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Is It Time to Wean?
How to make a good transition from breast to cup or bottle.

Weaning, or phasing out breastfeeding in favor of bottle- or cup-feeding, can be a complicated issue for any mother. To help, here's a rundown of the basic--and not-so-basic--factors for you to consider.
Deciding It's Time

The American Academy of Pediatrics (AAP) urges mothers to breastfeed for their baby's first year, but only about 16 percent of nursing moms reach that goal. "Going back to work, a big vacation without baby coming up, and a feeling of 'I want my body back' are some of the explanations I hear," says Marianne Neifert, MD, a pediatrician and the author if Dr. Mom's Guide to Breastfeeding (Plume, 1998). "And all of those reasons are valid."

For many women, however, weaning is something that "just sort of happens," Dr. Neifert says. The most likely scenario, she explains, is that a mom starts supplementing breast milk with formula, and her baby regularly gets both the breast and the bottle. "The mother's milk supply then lowers in response to the decrease in breastfeeding. The lower supply frustrates the baby, who gradually realizes that the bottle is the most reliable source of milk. Then he 'self-weans,'" Dr. Neifert says. "But really, he only stops nursing because he isn't nursed often enough."

Some moms do make--or surpass--the goal of breastfeeding until baby's first birthday. Stephanie Nakhleh, of Santa Fe, New Mexico, breastfed her daughter for two years. "I'd wanted Julia to wean herself," says Nakhleh. "By her second birthday, she'd feed very frequently. But only for a couple of seconds at a time." Nakhleh, who was also considering getting pregnant again, decided to take the lead in weaning Julia.

Babies Younger Than One

Experts agree that it's more important to wean slowly. Cutting your baby off quickly could be traumatic. He'd feel the abrupt loss of his number-one comfort, your breasts would probably become engorged, and you might miss the nursing ritual too. Moving slowly will help you adjust.

Ideally, you should start the process a full two months prior to your desired stop date, says Dr. Neifert. As you cut out nursing sessions, consider pumping instead, and save your breast milk for the bottle or cup. Gradually reduce pumping, and begin mixing breast milk with formula.

Substitute the bottle (or a cup) for your breasts only once a day for the first week. Use the bottle for a less important feeding, like one at midmorning. Then substitute two bottles a day the second week, and three bottles a day the third week. Your baby will ease into the routine. Baby's favorite feedings--maybe the first of the day and the last before bed--should be given up last, since she's probably most attached to these.

Need to wean faster? You can speed the process by introducing a new bottlefeeding every few days instead of once a week, but beware: You'll be at a greater risk for engorgement. You may have to pump a bit after baby is weaned to slow down your milk supply more gradually.

Babies Older Than One

Again, it's ideal to follow the two-month schedule. At week one your baby should be feeding on demand, and by week eight he should be comfortable with a sippy cup. To help:

Wear complicated clothing. A dress with a zipper down the back may be enough to deter nursing-out-of-habit toddlers.

Set a timer. Limit your toddler's nursing time by restricting it with a timer. Choose a less-than-average time to help move the process along.

Avoid feeding spots. Stay away from places like the chair where you normally nurse baby.

Find ways to stay close. The first phase of limiting this intimate contact will be the hardest, but it's eased if your baby doesn't feel abandoned. Be available to comfort baby and give her some undivided attention. More talks, bedtime stories, and games can fill this need.
It's not a good idea to wean when your family is experiencing an upheaval like moving or having a new baby. It will be tough for your child not to revert to nursing for comfort.

Wean to Cup or Bottle?
Doctors and dentists agree that it's best to wean your child to a sippy cup if your child is older than nine months and can use one. That's because bottles--unlike cups--are apt to become security objects, and constantly sucking milk or juice can cause cavities.

But if you're weaning a young baby, a bottle will be a more soothing substitute for your breast, since you can hold him while he feeds. And of course, an infant won't be able to hold a sippy cup anyway!

Preventing Engorgement

Wean slowly. Otherwise your breasts won't get the signal from your pituitary gland that the demand for milk is down, and they'll feel like they're filled to bursting.

If you do become engorged, cool packs can help relieve the pain, as can acetaminophen (like Tylenol). Going back to nursing isn't a good idea. "It might confuse your baby--and your breasts," says Dr. Neifert. "Instead, pump your breast milk." Baby can drink it, or you can mix it into his cereal.

Weaning Yourself

While some women are ecstatic about ending nursing, others have mixed feelings, and a few are downright wistful. "One minute you're thinking, How much longer is he going to be doing this? But the next, it's, Oh, my sweet baby is all grown up!" says Dr. Neifert. Her advice: Be thrilled about your baby's independence--but don't be surprised if you also experience a slight pang. You may miss the days when he needed you for everything, even his nightly feeding.

Your should know:

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.