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When You Simply Have To Wean

Dec07

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Dear Amy,

You have helped me with cloth diapers, baby naming, and travel with multiple children, and now I’m hoping you can help me again. My eight month old son is not thriving. At all. I don’t want to say that he’s stopped growing, but he’s barely registering on the percentile chart (which I know is to be taken with a grain of salt). Developmentally, he is way ahead of the game and has been crawling since he was six months old. Now he climbs stairs and cruises like it’s his job…we’re excited for his first steps, which we anticipate any day now.

We’re relying on our family physician, along with a referral to get his nutritional needs straightened out, in addition to a boatload of tests and lab work which just make my heart break. As part of his “failure to thrive” diagnosis, we quickly determined that he is not nursing well. He had been, but he is just too busy / distracted to nurse now. However, give him a bottle and he’s all about it. Since we need to quantify his nutritional intake, I had been pumping and supplementing with formula to fill his bottles. Now we need to make the move to formula only, due to crazy supply issues (insert Mommy Guilt here). And so this brings me to my question: How do I go about weaning? I know the the baby is okay with a bottle, but what about my boobs? I’ve heard about cabbage, but how long do I do that? And is it going to take four days, or a month of rock hard boobs before the faucet finally turns off?

Weaning on short notice was not really in my plan, and so now I’m just shooting for making it as (realistically) comfortable as possible.

Thank you!

First of all, dude, I am sorry you and your little guy are going through this. I really hope his doctors get to the bottom of things quickly, AND that things really can be solved with a nice steady uptick in calories and nothing more.

And I also CAST THEE OUT, MOMMY GUILT. I hereby declare this to be a Judgment Free Zone, unlike every other article on weaning I pulled up this morning during a cursory do-I-have-my-basic-facts-right check, because man, nothing like reading over and over again that you don’t really have to wean and shouldn’t wean and it’s all in your head and blah blah blah…even though you do, in fact and in your particular case, have to wean. Shut up, Weaning Articles! Stop being annoying.

That said, I still don’t see any reason why you can’t wean your son semi-gradually instead of super-crazy abruptly, if only to prevent your own discomfort. Going cold-turkey with cabbage leaves would not be my first choice if there was any other way, since this isn’t a case of you taking dangerous medications or being physically separated from your son for a length of time. And since you seem to have a pumping schedule down already, you can definitely make this easier on yourself and avoid the strap-on boulder-boob feeling. (Not to mention the hormonal craziness that can take over when you have boobs full of milk and a brain full of signals that something must be wrong and where’s your baby and etc.)

The best way to purposely wean your baby is to take the Don’t Offer, Don’t Refuse route. If your son starts rooting and turning into your chest, nurse him. But once he pops off, distracted-like, don’t encourage him to get back on. Instead, have a bottle ready and give him that, just so you know he’s getting enough to eat per doctor’s orders. Likewise, if he’s crying and acting hungry but DOESN’T seem to be nuzzling around for the breast, skip offering it and go straight to the bottle.

To offset any discomfort that comes from your milk coming in sans rooting, keep pumping, but eliminate one pumping session each day until you’re down to zero. If you feel full and uncomfortable during the increased stretches of time between pumping sessions, by all means go for the cabbage leaves or cold compresses as needed. (Hot compresses and hot showers will trigger letdown, so you might want to try keeping your shower as tepid as possible until you’re done.)

In my experience as a fellow Crap Milk Supply veteran, your supply may dry up fairly quickly and painlessly. I felt Noah weaned pretty abruptly at five months — we were nursing three times a day (then oftentimes following up with a bottle) and I was pumping twice. Since he also was a distracted nurser with a very poor suck, our nursing sessions were increasingly short and probably didn’t really involve that much milk. One morning he literally woke up and would. Not. Latch. On. He pulled away and howled in misery instead, but then accepted a bottle and sucked it down happily. I pumped twice that day at work, as usual (though I produced very little), and tried nursing again in the afternoon. Same thing. He just wanted no part of it. I stopped offering, he never rooted again. I pumped once the next day and then…that was that. I was dried up. No pain, no engorgement, just…done. Any letdown feelings afterwards were strictly of the phantom variety.

With Ezra, it was more gradual, but only because I was fighting the process tooth and nail, repeatedly offering and offering him boob first and then frantically pumping and taking supplements in case it was a supply thing. But it wasn’t a supply thing. He was just done. Once I finally accepted that he was done, I realized how little milk he was actually drinking from me because I think I felt the need to pump exactly once and then…I was done too. So if you are having supply issues, your body may be pretty amenable to the weaning process and ready to stop with the milk already, with just a few basic cues from your baby and a step-down in pumping.

Also promise me you’ll take care of yourself — weaning AT BEST can be a very bittersweet, confusing thing, and doing it under pressure or stressful situations like yours might mean that your emotions will be a tougher thing to handle than any engorgement issues. I know a lot of weaning advice involves handing over feeding duties to a significant other, but if you find that upsetting or get pangs over OH NOES LOSS OF BONDING, by all means stay involved in the bottle feeding or let him nurse first — even if it’s for all of 15 seconds before he pulls away.

