Emma Pickett IBCLC
Making the decision to end breastfeeding
Breastfeeding support is all about helping you to breastfeed for as long as you want to. We want families to reach their breastfeeding goals, and that means Breastfeeding Supporters are here for parents at the end of their breastfeeding experience, as well as at the start. Some families want to breastfeed for years. Some want to for months or weeks. If you are able to make the decision with the right information and feeling supported, we have done our job.
We want to make sure that you make the decision to end breastfeeding in a way that you will have peace with in the future. If you are struggling with breastfeeding, it may be that the right support can resolve issues and you can continue breastfeeding happily. We would want all avenues to be explored if the idea of ending breastfeeding is an unhappy one.
Are you hoping that ending breastfeeding might improve your child’s sleep? It’s important that parents understand what’s normal when it comes to how babies sleep: “No difference in night wakings or night feeds was found between mothers who were currently breastfeeding or formula feeding … Breastfeeding has no impact on infant sleep in the second 6 months postpartum.” (Brown and Harries 2015)
You might have been told you have to end breastfeeding to take a medication and the Drugs in Breastmilk Information Service can provide evidence-based information on the compatibility of breastfeeding and medications. Sadly, parents are often misinformed.
It can be valuable for you to talk through your decision to end breastfeeding before starting the process. A breastfeeding supporter can help you reflect on your decision, as well as help you take some practical steps to get the process started. Every family’s journey will be different because every child and parent’s relationship to the breast is different. There is no ‘one size fits all’ approach to ending breastfeeding. In some families, the breast is at the heart of parenting. A mother might breastfeed throughout the night and day to meet her child’s emotional needs in a host of different ways. In other families, a child might be feeding a couple of times a day, and even then, only when offered. You can see those families will have very different experiences around the weaning process. However, there are some general guidelines about starting the transition to ending breastfeeding.
Weaning under 12 months
If your baby under 12 months is ending breastfeeding, their nutritional requirements will obviously need to be the highest priority. A baby of around 7–9 months who is taking solid food reliably will still need around 600 ml (20 oz) of formula in 24 hours (NHS Better Health Start for Life 2023). From around 10–12 months, if we can assume that solids have become more established, we’re expecting still around 400 ml (13 oz) of formula in 24 hours. If a young baby is feeding roughly eight times in 24 hours (it could easily be more), then we would start by looking at the formula total needed over 24 hours and dividing by eight. If day one means one bottle of 30 ml of formula at some point in the day (perhaps before a breastfeed), when everyone is in a good mood, that is a good place to start. If that volume increases gradually until one feed is entirely with the bottle, we might then pause for a couple of days to let breasts adjust and to consider next steps. Dropping one breastfeed no faster than every three days feels sensible to reduce the risk of breast health problems.
What kind of bottle is best? Parents often get pulled down a rabbit hole when it comes to this question. If a family is ending breastfeeding, we have less need to consider which bottle is protective of breastfeeding. There is not one ‘best’ bottle. We are looking for the bottle which is affordable, easy to buy where a family lives and with replaceable teats that are also easy to find.
What about choosing the type of formula? Any ‘First’ formula is appropriate and babies do not need ‘follow-on’ formula.
“All infant formula have to be of a similar composition to comply with UK compositional requirements and all brands are nutritionally adequate for infants. If a substance was found that was definitely beneficial for infant health that could be added to infant formula, it would be in all infant formula by law.” (First Steps Nutrition Trust 2021)
After 12 months, full fat cow’s milk can be given as a main drink. With a younger baby, giving milk in a bottle is likely to be a first choice. We want all bottle feeding parents to be confident with a technique known as responsive bottle feeding (sometimes referred to as paced bottle feeding) which can help the feed to be a time for connection and communication and reduce the risk of over-eating. However, the NHS recommend that families move away from bottles from around 12 months, and that means some older babies will be moving from a breast directly to a cup. We want families who use powdered formula to understand that the powder may contain bacteria and other pathogens and there are careful recommendations about how to make up a bottle safely. (https://www.nhs.uk/start4life/baby/feeding-your-baby/bottle-feeding/how-to-make-up-a-feed/making-up-a-feed/)
When we talk about a baby under twelve months transitioning from breastfeeding, it is easy to get wrapped up on dropping breastfeeds and discussions of milk volume, but we must never lose sight of the fact that breastfeeding was about connection and an exchange of love and physical affection too. It was about oxytocin. We still want that oxytocin creation to happen. We are not just changing how a baby is fed but adding in a new method of feeding AND lots of opportunities for physical affection. Bottle feeding can happen skin-to-skin and there’s lots of time for snuggles and connection.
