How Long Should I Breastfeed And How Do I Wean?

What is weaning?

Weaning is when you begin to add foods to your breastfeeding baby’s diet. Experts say that you should feed your baby only breastmilk until he is six months old. You can continue to breastfeed your baby longer while feeding your baby other types of food. Breastfeeding alone for up to six months can decrease your baby’s risk for illnesses. These illnesses include respiratory (lung) infections, allergies, asthma, and stomach problems.

Why is weaning important?

• Once your baby reaches six months of age, he needs other foods to meet his nutrition needs. Your baby needs certain vitamins and minerals, such as iron to allow for normal growth and development.
  
  
• Weaning helps your baby learn eating skills. Your baby will learn to move food in his mouth and chew. He will also learn to hold and use a spoon to feed himself.
  
  
• Weaning allows your baby to try new tastes and textures. This helps your baby learn to eat different foods from all of the food groups.

When should I begin weaning my baby?

Talk with your caregiver about the best time to wean your baby.

• Weaning should begin when your baby is six months of age. If you wean your baby before six months of age, do not start weaning before he is 17 weeks old.
  
  
• Your baby may show signs that he is ready to wean. Signs include putting items, such as toys in his mouth. Your baby may chew on his fists and watch others with interest when they are eating. Your baby may also seem hungry between breastfeeding sessions and want to feed more often.

What reasons do breastfeeding mothers wean early?

There are many reasons why a woman might want to wean early. Most of these problems can be resolved to allow breastfeeding to continue. If you are thinking about weaning early, talk with your caregiver. Ask your caregiver about ways to solve these common reasons for early weaning:

• Sore nipples. It is normal to have some pain during the first two weeks of breastfeeding. You should not have nipple pain between feedings or once your milk starts flowing during a feeding.
  
  
• Low breast milk supply. You may feel that your breasts are not making enough milk to satisfy your baby. Most mothers do make enough milk for their babies, even if they think they do not.
  
  
• Plugged ducts and engorgement. Plugged ducts occur when the tubes inside your breast that carry milk become clogged. This may cause tender lumps in the breast. Engorgement may occur three to five days after birth. The breasts become swollen and painful, which can make breastfeeding uncomfortable.
  
  
• Lack of support. It may be hard to keep breastfeeding if you do not have the support of your partner, family, or friends. Talk to your partner, family, and friends about the benefits of breastfeeding. Talk to your caregiver or take a breastfeeding class. Understanding how breastfeeding works may make it easier for you to keep breastfeeding.
  
  
• Returning to work. Breastfeeding may be hard for women in the workplace. This is especially true for women who work full-time. Check with your supervisor about providing time to nurse or express milk at work.
  
  
• Health problems. When your baby has health problems, it may be harder to breastfeed. This may occur if your baby is in the hospital for a while after birth.

Why should I avoid weaning early?

With early weaning, breast milk is replaced by foods that do not provide the balance of nutrients your baby needs. Also, your baby does not get the full protection from illness that breastfeeding provides. Problems that may occur with early weaning include:

• Digestive problems, such as diarrhea. Your baby’s digestive system is not ready for solid food until about six months of age. Early weaning may also be a risk factor for celiac disease. This is when the body cannot process gluten, a substance found in wheat and other grains.
  
  
• Infections, such as ear and respiratory infections.
  
  
• Skin problems, such as eczema. Eczema causes skin swelling, redness, and itching.
  
  
• Excess weight gain. Your baby may be at risk for increased weight gain later in life.
  
  
• Nutritional problems, such as not enough iron or other nutrients.

Why might I need to stop breastfeeding before the recommended time for weaning?

There are times when breastfeeding may not be safe for your baby. In these cases, your caregiver may tell you to stop breastfeeding. Talk with your caregiver if you have concerns about any of the following:

• Active tuberculosis. If you have an active tuberculosis infection, that has not been treated, you will not be able to breastfeed. Talk with your caregiver before breastfeeding if you have started treatment for an active tuberculosis infection. Also talk with your caregiver before breastfeeding if you have been treated for a tuberculosis infection in the past.
  
  
• Human immunodeficiency virus. Women who are positive for human immunodeficiency virus (HIV) may avoid breastfeeding. This may help decrease the risk of passing the virus to the baby through breast milk. Ask your caregiver before breastfeeding your baby.
  
  
• Active herpes lesions. If you have a disease called herpes simplex and you have lesions (sores) on your breasts, you may not be able to breastfeed. See your caregiver if you have breast lesions, and ask him about breastfeeding.
  
  
• Varicella. Varicella is the virus that causes chickenpox. If you have the chickenpox rash, it can spread to your baby. You may need to use a breast pump or express milk to feed your baby until the rash can no longer spread. If your baby already has the rash, you and your baby may need to stay away from others, but you may still be able to breastfeed. Ask your caregiver for more information about varicella.
  
  
• Taking certain medicines. If you are being treated for cancer or certain medical conditions, the substances used in your treatment may harm your breastfed baby. These substances include antimetabolites, radioactive isotopes, and chemotherapy medicine. You may need to wait for a certain time after treatment before breastfeeding your baby. If you are taking medicine or getting treatments that can harm your breastfed baby, you may need to add bottle-feeding. If you have questions about receiving these treatments while breastfeeding, talk to your caregiver.
  
  
• Alcohol abuse. Alcohol is found in adult drinks such as beer, wine, and whiskey. If you drink alcohol often, or in large amounts, you may not be able to breastfeed. Talk to your caregiver if you drink alcohol.
  
