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Thursday, December 5, 2013
When and How to Wean
I have a 19 month who is still breast-feeding. In fact, she wants to breast-feed all the time. I am a stay at home mom so she has my attention most of the day and night. She chases me around the house to breast-feed. I know she is getting plenty of milk by the amount of soiled diapers and listening to her swallowing. I`ve tried to get her interested in other foods, and other stimulation, such as reading, playing, etc. If I don`t feed her most of the time she cries and won`t stop acting up until I let her nurse. She has become very demanding. Sometimes I feel that is all I do all day long is breast-feed. She won`t eat meals much of the time, but wants to nurse instead. Should I continue nursing or try and wean her? What is the best method to wean her from the breast?
Congratulations on your extended breastfeeding relationship with your daughter--and it has become part of the relationship you have with her. It is not simply food to her. She probably also wants to breastfeed when she needs to touch base with you. Toddlers are so busy learning new things, which can become a bit overwhelming for them at times. When that happens your toddler may request the security and closeness with Mom that breastfeeding provides. If she senses that all is not well with you, she may want to breastfeed even more often. She doesn`t realize that the increased breastfeeding is one reason that all is not well with you or that her extra requests are only making the matter worse!
Of course, a toddler is also gaining a sense of being a separate person from Mom, and the words "no" and "mine" are often heard from a child this age. Gaining a sense of independence is a wonderful thing, but a toddler must also begin to learn that there are limitations on this independence because other persons have rights too. This requires that parents set some limits and stick to them. An 18-month-old usually is old enough to begin to learn that she is not the only participant in the breastfeeding relationship; mom is a participant too. At 18 months most toddlers are old enough to learn that both participants have a say about how this relationship progresses. If you find your daughter`s frequent requests are interfering with the breastfeeding relationship for you and you need to set some limits, do so but be ready to stick to them if there is an initial period of protest.
Many mothers have found they could comfortably limit toddler breastfeeding by starting with feedings that seem less important to the child. (Sleep-related breastfeedings, before or after nap or nighttime, seem to be among the most important for many toddlers.) Some ways mothers have found to limit frequent toddler breastfeeding include: * Not breastfeeding when away from home with a toddler, unless out for an extended period. * Telling a toddler he cannot breastfeed until the kitchen timer rings, and then setting the timer for an hour or two * Beastfeeding when requested but limiting the amount of time the child may beastfeeding, e.g. "You can breastfeed until I count to 20." (You speed or slow the count depending on what is happening.) * Requiring that breastfeeding only occur in a specific spot in the home-often one that is far from the center of activity and a room that is kept dark and boring!
Be sure she is given a choice of other activities she may do instead of breastfeed. If she`s allowed to choose, she still feels that she can exert some control over the situation. (See the example in the next paragraph.)
If you decide to set some limitations, prepare her and introduce only one at a time. The day before you intend to implement an idea, tell her what will be different the next day. For example, you might say, "Honey, you`re getting to be a big girl now. Big girls don`t (insert the word you and she use for `breastfeeding`) as much as little babies, so starting tomorrow morning when you get up, we`ll only be able to `breastfeed` when you hear the buzzer ring. Let me show you how it sounds. (Set the timer for a minute and ask her to listen.) If you want `breastfeeding` before it rings, we`ll find something else to do, such as read a story or eat a different snack." Repeat the information several times that day, using the same words so the message is consistent. Be sure to say at bedtime, "Remember, when you wake up tomorrow we are going toâ€¦" If she cries or acts up when she asks to breastfeed and is told she must wait, use those same words to remind her of the way things are to be. Then you might say, "I haven`t heard the buzzer/timer yet. Would you like a cup of (insert a healthy liquid) or a snack of (something healthy to eat) or would you rather cuddle up and read a story?" She now has a choice; breastfeeding just isn`t one of them. Expect some protest since that has worked for her before, but if you are patient yet firm, it won`t last long. Also, be sure to set the timer to coincide with sleep-related breastfeedings if those are important to her.
The American Academy of Pediatrics advises breastfeeding for at least a year and however long after that as desired by the participants in the breastfeeding relationship. Toddler and preschool breastfeeding are very common in many human cultures. Weaning is a process, and you and she began it months ago when you first started giving her foods other than your milk. Although the decision to completely wean is one option, sudden weaning can be physically or emotionally uncomfortable for the baby/toddler and mother involved. You may find that you enjoy breastfeeding again once some limits are enforced. For a more in-depth discussion, consider joining a La Leche League group. One of their four meetings is devoted to the topic of weaning. (You can link to a page that helps locate groups in specific areas by going to www.lalecheleague.org/) You also may be interested in reading the newly revised Mothering Your Nursing Toddler by Norma Jane Bumgarner, How Weaning Happens by Diana Bengson or The Nursing Mother`s Guide to Weaning by Kathleen Huggins.
Karen Kerkhoff Gromada, MSN, RN, IBCLC
Adjunct Clinical Instructor
College of Nursing
University of Cincinnati