All good things must come to an end, and a breastfeeding relationship is one of them. .
New moms—especially if they’re having a hard time—often ask me when they should wean their baby. The answer is really between them and their baby. Guidelines such as that of the American Academy of Pediatrics which suggest mothers give their babies exclusively breastmilk for the first 6 months, and breastmilk plus supplementary solids for at least a year, can be helpful; but in my experience, moms breastfeed as long as it is working well for them, and sometimes longer if they can. At other times babies make the decision themselves, and moms follow along.
How Long it Takes
It is usually easiest on mother and baby if weaning is done slowly. It is often recommended that a mother allow three to seven days for each feeding replaced by formula or other foods so that her body can adjust to making less milk. The first day she drops a feeding, mom may need to express a little milk so she does not get uncomfortably full. This process would take close to a month for weaning from full time breastfeeding.
Faster Weaning Suggestions
For a mom who wishes to dry up her milk faster, suggestions for more quickly lowering supply include:
Sage tea—two to six cups a day. This can be made by mixing 1 teaspoon dried sage in 1 cup of water. Alternatively, ¼ tsp of powdered sage can be taken three times a day for 1 to 3 days, or 30-60 drops of sage tincture 3-6 times a day.
Pseudoephedrine (Sudafed)—lowers prolactin and will decrease supply. A typical dose is 60 mg. four times a day. This should be kept up while weaning as the effect is reversible for the first days.
Estrogen containing oral contraceptives are known to decrease supply—which is why they are not recommended during breastfeeding, even though they are safe for the baby (after 6 weeks). A mom wishing to wean could return to her old contraceptive (not a progestin-only mini pill) and this would lower her milk production.
Other herbs that are said to decrease milk supply are peppermint, spearmint, and parsley. Lots of Altoids would probably work and mom would have very, very fresh breath.
Cabbage leaves—chilled green cabbage leaves left on until they wilt and reapplied as needed for comfort. Other ideas include cold compresses—20 minutes at a time several times a day, and ibuprofen or other pain reliever.
In general, a mother should avoid getting overly engorged, as this can lead to plugged ducts and mastitis. Expressing enough milk for comfort will help prevent complications and won’t cause a rebound in supply.
Another recommendation is to avoid nipple stimulation and to wear a firm supportive bra.
What about the baby?
Most younger babies are OK with weaning as long as they are happily taking formula. One technique for the transition is to mix formula with breast milk if a baby is having trouble adjusting to the taste.
Older babies may have more objections, and the following suggestions may help:
Start dropping feedings that are least important to your child (this is usually mid day feedings). Choosing an activity that is incompatible with nursing such as going to the playground can be a good idea. This principle of distraction and substitution also works well to help avoid confrontations over breastfeeding. It can be a good idea to have dad put the baby to bed for a while if nursing is a part of the sleeptime routine. It can also help to delay feedings until they are in fact skipped—later, after supper, etc.
Hopefully, these suggestions will help you and your baby move onto another phase of your relationship together with a minimum amount of discomfort and emotional distress.