And once you’re done with weaning, go out and buy yourself some kick-ass bras or lingerie or cute tops that celebrate the Return Of Boobs For Decorative Purposes Only. Because they’re still pretty great, you know?

Photo credit: Thinkstock

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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15 Responses to “When You Simply Have To Wean”

  1. Olivia Dec 07 at 3:18 pm Reply Reply

    Super advice. Also something to keep in mind is hormonal mood swings during weaning. This is something I’ve been hearing more about lately. I’ve been weaning now that I’m pregnant and have been rather cranky during the process. I’m not sure how much that has to do with weaning and how much has to do with being pregnant, though. Anyway, don’t be surprised if you feel that way.

  2. Karen Dec 07 at 4:14 pm Reply Reply

    Yes! Great suggestions. Depending on yours and baby’s needs and preferences, no reason why you shouldn’t have a pleasant, gradual wind down over several days or weeks. If the baby is only nursing a few minutes at a time or per day then why quit cold turkey? II was able to comfortably slow my nursing down by reducing pumping and nursing sessions. And in case you need to hear something positive, I was warned by a friend about feeling depression like symptoms after weaning. Instead, after I weaned I felt like I had been depressed during nursing and that it lifted as soon as we stopped. My kid was a crappy (but successful) nurser that I fought for 13 months and I think I was so relieved to be done with the whole thing… Good luck!

  3. JCF Dec 07 at 4:17 pm Reply Reply

    I’ve weaned two kids so far by dropping one feeding every couple of days.  On day I’d decide to skip the feeding before the morning nap, then a few days later, I’d skip the afternoon nap, so on and so forth.  It was pretty painless, although I do remember feeling a bit sensitive (physically and emotionally) for a week or so.  I was really glad I had done things that way, because I did have some discomfort for a day or two after dropping the last feeding.  I’m assuming that would have been straight up pain had I done things more quickly.  

  4. Jess Dec 07 at 4:28 pm Reply Reply

    Oh, definitely have to second the hormonal mood swings! My son suddenly refused to nurse around three months, so I ended up exclusively pumping until he was a year. Then, between my supply getting lower, my pump breaking, and being SO DONE with it all, I just stopped. I had a couple of uncomfortable days, but I was surprised how quickly my supply dried up. A couple times I had to manually express a bit of milk so I could be more comfortable, but otherwise it wasn’t a big deal. What I wasn’t prepared for was the mega hormones, yikes! I became so moody and headachey and crampy and dizzy and tired for about a month. Honestly it was like being pregnant again (and I actually did get pregnant again about 3 months later, so I could compare :) ). I spoke to my midwife about it and apparently it’s completely normal, although it doesn’t necessarily happen to everyone. So just in case, be prepared and take care of yourself! Good luck!

  5. Stefanie Dec 07 at 4:36 pm Reply Reply

    My go-to relief for engorgement was to wet my nursing pads and put them in the freezer.  Pop them in the nursing bra, and aaahhhhh.  And thank you, Amy, for putting an article on the internet about weaning that isn’t full of mommy guilt!

  6. Brooke Dec 07 at 6:54 pm Reply Reply

    I know this is not what you asked, and I’m not a doctor, etc etc. I obviously don’t know what is going on with your son. But my daughter was kind of small and then just dropped off the growth charts. She didn’t stop growing, but she slowed waaaay down. So we had the lab work, the weigh ins, the nutritionist, etc etc. And then! We discovered this thing called constitutional growth delay. It basically means kids slow way down on growing at 6ish months and fall off the bottom of the growth chart, and then around 3 years old they pop back up, but stay smaller than their peers until puberty. It’s diagnosed with an x-ray of the hand to check bone age. It might be worth checking into, if this seems to fit.

    I only mention it because it’s pretty rare, and I’m that crazy mama always telling people about it.

  7. Meghan Dec 07 at 8:12 pm Reply Reply

    So just another idea, and you may have already thought about it and decided against it, but if you wanted to keep using your breastmilk you could fortify it. My one daughter was very very tiny and so she needed extra calories so we used formula to increase the caloric content of my breastmilk. It is definitely a pain to pump and then bottle feed but if you did want to continue using your milk you should ask your nutritionist about fortifying.

  8. Susan Dec 07 at 10:29 pm Reply Reply

    I want to second what Brooke said, and all the same caveats too. I’m not a doctor, but the mom of a 22 month old peanut. She weighs 20 pounds and has for several months. Her weight gain dropped off at around 8 or 9 months and her height is still below average (30 inches currently). She’s still growing, albeit waaaaay slower than the pack. But her cognitive, physical, and emotional development are all right on schedule and her doctor also indicated it’s probably ‘constitutional growth delay’. Not sure if you have done this yet, but I’d seek a second opinion before quitting breastfeeding. And GOOD LUCK, NO GUILT!

