Q: My baby will be two years old soon and I've strictly breastfed her. I've been trying to wean her for about a month now. She refuses to eat food at home. When I offer food she won't eat or will throw up anything she's eaten as soon as she sees it's time to nurse. She only drinks and keeps breast milk and water down. At daycare, however, she eats whatever they offer her, and I purposely don't send pumped breast milk bottles. What can I do? I don't want to just abruptly stop nursing her.
A: At nearly two years of age, it’s definitely time for babies to make the transition from breast milk to solid food. Babies need the extra calories, protein, fiber, vitamins and minerals offered by a variety of foods, including whole grains, fruits, and vegetables. I understand your concern that your daughter won’t get enough nutrition since she refuses to eat at home, especially when she throws up after eating any foods that you offer her. She might be throwing up because she’s emotionally upset, and that’s likely since she’s able to eat better at her daycare. But there’s also a chance that she’s suffering from a gastrointestinal disorder that causes her to throw up after eating. For this reason, there’s no simple answer to your question or quick fix for your daughter’s dilemma. It’s important to make an appointment with your pediatrician so that your daughter can be evaluated and so that any digestive disorders can be ruled out. Once you and your pediatrician are sure that your daughter’s digestive function is fine, it might be helpful to work with a pediatric dietitian to begin the process of weaning your daughter from breast milk as you begin to introduce more solid foods. Some experts are advocates of the “cold turkey” method, which involves discontinuing nursing abruptly. This would likely be a bit difficult for you and your daughter, but after a day or two of mourning the loss of the breast, most older babies begin to eat solid foods and drink liquids from a sippy cup just fine. Healthy babies generally eat when they’re hungry enough, no matter how badly they’d like to nurse. Other experts advocate a more gradual weaning from the breast, while gradually increasing the baby’s reliance on solid foods. This approach requires a lot of discipline, such as only allowing your baby to nurse at certain times of day, while progressively reducing the number of times your baby nurses as well as the duration of each nursing session. Whichever approach you choose, you’ll probably have to steel yourself for a few days of tears and emotional turmoil. It’s important to remember that breastfed babies derive not only nutrition from nursing, they also derive emotional comfort from the close physical contact with their mothers. When making the transition from breast milk to solid foods, be sure to keep holding and hugging your daughter often, and this will help her understand that she doesn’t have to nurse to be held and hugged by you. The good news is that babies are remarkably resilient and adaptive, and they almost always accept new circumstances and routines when we offer them kindly and consistently. Once you’ve made the firm decision to wean your daughter from the breast and you’'ve got a good plan to do it, chances are excellent that your baby will be happily eating solid foods in less than a week.