Breastfeeding - deciding when to stop

Breastfeeding

The World Health Organization recommends that all babies be exclusively breastfed for 6 months, then gradually introduced to appropriate foods after 6 months while continuing to breastfeed for 2 years or beyond.

Stopping breastfeeding is called weaning. It is up to you and your baby to decide when the time is right.

Some babies decrease the number of breastfeeds as they begin to commence solid feeds. The first foods are really educational tastes and not much food is ingested. Once they’re established on solids, and start taking 3 solid feeds a day, they start gaining the nutritional benefits from solids and rely more on them for their growth and development (around 9 months).

Breastmilk in the first year

Breastmilk contains all the nourishment needed to promote normal healthy growth and development in babies in their first 6 months of life and remains the most important food during their first year.

Solids during your baby’s first year complement breastmilk and do not replace breastfeeds. Your baby should still breastfeed on demand, as your breastmilk is their primary source of nutrition until closer to the end of their first year.

Babies weaned from breastmilk prior to their first birthday will need to be given infant formula. Please consult your maternal and child health nurse for further information on this.

Infant formulas are generally not necessary after the first 12 months, as your child should then be consuming a large range of foods including dairy products. If you need to replace a milk feed (breastfeed or formula), full cream cow’s milk can be used.

Breastfeeding benefits

Breastfeeding even for a short time is beneficial.

In the first few days after your baby’s birth, your breasts produce colostrum. This rich substance contains vital ingredients, including immunoglobulins and cells that help your baby’s immune system.

There is ample evidence that babies who are breastfed for the first 6 months of life do not experience as many (or as severe) episodes of common childhood illnesses. These include gastroenteritis, respiratory illnesses and middle ear infections.

Stopping breastfeeding early

Sometimes, weaning needs to happen earlier or more quickly than planned.

It is normal for a parent to feel sad when they wean, especially if it is earlier than expected. A parent may feel they have no choice but to wean. However, most breastfeeding difficulties can be overcome with help. An Australian Breastfeeding Association counsellor, lactation consultant or maternal and child health nurse can offer you information and support.

Returning to the paid workforce need not mean having to wean. Many parents combine breastfeeding with part or full-time work, study and other commitments.

Take your time to wean your baby

Depending on your baby’s age and need for sucking, you can wean either to a cup or bottle. If you decide on a bottle, eventually your baby will need to be weaned from that.

Start with whichever breastfeed of the day your baby seems least interested in. If the breasts are uncomfortable when a feed is missed, you may need to express a small amount for comfort, to avoid blocked ducts or discomfort from fullness. Reduce either the time of expressing or volume removed over days for the breasts to adjust. Then cut out another breastfeed every few days or even each week, depending on your breast comfort and your baby’s willingness to cooperate.

The concentration of antibodies to bacterial and viral diseases in breastmilk is increased as weaning progresses and milk supply reduces. This ensures that your baby is protected as they are being introduced to new foods and exploring new surroundings.

Remember to give your baby plenty of cuddles during the weaning process so that you and your baby still have plenty of close time together.

Slowly reducing the number of breastfeeds protects your baby during the weaning period and will also help you avoid problems such as mastitis. If you need to wean your baby quickly, talk to a healthcare professional or a lactation consultant about caring for your breasts.

When to introduce solid foods

Breastmilk or infant formula should be your baby’s main source of nutrition for around the first year of life. Health professionals recommend exclusive breastfeeding for 6 months, with a gradual introduction of appropriate foods in the second 6 months and ongoing breastfeeding for 2 years or beyond.

Babies show they are ready to start solids when they:

• start showing interest when others are eating
• start making gestures that seem to say ‘feed me too’
• stop pushing out any food put in their mouth (disappearance of the tongue-thrust reflex)
• start being able to hold their head up and sit without support.

Talk to your maternal and child health nurse about your baby’s readiness to eat.

Iron requirements

A baby born at full term has a store of iron passed on from the mother during pregnancy. You may be concerned about your baby’s store of iron running low at around 6 months of age. Breastmilk contains small amounts of readily absorbed iron, and recent studies have shown that the risk of iron deficiency is very low in full-term healthy breastfed babies who continue to breastfeed past 6 months as solids are introduced.

Breastfeeding while pregnant

If you become pregnant, you may choose to continue to breastfeed or you may like to gradually wean your baby. This is an individual choice. Whether or not you choose to continue breastfeeding, it is important to maintain a healthy diet.

Seek advice from your health professional or the Australian Breastfeeding Association.

Extended breastfeeding

Some parents and babies enjoy breastfeeding so much they are in no hurry to stop. It is not unusual for children up to 4 years of age to continue to be breastfed.

Family members and friends may feel uncomfortable about extended breastfeeding and it can be helpful to have information to give your family and friends about why you have decided to keep breastfeeding. This may include information about the continued health benefits, security and comfort for your child.

The child who does not want to be weaned

You may be ready to cease breastfeeding, but your child may resist all your attempts to do so. Your approach will depend on your child’s age. There are many strategies for weaning a baby.

Unfortunately the child would need to be able to take a bottle, sippy cup, or straw cup comfortably before you are able to wean, to ensure they are able to take adequate feed volumes.

If your child can talk and understand well, talk with them about your breastfeeding. Explain that you are going to stop and introduce other ways that you can enjoy being close together. You could seek professional advice about weaning or difficulties associated with weaning.

Where to get help

• Your maternal and child health nurse
• Australian Breastfeeding Association Breastfeeding Helpline Tel. 1800 686 268
• A lactation consultant – contact Lactation Consultants of Australia and New Zealand (LCANZ) Tel. (02) 9431 8621
• Maternal Child Health Line Tel. 13 22 29 (24 hours, 7 days)
• Your GP (doctor)