weaning

There is no accepted ideal time to wean children either from the breast or from the bottle. There are considerable cultural differences in when children are weaned from the breast. Some "authorities" claim that the fact that in some countries breast feeding typically continues to age four, five or six means that this is a good idea for our culture. I think not. What works in one culture is not automatically appropriate in another - if you think about it, these many differences in practices and beliefs are what make different cultures different.

The argument that breastfeeding until two or more years old is "natural" and therefore superior because it is practiced in more primitive societies is subtly and fundamentally flawed. While it is true that this method of infant nutrition in subsistence cultures works after a fashion, the fact that in wealthier societies
  • infant and childhood survival rates are dramatically higher
  • overall disease rates are lower
  • frank malnutrition is much lower
  • ultimate body mass is dramatically higher (e.g. observe the increase in adult size in the United States from the Civil War until the present time, which is solely attributable to improved nutrition)
  • ultimate IQ scores are higher, again to some degree (probably large) attributable to improved nutrition of both fetus and child
makes the argument that breastfeeding for a very prolonged time is somehow imperative very weak from a rational standpoint. In my view, the simpler, thus more likely interpretation of the available evidence is that while infant breastfeeding is definitely of great benefit, in developed societies, there is a wide range of latitude involved in choosing an acceptable time to wean toddlers. This is because of the availablity of plentiful, safe, and varied food for toddlers and children. (And, no, I don't want to discuss this with you via flames.)

General weaning tips:

Weaning from breast to bottle:

The first big weaning tip I can give breastfeeding mothers who plan or need to wean much before a year old is to let the infant have an artificial nipple just enough that he will accept it as an alternative food source in a pinch. This does not interfere with nursing at all (see nipple confusion). A little water every day or two at first, then only as much artificial nipple exposure as is necessary to keep Baby reminded that milk can come from this funny bottle thing, too. Then when the time comes to go back to work or whatever, I use this method:
  1. Give yourself at least two weeks to wean before your baby absolutely must be off the breast. "Cold turkey" is uncomfortable and can lead to mastitis and even a disfiguring breast abcess. Don't do it if you can avoid it.
  2. Start on day one by limiting the nursing to about 7 or 8 minutes on each side by the clock for each nursing. Then immediately offer enough formula to fill the baby up. (If you will use the powder, you can just mix up two ounces - one scoop of powder - and you won't be wasting much.) Do this again the next day - same nursing time, then bottle to fill.
  3. On the third day, drop one minute from the nursing time and do, for example, 6 minutes on each side and then again, formula to fill the baby up. Again, repeat that nursing time the next day.
  4. Every other day, drop another minute, and formula to fill. Soon, towards evening you will notice that your breasts are not very full at all. You may now start skipping the nursing altogether and just offer the bottle, as much as Baby will take.
  5. As the days go by, you will substitute more bottles for nursings and pretty soon Baby is off the breast and on the bottle.
  6. If you misjudge and get engorged after bottle feeding (almost never happens but just in case) you would pump just enough milk to relieve the pressure and slow down a bit with your substitution schedule.
This method has worked very well for me over the years and I have never had a mother get mastitis doing this slow weaning technique.

Breast to cup is about the same as above.

Nurse for seven minutes, then offer the cup with formula (or whole milk if it is appropriate - if the baby is at least about a year old, you can go right to whole cow milk without the formula stage, and this is what I personally recommend). Then, every two days or so, drop a minute from the nursing time and wean off the breast as above. You might need to go a little slower - maybe drop a minute every third day - if you are getting resistance from the baby or if she isn't drinking very well from the cup yet and isn't getting enough from that route to displace the breast milk.

Going from bottle to cup is usually easy. Read the section on milk refusal for pointers if your child doesn't want to even try the cup. Once Baby takes the cup, you can simply substitute cup for bottle at more and more feedings and pretty soon you are done with it.

Last point: when your child walks around the house with a bottle in hand begging for you to refill it, it is time to wean.



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