Expert: Sally Wendkos Olds - 4/15/2009

Question
QUESTION: My son is 13 months old and is still nursing first thing in the morning, at noon (if I am home but at daycare is drinking 1/2 a cup of rice and homo milk, immediately after daycare around 4:30pm, he tries at bedtime at 7pm but lately I'm trying to give him the rice/homo milk (as my husband and I have two and a half year old to put down as well)and then he wakes again around 10-11pm to feed. Sometimes he will wake in the night but I'm sending in my husband so that he doesn't pick up the habit of nightime nursing again. Anyway, I am looking at dropping the late 10pm nighttime feed as long as he's getting enough milk...he eats very well during the day, almost too much I think at times, sips at water but doesn't get juice, weights 27lbs and was 8 lbs 12oz at birth...can't remember last height check but he was in the 75th percentile for height and 99th percentile for weight. So,hopefully that info helps but what I would like to know is how to end that feed but have him sleep through the night. He also seems to have no desire to wean and I wondered how long he would go on for? I don't mind breastfeeding until summer and if he's not ready to stop then what do I do?
Thanks for all your help.
Michelle

ANSWER: Dear Michelle, Because of a technical glitch in the allexperts.com system, my original answer to you (below) got deleted when I tried to post the follow-up (way below). I hope this clarifies things for you. Regards, Sally
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ORIGINAL QUESTION & ANSWER:

Question: My son is 13 months old and is still nursing first thing in the morning, at noon (if I am home but at daycare is drinking 1/2 a cup of rice and homo milk, immediately after daycare around 4:30pm, he tries at bedtime at 7pm but lately I'm trying to give him the rice/homo milk (as my husband and I have two and a half year old to put down as well)and then he wakes again around 10-11pm to feed. Sometimes he will wake in the night but I'm sending in my husband so that he doesn't pick up the habit of nightime nursing again. Anyway, I am looking at dropping the late 10pm nighttime feed as long as he's getting enough milk...he eats very well during the day, almost too much I think at times, sips at water but doesn't get juice, weights 27lbs and was 8 lbs 12oz at birth...can't remember last height check but he was in the 75th percentile for height and 99th percentile for weight. So,hopefully that info helps but what I would like to know is how to end that feed but have him s
leep through the night. He also seems to have no desire to wean and I wondered how long he would go on for? I don't mind breastfeeding until summer and if he's not ready to stop then what do I do?
Thanks for all your help.
Michelle
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Answer: Dear Michelle,

First, congratulations for giving your son the best start in life by breastfeeding him!

It sounds as if you are doing the right things to get him used to the idea of weaning -- giving him the rice & milk and sending your husband in to him during the nighttime wakings. I imagine that he is eating a wide range of solid foods also. (I'm not familiar with the rice & milk combination and am not sure why you're giving him this, but this is another story.) It sounds as if he is growing very well.

The last nursing at night and the first one in the morning are often the last to be given up, so it might be a little hard to stop that late 10pm feed at this time. You can try by having your husband put your son to bed. But don't be surprised if he still wants to nurse. Some babies are ready to wean by the end of the first year -- others would go on until they start school if their moms would let them!

I am attaching an excerpt from the manuscript of the newest revision of my book (see below) with suggestions for weaning. I hope some of them will be helpful.

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 pediatrician Laura M. Marks, M.D.
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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!
. Don't 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 during activities not associated with breastfeeding, such as reading a picture book, telling stories, or singing.
. 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.
* Explain that "milky" (or whatever your special name is for nursing) is "all gone," "went bye-bye," or something similar.
* Give one week's notice and count down every night. Then give a special "big boy" or "big girl" present on the last night.
. 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." If you're already home, you can say, "Yes, but first I'm going to get a drink of water." Then get him involved in some activity with you, don't sit down, and maybe he'll become interested in something other than nursing. Meanwhile, you haven't said no, and you've made a start.
* Enlist your child's favorite people. Ask her father, or grandmother, or an adored babysitter 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. The first time I [Sally Olds] put my 18-month-old granddaughter to bed without her mother around, who had always nursed her to sleep, I helped Anna fall asleep by taking her into my arms in a rocking chair and singing every song I could possibly remember. I think she went to sleep in self-defense, so she wouldn't have to put up with my singing!
. 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. Remember that nursing through an illness is a great way to get food and immunities to an ill child.
. 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."  
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Later this morning:

Answer:  Dear Michelle,

Since, as I wrote earlier, I am not familiar with the practice of giving a baby a combination of rice and milk in a bottle, I consulted Connecticut pediatrician Dr. Laura Marks for her opinion of this practice. Here is her response:

"I have not heard of this rice/milk combo.  The only negative I can think of is that it sounds similar to adding rice cereal to the bottle for infants in an attempt to make them sleep through the night.  This can lead to obesity.  I am not sure if this is done under the instruction of a physician or if the mom is doing this on her own.  I would encourage her to consult her pediatrician."

Best wishes, Sally

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QUESTION: Thanks for all your help Sally. Sorry to confuse you with the rice/homo milk combination. We only started him on rice milk because his sister had a deadly allergy to milk and we wanted to be safe. He has had testing and is not allergic but won't take the homo milk on his own so we are doing half and half. I tried pumping but he refused my milk from anywhere but the breast! What a cheeky monkey. Thank you very much though for following through on my confusing milk situation.
Does it seem that the amount is okay? One feed in am., 1/2 cup of rice/milk at lunch, a feed at 5pm, 1/2 cup rice/milk at bedtime and one feed at 11pm? He's a big boy so I don't want to overdo it or underdo it.
Thanks.
Michelle

Answer
Dear Michelle,

This is really hard to answer from a distance and without enough information. For example, I don't know whether the amounts of rice milk and cow milk are 1/2 cup total or 1/2 cup of each rice milk and cow's milk. I don't know the total number of ounces that your baby is taking in a day or the additional number of times that he breastfeeds. And I don't know how much solid food he is eating. If you want to cut down the amounts of rice milk and give him only homogenized milk, you can gradually change the proportions of each until he is drinking only homogenized milk in his bottles. I really think that the best thing for you to do is to talk to your pediatrician who can not only guide you on what your baby should be eating but on how he is doing in terms of growth.

Best regards,

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 pediatrician Laura M. Marks, M.D.