Expert: Sally Wendkos Olds - 3/19/2005

Question
Thanks for your quick response. I do have a follow-up question. Is there any way I can wean her tearlessly? I had hoped that a cuddle and sippy cup with milk would be a good substitute for nursing, but failing that, I'm not sure what to do. She's still very attached to the breast, and I don't mind waiting a bit longer until she loses interest, but what if she doesn't? I know people whose kids have enjoyed nursing into their 5th year of life, and I don't think I could last that long!

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Followup To
Question -
My 14 month old is still nursing 3x a day and loving it, which is fine. But we're trying to get pregnant again, and I don't know how long I'll be able to physically withstand both nursing and pregnancy (had VERY SEVERE morning sickness the first time 'round), so I'm thinking about weaning her gradually. The problem is, what do I wean her onto? She absoluately refuses cow's milk and formula. I've tried introducing both many, many times in the sipper cup that she happily drinks water from. She will eat cereal that is mixed with milk or formula but will not drink either alone. Any suggestions?
Answer -
Dear Alison,

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

It's good that your baby does drink water from a cup. You might try giving her juice from a cup also. She can get her calcium from cow's milk in her cereal and you can put milk into other foods as well, like pudding. Perhaps you can give her yogurt daily (fruit-flavored maybe), ice cream, or cheese as finger food, etc.  for more calcium. Check all of these suggestions with your pediatrician, but I would not worry about calcium intake. Every couple of days try giving her milk in a cup; babies (like adults) often change their minds! Her holdout shouldn't last too long. If it does, perhaps your pediatrician should investigate whether she is allergic to cow's milk. However, it seems unlikely that she's refusing milk because it is causing her discomfort, since she takes it in cereal without complaining, but if her refusal keeps up, the allergy possibility might be worth looking into.

Good luck!

Sally

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.  

Answer
Dear Alison,

I understand your concern about weaning your daughter -- it's true that some children hate to give up the breast! They know a good thing when they have it!

I have an entire chapter about weaning in my book, which maybe you can pick up at your local library. Basically my point of view is that if you are ready to wean, you can initiate the process without waiting until your child shows readiness. I am attaching a few suggestions from my book.

Good luck -- Sally

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.
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Excerpt from TCBB:

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 babysitter, 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 for children (and adults, too) to manage only one change at a time.
  First, pinpoint the nursing session your child shows the least interest in. It will probably be 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 Box 18-2.
  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 babies 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.
  
  BOX 18-2:  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 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.
  *  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 any more. Focus on the many things he can do for himself, like dressing herself 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 she's in a super mood and so it's good for both of us."