Whatever age a baby is when breastfeeding ends, we need parents to be prepared for some possible impacts on them. Ideally, the transition from breastfeeding to exclusive bottle feeding happens gradually. If you have been producing a full milk supply, it is going to take time for your body to get the message that the order has changed. If that isn’t handled carefully, at the very least we could be looking at engorgement and blocked ducts. In more serious cases, we could be increasing the risk of mastitis and abscesses. A gradual weaning process means it’s more likely that the body will adapt. The grape-like lobules in the milk storage areas can feel lumpy under the skin and this can be frightening if you have spent months, or even years, associating lumpiness with blocked ducts. Milk storage areas that remain full are doing some important jobs. Fullness is part of the natural process which slows milk production. However, this is a balance, and we want the reduction to be as comfortable as possible. Breasts need to be well supported (but not squashed). Pain relief may be helpful. Cool compresses, and even cabbage leaves, may also provide relief. There are physical adaptations that are needed, but also emotional ones. You might experience ‘weaning blues’ even if you very much wanted to end breastfeeding. Your body is adapting to a change in hormones. Previously, with every breastfeed, there was a release of oxytocin. Your body may miss that, and you may have some other complicated feelings alongside the end of breastfeeding. It’s important for you to be gentle with yourself and reach out for support if you need to.
Weaning an older toddler
Let’s imagine we are talking about ending breastfeeding an older child. We start with doing some thinking about this child’s relationship to the breast. Are they more likely to ask at a particular time of day? Or when you are engaged in a certain activity? Are they hungry for food or hungry for connection? Once we understand when requests for a breastfeed are more likely, we can reflect on what a child will need to replace breastfeeding. The act of weaning is not simply the act of removing breastfeeding. Many new things often need to be added in. We can think of breastfeeding as being like the ‘Swiss army pen knife’ of parenting. It contained so many different tools and met so many different needs. Now you are taking it out of your tool belt, and you’re going to need to replace it with some new things. Some parents will learn to parent in different ways. Your child may need new ways to ask for help in emotional co-regulation. They may need a new language that helps them feel empowered and in control of their world. They may need a new language of sleep and getting to sleep. They may need help to find ways to say, “I’m feeling a bit vulnerable, and I need to check in with you.”
It may be that breastfeeding is the tool a child uses to physically calm themselves. It is how they wind down when they are buzzing. It is also often used as a tool for sleep. It makes biological sense when you think that breastmilk contains hormones that aid sleep for any age – for both the nursling and the parent. Nurslings of any age can enjoy breastfeeding as a way to transition to sleep, whether it is for a nap, at bedtime or after waking in the middle of the night. Breastfeeding might also be their decompressing tool when they feel overwhelmed at other times. They may be experiencing physical pain or feeling unwell. They may feel afraid.
Weaning is not a battle of parent versus nursling. It is trying to find a new world together, with compassion, that meets the needs of everyone. A lot is going to depend on the age of the child, but if your child is verbal and is able to understand what you are saying, they can be a partner in your process. You might start with conversations in daily life that explain milkies don’t last forever for everyone. These conversations can happen long before they are personalised to say, ‘One day, YOU will not have mummy milk.’ We want your child to understand that one day breastfeeding ends and that can be hard, but it ends for everyone eventually. In the park, you might point out an older child on a skateboard, ‘I wonder how old he is. I think he’s about ten. I wonder how old he was when he stopped having mummy milk and how he felt about that?’ A parent might talk about people in the supermarket, characters in the background of picture books or television friends. Does Peppa Pig still have mummy milk? It is never discussed so we assume not. I wonder how old she was when she stopped? How does she get to sleep now? What does she do when she wants to feel close to mummy pig?