  9. Corie Dec 08 at 9:10 am Reply Reply

    I was also going to recommend fortifying your breast milk with formula so it’s not completely wasted effort. (I had to do that for my son for his first two months because he was a preemie. It led to me exclusively pumping for 7 months and then gradually switching over to formula so that I fully weaned at 9 months.) I would suggest taking a more gradual approach…drop one pumping/nursing session and space the rest out (if possible). Give your body a few days to adjust so you stop getting engorged, and then drop another. It might take a few weeks, but once you’re down to 2 pumping/nursing sessions, it’ll probably be pretty easy to drop them. I went from 3 pumps per day to 2, and then a week later tried to go to only one but that was it. I did that once, and haven’t touched my pump since (except to clean it and pack it up so I can pull it out again for our next one).

    Good luck!! I know it’s tough – I had HUGE mommy guilt about quitting pumping, but it was sucking the life out of me and I was miserable the whole time I was doing it. My son got 7 months of (almost) nothing but breast milk, which is a whole lot more than lots of babies in the US get, and I stuck it out through having to pump rather than just being able to nurse. That’s something to be proud of, and you should be proud of sticking it out for this long.

  10. Mairi Dec 08 at 2:14 pm Reply Reply

    As usual, you have offered good, sound advice that is in direct response to her answer. My only very slight, flinchingly offered advice is that no mention of contacting a certified lactation consultant was ever made by the asker, Amy or any of the commenters that I have seen and that would be my first suggestion, even before seeing your ped. The thing is, as a general rule, doctors know very little about nutrition and practically nothing about breastfeeding. They truly don’t study it in school for more than a day or two if they’re lucky. I’m speaking from an insider’s perspective as my husband is currently in medical school and very involved in nutrition and lactation issues. An IBCLC could offer new insight into your issue and help you reach your goals (whatever they may be). It was worth it for me and turned an out of control situation into a comfortable long-lasting, healthy nursing relationship. Best of luck!

  11. MR Dec 08 at 9:10 pm Reply Reply

    First off, CONGRATULATIONS!!!  You bf your baby for 8 months! That’s awesome! And despite his slow physical growth, he is thriving. You are doing great, Momma! I’m sorry you are having to wean before you wanted to, but I hope you take the time to appreciate that you gave him the best for the especially crucial first months. If you can, try to think of formula at this point as an extension of giving him solids. There should be no mommy guilt involved here.  The best way to wean cold turkey is to pump only enough to relieve pain, but leave the sense of fullness. Good luck!

  12. ksmaybe Dec 08 at 10:04 pm Reply Reply

    First a big hug and you are doing everything you can to the questioner! Second, thank you to Brooke and Susan. My daughter follows the same path you have mentioned….with the caveats on the growth charts, which she has been plotted against the CDC charts not WHO, so, whatever, but she went from 90th to below 5th over the course of 6 months to 18 months. She managed to cross back to the + side of the 5th, by age 2, but well, she’s tiny :) I’m still nursing her at 2 yo. but the battle from 6 months to age 2 just plain sucked. I’m relieved to hear others have gone through it and that there may be a recognized name for it. You can bet I’m asking our ped at 2.5 years if she’s heard of it!

  13. liz Dec 09 at 3:15 pm Reply Reply

    I pumped for nine months (my son hated to face inwards and just. wouldn’t.), and I just cut out one pumping session every three days or so. If I felt like I NEEDED to pump, I did.

    However, I need to say that that was 9 years ago and I am still leaking a bit. Just enough to stain my bras, but not enough to show through my shirts. I’ve been checked out by various doctors for it and I’m not the only one this happens to.

    Your mileage will almost certainly vary from mine.

  14. Kimm Dec 10 at 12:23 pm Reply Reply

    We have gone through something similar, my son was diagnosed failure to thrive at 4 months, he’s really tall, early crawling, pulling up, etc, so active and easily distracted when eating. We are giving him cereal and solids- started cereal at 4 months but kept bf-ing some, still trying to get him to gain more weight, but he’s better. My Mom says I was skinny too, maybe part of it is genetic, who knows. It’s so hard because we live where everybody’s kids are hugely fat, and the other moms all say, poor thing, he’s so skinny-makes me feel like a bad mom. You are doing a good job, I just wanted to say! Doing what’s best for your baby is what a great mom does.

  15. Hollie Dec 10 at 7:47 pm Reply Reply

    Everything that Amy said. And ooooooh my goooooosh, the hormones. My child suffered from several unidentifiable food allergies transmitted through breastmilk and my pediatric GI told me to wean her, immediately. As in, never give her the breast again after you leave this office. WELL. That was the most awful 36 hours of my life, followed by ten horrible days of engorgement, depression, mood swings, feelings of failure, insomnia, and crying jags. At the time, the doctor made the switch to formula so urgent, but my focused-only-on-one-thing brain did not think “Hmm, I can pump a few times per day and taper that off instead of never expressing milk again!” Pump. Pump as much as you want and take as much TIME as you want. Maybe it will save you :) Good luck with the new diet; hope you see improvement immediately!

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