4 Steps for Weaning with Love

For me, weaning my daughter from the breast was a piece of cake. At the tender age of 1 month, she stared me in the face, began howling, and refused to take my breast into her mouth. The howling didn't stop until a warm bottle appeared several minutes later.

A year later, the child who so willingly gave up the breast is significantly more reluctant to give up her beloved "bah," so much so that she's flung six sippy cups from her stroller and into the path of various speeding cars -- there's $30 I won't be getting back.

As you may have guessed, breaking up with the breast or the bottle can be hard to do, and for good reason. The breast has been the main source of nutrition for baby's entire life. And let's not discount the security, comfort, and warmth a child derives from snuggling up close to another warm body.

These transitions have quite an impact on a parent as well; there's not a mother out there who doesn't feel a pang or two every time her little baby takes on a new big-boy or big-girl task. It's inevitable: Every parent has to wean her child. But it doesn't have to be painful -- and you can continue to snuggle as much as you want!

The American Academy of Pediatrics recommends that mothers breastfeed their babies for a full year. It's a wonderful goal, and more power to you if you can reach it. Unfortunately, it's not possible or practical for everyone.

One of the most common reasons for weaning is returning to work. Other women simply want their body back. "I felt like I spent all of my time manipulating my boobs," says Margie Smith, of Columbia, South Carolina. "It was easier to bond with Amy when I used the bottle -- I felt like I had more control."

Whatever your reason, "don't let anyone judge you," says Katy Lebbing, manager of the Center for Breastfeeding Information and a certified lactation consultant at La Leche League International. "The most important thing to do is to wean gradually and with love." Here's how to do it, step by step.

You'll need about a month to complete the process. It may sound like a long time, but the gradual approach is vital for both you and your child. Babies don't take change lightly, and a bottle -- or a cup, if you're weaning a child over 9 months of age -- no matter how well-designed it happens to be, does not feel like a breast.

Another thing to consider is your own breast health. When I weaned, a well-meaning but old-fashioned doctor told me to stop nursing cold turkey, bind up my breasts, and wait. I obliged, and a few days later, my left breast turned red, hot, and painful, and I spiked a fever of 102 degrees.

The reason? "All of that milk had nowhere to go," says Freda Rosenfeld, a board-certified lactation consultant and nutritionist in Brooklyn, New York. "Then your milk ducts get clogged and painful."

If there's any bacteria in there, you wind up, like I did, with a breast infection called mastitis. Over-the-counter pain relief, warm compresses, and antibiotics can clear it up, but you feel pretty miserable. The best strategy is to wean slowly. If your breasts are full and it's not time for baby to feed, pump enough to relieve discomfort, which will help prevent clogged ducts but won't encourage milk production.

For babies younger than 1, he'll recommend starting your child on a cow's milk-based formula. If you're weaning a child 1 year of age or older, he'll recommend that you go straight to whole cow's milk.

There are formulas on the market designed for toddlers. You can try them if you want, "but there's no real benefit to using these formulas over whole milk," says Daniel Neuspiel, MD, associate director of pediatrics at Beth Israel Medical Center, in New York City. And because parents usually serve formula in bottles, "using formula may encourage bottle use in children 1 and over, which may lead to dental and orthodontic problems down the road," says Dr. Neuspiel.

It's important to remember that for kids older than 6 months of age, solid food plays a role in weaning. "Your child has been getting vital nutrients -- protein and calcium -- from breast milk," says Rosenfeld.

"You need to make sure his diet is rich enough in these nutrients, which means adequate intake of healthy solids." Dr. Neuspiel suggests yogurt and cheese to provide much-needed calcium. Iron may be an additional concern; finely chopped dried fruit and enriched pasta can up baby's iron intake.

"Weaning a 3-month-old is different from weaning a 6-month-old," says Lebbing. "There are different issues to consider, depending upon what's going on developmentally."

Around the 3- to 4-month mark, many parents start sleep training their baby, "so don't substitute a bottle at bedtime," says Lebbing. Weaning and adjusting to a new sleep routine all at once are stressful for a little baby. The same goes for introducing a 5- or 6-month-old to solids; keep using the breast at times nearest to these stressful events.

With toddlers, time weaning well before or after big changes, such as the arrival of a new caregiver. And if your toddler has never used a bottle before, go right to the cup so you won't have to break him of the bottle habit later.

Begin weaning by replacing one feeding a day with a bottle or cup for one week. "Feedings that have a strong emotional or comfort component should be eliminated last," says Lebbing.

"Typically, those are first thing in the morning and before bed." The next week, eliminate two feedings a day. As each week passes, eliminate an additional feeding.

But if you want to hang on to the before-bed feeding or any other feeding that makes you feel close, "go ahead," says Rosenfeld. "You don't have to eliminate everything unless you really want to."

Some parents find that taking away the bottle is even more stressful than weaning from the breast. Portable and easily replaceable, bottles are the ultimate convenient comfort object. I've yet to hear of a child who willingly pitched her bottle.

"Unfortunately, too much bottle use can lead to tooth decay, especially when it's used as a sleep aid," says Dr. Neuspiel. A child who falls asleep with a bottle in her mouth is coating her teeth in sugary liquid, which is a breeding ground for tooth troubles.

Introducing a cup to a die-hard bottle sucker won't be a piece of cake, but you can make it easier.

• Start early. It's easier to get a 10-month-old to use a cup than it is to wrench a bottle from a toddler.
• Take it slowly. As with breast weaning, the gradual approach is best. Replace one feeding a day with a cup of your child's favorite drink for one week, two for the next, and so on. Leave morning and bedtime for last.
• Make baby part of the process. Kids 1 and older are notorious for wanting independence, so let an older child choose his own sippy cup.
• Be strong. Getting rid of the last couple of bottles can be tough. One strategy is to only offer the bottle when it's filled with water or another beverage your child doesn't relish, then offer the cup with his favorite. If that doesn't work, Dr. Neuspiel recommends the hardline: Pick a time where there are few distractions, and get rid of your bottles. When your child wants one, offer him a cup. He may resist, "but when he sees that a bottle isn't an option, he'll take the cup."

Originally published in American Baby magazine.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.