Reading picture books about weaning can also be an extension of this conversation. For many young children, reading a book is a time where they are most likely to focus, and the repetition is ideal to embed new concepts. You may like to go one step further and make your own weaning book. Using online photo companies, it’s possible to create individualised books using family photos with familiar phrases, that give everyone a sense of ownership of the process. Young children often like to see photos of themselves, and you can include photos of their sleeping space, special toys and their favourite foods and activities.
Alongside reading picture books, eventually the time comes to put the theory into practice. You will need to explain to your child that one day milk will go away FOR THEM. You might share pictures of early breastfeeding and share memories. You might talk about how you have loved breastfeeding and how special it is and how you will find it hard to say goodbye too. This conversation doesn’t just happen once but is sprinkled throughout some days at different times. It might happen at the park or during dinner. Ideally it happens at times when emotions are steady to start with, and there is time to explore feelings that arise. A child as young as 18 months or two years old may not be able to articulate, or even fully comprehend what is being said, but repetition may help and it makes sense to try and offer some explanation, rather than underestimate their level of understanding. It is important that you reflect on how you will explain to their child WHY breastfeeding is going away. Some parents struggle with doing this authentically. You will see stories online of parents rubbing their nipples in unpleasant tasting foods or even chilli oil (ouch). Breastfeeding has been such an honest and beautiful connection. If a parent has breastfed their child for several years, it seems a shame to end it with something inauthentic, and something they may later look back on with suspicion. Are we really protecting them?
Many parents fear speaking honestly. They want to say things like, ‘milk is going away because you are getting older’ or ‘I think we will both sleep better if we don’t have milk at night.’ Neither of those concepts really make sense to a child. Why is milk going away? Being ‘older’ or ‘a big boy’ doesn’t mean they don’t need you! They may feel they sleep better at night because they have milk. They don’t want a parent to do this for them! If a parent can find a starting place that is truthful, they will be able to continue with that honest communication. You might say something like, ‘My body is going to stop making milkies’ or ‘my boobies are tired, and my body is tired and I’m going to help you say goodbye to milkies. I know it will be hard and sometimes you might feel angry and sad that boobies are going away, but mummy cuddles will always be here.’
A nursling who is weaning reluctantly has every right to be angry. Just as you have a right to wean, your nursling has the right to be angry and disappointed. It is important that they understand the feelings they express are to be validated. There is a misunderstanding by some that validation is a tool we use to calm children down. When we say, ‘I understand’, that we are actually hoping it is enough to stop them being upset, but in fact things might be more painful initially. A child who knows that their feelings are being listened to and recognised, is eventually going to be in a better place.
It is sometimes said that distraction is a valuable weaning tool. I have said it myself in the past. For much younger children, it can be useful as you seek to meet their needs in other ways as quickly and as effectively as possible. It is natural to not want to imagine that a child is experiencing pain. If there is a way to avoid seeing distress or anger, that sounds like an ideal scenario. However, distraction shouldn’t be about pretending weaning isn’t happening. We are not aiming to wean and hope they don’t notice.
The psychotherapist Philippa Perry describes how distraction ‘can be an insult to a child’s intelligence’: “What message does distraction convey? Imagine you fall over and badly graze your knee how would you feel if your partner, instead of being concerned or interested in the pain or the blood or the embarrassment, pointed out a squirrel or promised that you could play your favourite video game?” (Perry 2019)
Distraction is attractive in the short term. It might feel like a handy short cut, but this may not be the best time for short cuts. Of course, it does depend on what a child’s motivations for wanting the breast are. Ideally, if distraction does happen, it should be on-topic and meeting the underlying need. If your child is requesting connection and time with you, then offering a different loving focused activity isn’t distraction so much as offering a new way to meet the same need. However, a child who is asking for connection, and is instead offered a screen and a snack, is not having that need met respectfully.
If we see weaning from breastfeeding as a time to add in new parenting tools and new languages, what can that look like in practice? A new language around thirst and nutrition is about providing opportunities. Does the child have a cup they can use independently that is within easy reach? Do they have a way to request snacks or to explain when they feel hungry? All they may be skilled to do in that situation is to ask for a breastfeed.
