinpoint the nursing session your child shows the least interest in, probably the early evening or noontime feeding. Eliminate this one first.
  If your baby is under a year old, you may want to substitute a bottle. Most babies enjoy sucking on a bottle until they’re well past a year, but not all find them appealing. If your baby doesn’t seem interested in drinking from a bottle, don’t try to force it on him. Instead, substitute something else, like a cup of milk (formula if your baby is under a year) or juice, or a few spoonfuls of applesauce.
  For an older child, the substitution can be any of a number of things—a game, a cuddle, a walk to the park, a reading session with a favorite book, a piece of fruit or other healthful snack. Most important is your involvement with the activity, so that you show your child that you can show your love for him in many ways. For suggestions on weaning the older nursing child, see the following section.
  Wait several days (up to two weeks) and then eliminate the next lightest feeding of the day. Keep doing this until you’re down to one nursing a day, probably the first one of the morning or the last one at night. By now, you’ll be producing very little milk and your child may give up this last feeding easily. Or you may decide to continue this one favorite feeding for a while longer. Many children wean easily during the day but want to continue nursing at bedtime for some time. Weaning this way should take from a couple of weeks to a couple of months or longer.
Suggestions for Weaning
the Older Child
• Make an agreement with your child about the places that nursing can take place. For example: only at home, in the car, or in a friend’s house, but not in a restaurant or other public place.
• Make nursing sessions shorter.
• Use distraction. Before a child might ordinarily nurse or as you’re bringing a brief nursing session to an end, involve her in an interesting activity.
• Offer something your child likes to eat just before he would ordinarily nurse. It’s better to forestall a request to nurse than to deny it.
• Change your routine. At a usual nursing time, go out for a walk or a ride, or invite a playmate over, or bring out a new toy.
• Stay away from the places where you ordinarily nurse. If you’re used to nursing in a special chair, hide it or move it out of your home temporarily.
• Don’t sit down in front of your child, since many little ones associate sitting down with nursing time. Just keep on the move in the early days or weeks of weaning. Think of it as another opportunity to exercise!
• Do not uncover your breasts in front of your child. This will remind him of nursing when he may not have been thinking about it.
• Lavish physical affection on your child in activities not associated with breastfeeding, such as reading a picture book, telling stories, or singing.
• Enlist your child’s favorite people. Ask her father, or grandmother, or an adored baby-sitter to get her up in the morning or put her to bed, or to go to her in the middle of the night, depending on which nursing session she asks for.
• Focus on eliminating the nursing sessions that are least important to your child and most inconvenient for you, and let the others continue for a while.
• Talk to your child about weaning as a definite occurrence in the future (after the next birthday, perhaps, or after Santa Claus comes). Even if there’s some backsliding after these events, your child will think of nursing as ending someday. One mother told her three-year-old a story about a little rabbit whose mother said, “I love you and I love to nurse you, but my milk is going away and it’s really special milk for babies.”
• Emphasize what a big boy or girl your child is. Stress some of the benefits of getting older, like going to nursery school, having play dates, not wearing diapers anymore. Focus on the many things he can do for himself, like dressing himself and using the potty. Talk about nursing as something that’s important for little children but not for big ones. One mother told her three-year-old that if she was old enough to chew gum, she was too old to nurse. The little girl was not about to give up her sugar-free bubble gum and never asked to nurse again.
• If your child is over three, you might be able to make a contract—to promise some special “big boy (or girl)” outing or treat one week (or whatever time period you set) after the last nursing. A child younger than this won’t be able to keep his end of the bargain—and even a three-year-old might not be able to.
• Ask your child to postpone a nursing; this will sometimes lead to his forgetting it. A child who asks to nurse in public, for example, can often accept waiting “until we get home.” At some times he’ll dash into the door and climb onto your lap to collect what’s been promised; at other times he’ll become interested in something else.
• While you’re weaning, continue to be willing to nurse your child at times when she’s especially needy. If she hurts herself or is sick or unhappy, depriving her of the comfort she’s used to will only create more unhappiness for both of you. Once she’s weaned, you’ll be able to comfort her in other ways.
• Stay away from traumatic techniques like painting your breasts with pepper, soot, or evil-tasting substances. Allow your child to keep his happy memories and his trust in you. The best way to end this stage in your child’s life is through an agreement between the two of you—even if that agreement originates with you rather than your child.
• Recognize those times when nursing is just what your child needs. As one mother said, “A lot of times when he asks to nurse I can distract him, but when he really needs it, I nurse—and then he’s in a super mood and so it’s good for both of us.”