  
• Drug abuse. If you use illegal (street) drugs, also called drugs of abuse, you may not be able to breastfeed. Street drugs include heroin, cocaine, methamphetamine, and others. Talk to your caregiver if you use drugs and need help to stop.

How do I wean my baby?

Weaning can be done slowly, quickly, partially, or fully. You can continue to breastfeed your baby while weaning him to solid foods and thereafter. How you wean is up to you and your baby. Children go through different weaning stages as they grow older. During these stages, children learn how to eat different types and textures of food. They also start to learn to feed themselves. Talk to your child’s caregiver. He can help you decide the best way to wean for you and your baby.

• When your baby is 6 months old, start to give him solid foods two to three times per day. Mash or puree all foods given to your baby until he is eight to nine months old. Good first foods to give your baby include baby rice and pureed vegetables and fruit.
  
  
• When your baby is 6 to 9 months old, keep feeding him solid foods 2 to 3 times per day. Start to give him food that is mashed with soft lumps. The lumps help him learn to eat foods with more texture. Also start giving him soft finger foods, such as small pieces of cheese. At this stage, your baby will start learning to feed himself. You can also start giving him liquids in a lidded cup. Your baby will likely still breastfeed about four to six times per day. This may continue until he is on a full diet of solid foods.
  
  
• When your baby is 9 to 12 months old, feed him solid foods 3 to 4 times per day. You can also give him one or two healthy snacks if needed. Start to give him hard finger foods, such as bits of low-sugar cereal or pieces of cracker. Also give him minced and chopped foods. Focus on giving him foods that your family eats. This will get your baby used to eating the types of foods your family enjoys. At this stage, your baby may start using a spoon to feed himself.
  
  
• When your baby is 12 months old or older, he should be eating mostly family foods. Up to age 12 months, breast milk may have been the major source of energy for your baby. After 12 months, most of your baby’s energy should come from solid foods. Until your child is two years old, avoid foods with a high choking risk. These include raw carrots and whole nuts. When your baby is 12 months old, you may be able to start giving him cow’s milk to drink. Do not give your baby cow’s milk to drink before he is 12 months old.

What foods should I feed my baby when weaning?

• Once your baby is eating solid food well, give him a variety of healthy foods each day. This provides him with a range of nutrients to meet his needs as he grows. Most importantly, feed your baby foods from the four food groups:
  
  
  • Protein, such as meat, fish, eggs, and lentils.
    
    
  • Starchy foods, such as potatoes, rice, pasta, cereals, and bread.
    
    
  • Fruits and vegetables, such as pears and sweet potatoes.
    
    
  • Dairy products, such as full-fat yogurt and cheese.
  
  
• Feed your baby only foods that are high in nutrition. For instance, limit fruit juices. Breast milk is higher in nutrients than fruit juice.
  
  
• Feed your baby foods that contain enough iron, zinc, fat, protein, vitamins, and other minerals. Once your growing baby reaches six months of age, breast milk does not provide enough of these minerals. After age six months, your baby needs to get these minerals from other sources. Foods that contain iron and zinc include meat, poultry, fish, and eggs. Other iron-rich foods include spinach and baby cereal with iron added. For your baby’s first two years, do not restrict the amount of fat in his diet. Your baby needs fat for energy and nutrition. Talk with your baby's caregiver about how to make sure your baby is getting the right foods.
  
  
• Breastfeed throughout the weaning process to help prevent allergies. This may be most helpful if allergies are common in your family. Talk to your caregiver about giving your baby foods that may cause allergies. These include milk, eggs, fish, shellfish, wheat, soy, peanuts, and other nuts. Also ask your caregiver about checking for allergies. This is done by giving your baby foods that can cause allergies one at a time for a few days each. This helps you see which foods may cause a reaction. Be sure to do this only as directed by your child’s caregiver.

What problems may occur when weaning my baby?

Correct weaning is an important step in the development of your baby. Even when you wean your baby correctly, problems may occur including:

• You may get plugged ducts, engorgement, or an infection. To prevent these problems, slowly increase the amount of time between feedings. Expressing milk between feedings can also help.
  
  
• Your child may resist weaning. He may not want to give up breastfeeding. This occurs more often with children over one year old. To ease your child into weaning, slowly introduce the bottle. You may also want to keep nursing at certain times, such as before your child naps. Depending on your child’s age, you may need to explain to your child why you are breastfeeding less often.

When should I call my caregiver?

Call your caregiver if:

• You feel you are not making enough breast milk for your baby.
  
  
• You have nipple pain while feeding or between feedings. Your nipples may look red, dry, and cracked or bleeding. They may have scabs on them.
  
  
• You have a fever (increased body temperature) or your body feels very achy.
  
  
• One or both of your breasts is red, swollen or hard, painful, and feels warm or hot.
  
  
• Your signs and symptoms of engorgement are not getting better within 24 hours.
  
  
• You have questions or concerns about breastfeeding or how to wean your baby.

When should I seek immediate help?

Seek care immediately or call 911 if:

• Your baby is having trouble breathing.
  
  
• You are feeding your baby new foods and he chokes or begins to turn blue in the face.

Where can I get support and more information?

You may want to wean earlier than recommended. Keep in mind that proper weaning helps set up your baby for a lifetime of healthy eating. For more information on weaning, talk to your caregiver. You can also contact the following:

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village , IL 60007-1098
  Phone: 1- 847 - 434-4000
  Web Address: http://www.aap.org
  

Care Agreement

You have the right to help plan how you are going to wean your baby. To help with this plan, learn as much as you can about weaning. Ask your caregiver any questions you have. You and your caregiver can work together to plan the best way to wean your baby.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.