Giving a child a new language to ask for connection and affection is often at the heart of weaning from breastfeeding. When a child continues breastfeeding beyond infancy, the dialogue of requesting a breastfeed and having that need met can feel powerful and wonderful. The most important person in their lives is pausing and meeting their request. When they have that urge for parental love and a sign of affection, they have the tools to do that. If that tool is taken away and no alternative is given, the risk is that the child feels not only rejected but also disempowered and destabilised. That was the only way that they knew how to ask for a physical sign of love. It was the only way they knew how to say, ‘Hey I need you for a moment!’ Can your child ask for a cuddle? Do you ask them for a cuddle? What other kinds of physical affection do you model in your home and have words for? You may want to add in more times for attachment play and power reversal play, where your child feels in control and taking the lead. Attachment play may only last for 10-15 minutes but it’s a time when you give your child your focus and your energy.
A feed that is sometimes difficult to drop is the reconnection feed that happens when a child is reunited with their parent after a day of nursery and work. That feed is a powerful moment of a child decompressing at the end of a long day and celebrating seeing the parent again. Some children will arrive home full of energy, and high energy connective play and physical games may meet a need. Some are tired and are looking for a moment of peace. Activities like a hand massage or head and shoulder massage can be special, and the nursling might take the role of the facilitator and the expert. Dens are a great tool to give little people a sense of fun and excitement. You can create a cuddle nook which may be a tent or a home-made den, with cushions, bean bags and fairy lights. This isn’t a place where breastfeeding happens but where reading and cuddling and other kinds of physical connection occur. It would be sensible to discuss in the morning what will happen at the reunion. Another caregiver could mention it and remind the child during the day. The parent might even be able to speak to them on the way home via a video call to prepare them for what is going to happen.
Alongside introducing a new language around connection and physical affection, other boundaries around breastfeeding are progressively being put in place. Breastfeeding might still happen in the day, but only in certain places. Perhaps no longer on a particular chair or restricted to a less interesting and stimulating room. You might agree to do a feed for a short period of time and then offer a different activity that may be more appealing. If you are saying, ‘not right now’, you can give them a choice about what might happen instead to help them feel they have some control over the process.
What about night weaning? What can be helpful is the concept of habit-stacking (a term used by Lyndsey Hookway). We want the child to have more than one association with safe and soothing bedtime and the process of falling asleep. Then as the breastfeeding is removed, they are left with something familiar that already helps their brain to think, ‘Ahh, yes, sleep time now.’ After all, being a creature of habit is a normal human state of affairs. Adults would also not be thrilled if our familiar routine was yanked out from under us overnight. Parents can introduce one or two additional habits alongside breastfeeding. It is something that involves the parent, so they are still offering co-regulation once the breastfeeding goes. It will differ for every child. Some would be irritated by stroking or patting and may prefer something auditory. A parent might choose a gentle phrase that can be repeated. They might tell a narrative along the lines of, ‘You are sleeping now. Mummy is sleeping now. Granny is sleeping now. Cats are sleeping now. The birds in the trees are sleeping now.’ When it later comes time for night weaning, the parent can add in, ‘Boobies are sleeping now.’ Some families might choose gentle singing or a white noise machine with ocean sounds.
For older nurslings, a guided meditation can also be a valuable tool at bedtime and the peaceful language repeated during the night in smaller chunks. An older child may also be able to express an opinion on what they would like to use as their additional sleep habit. At the same time, it can be useful to have conversation in the day about the process of falling asleep, to help reinforce that this is a process that involves an element of choice. How does Daddy fall asleep at night? How does a friend? What do they do when they can’t fall asleep easily? A parent might role play falling asleep with cuddly toys during playtime. What is teddy going to choose? And teddy might be angry with Mummy because booby isn’t happening throughout the night. A parent might ‘play bedtimes’, where they are the child, and the nursling becomes the parent. Or original roles might be maintained, and the parent offers alternatives to the breast. Role play can be a useful way to work through emotions.
Breastfeeding toddlers often haven’t attached to a cuddly toy at bedtime. Why would they? The parent is their cuddly toy. However, it might be useful to introduce a transitional object for the first time, to provide one further means of support if night weaning is going to happen. Again, with an older nursling, this is something they may to like have agency over. A parent might explain that one day boobies will go away, and they can choose a new friend to be with them at night to help them.
In the nights prior to the onset of night weaning, daytime conversation is valuable. This is not something that comes out of the blue. However, weeks of preparation are unlikely to be helpful. Being gentle is not always the same thing as being very slow. A young child is unlikely to have a sophisticated sense of time and concepts like ‘next month’ or even ‘next week’ are fairly meaningless. Something like ‘in a few days’ might be more useful. You might discuss it on the bus, walking back from the park, at dinner time. You could eventually remind their child that, ‘tonight is the last night that booby happens all night. Then tomorrow booby is sleeping at night.’ Or you might say, ‘tonight is the last night booby happens all night. Tomorrow, we can only do two boobies at night.’ You remind them that it will be hard, and you will be there to help them. Then the during the day, prior to the big night, there are lots of reminders.
What is important is to emphasise that you will be there to support your child, whatever they are feeling. We are not implying that we are asking them to be a ‘good boy’ or to ‘try hard’. Equally, the next morning, we are not praising them for not being upset. All feelings are welcome because the child is loved unconditionally. If you have a partner, they can provide important support for both of you, but it is not ideal if your approach to weaning involves you stepping away entirely and leaving your partner to take over (or for you to leave the home entirely). Your child is scared and experiencing their first major loss in their life. They need to know they are not losing you entirely. You are there to support them through this loss. And you’ll also need to practise your new skills of providing comfort and co-regulation. Sometimes when parents do attempt to use separation as a weaning technique, it can leave a child feeling more vulnerable and even more desperate for breastfeeding to continue. Sometimes there is no alternative other than to face difficult feelings and to be there for your child during their time of loss.
Ending breastfeeding is hard. Even the most careful and loving parent who approaches the weaning process sensitively and gently may find it upsetting and difficult. Just as we make space for little people to feel sad, we may need to allow ourselves to have mixed feelings too. As AA Milne says (as quoted in the weaning book, ‘Booby Moon’ by Yvette Reid): “How lucky am I to have something that makes saying goodbye so hard.” Then, when you are done, take a moment to look back and celebrate your breastfeeding achievement. Remember those early days and weeks. Remember the special times. IBCLC Glenni Lorick says that parenting is a ‘series of weanings’. This has probably been your first. Well done for getting through it.
Emma’s book: SUPPORTING THE TRANSITION FROM BREASTFEEDING: A GUIDE TO WEANING FOR PROFESSIONALS, SUPPORTERS AND PARENTS will be published by Jessica Kingsley Publishers soon.
- Brown, A. and Harries, V. (2015) ‘Infant sleep and night feeding patterns during later infancy: association with breastfeeding frequency, daytime complementary food intake, and infant weight.’ Breastfeeding medicine 10, 5, 246–252. doi: org/10.1089/bfm.2014.0153
- Drugs in Breastmilk information service: https://www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk/
- NHS Better Health Start for Life (2023) What to Feed Your Baby. UK: NHS Public Health England. https:/www.nhs.uk/start4life/weaning/what-to-feed-your-baby/7-9-months/
- First Steps Nutrition Trust (2021b) Infant milks: A simple guide to infant formula, follow-on formula and other infant milks. London: First Steps Nutrition Trust. https://www.firststepsnutrition.org/parents-carers
- Perry, P. (2019) The Book You Wish Your Parents Had Read (and Your Children Will Be Glad That You Did). London: Penguin. P.79
- Hookway, L. (2021) Still Awake: responsive sleep tools for toddlers to tweens. London: Pinter & Martin.
- Reid, Y. (2021) Booby Moon: a weaning book for toddlers. New Zealand: Yvette Reid.
- Lorick, G. (2009) ‘Life is full of weanings’, Conservative Granola Mommies, 2 March. https://conservativegranolamommies.blogspot.com/2009/03/life-is-full-of-weanings.html.