Breastfeeding full breast
Engorgement | WIC Breastfeeding Support
It's normal for your breasts to feel different after your baby is born. They are making milk and have extra blood flow, so they may feel tender and full. But if your breasts are warm, hard, and painful, they may be too full of milk, or engorged. If you think your breasts are engorged, speak with your WIC breastfeeding staff.
Causes of Engorgement
Engorgement happens when milk isn't fully removed from your breast. It can happen any time, but it's most likely to happen:
- As your milk transitions from colostrum to mature milk.
- If there are sudden changes in how often you nurse, such as skipping a few feedings or pumping sessions.
Signs of Engorgement
If your breasts are engorged, they may be hard, full, warm, tender, and painful, and you may have a low-grade fever. It may also be hard for your baby to latch.
Preventing Engorgement
Engorgement is uncomfortable, and it can lead to other issues like plugged ducts or a breast infection. It also can slow or lower your milk supply, because your body is not getting the message to make more milk. Breastfeeding or expressing milk every 2-3 hours and taking good care of yourself can help prevent engorgement.
Breastfeed Often
- Breastfeed your baby often in the early weeks, 8-12 times in 24 hours.
- Make sure your baby latches well to ensure baby can remove milk effectively.
- Consider avoiding pacifiers and other artificial nipples until you and baby are comfortable and breastfeeding is going well. That will help regulate your milk supply.
- If you are going back to work or school, express milk frequently and at regular intervals while you and baby are apart.
Take Care of Yourself
- Eat well, drink plenty of fluids (especially water), and get enough sleep.
Relief for Engorgement
For most moms, engorgement usually goes away in a few days with these tips:
- Breastfeed first from the engorged breast.
- Before feedings, encourage your milk flow. Put a warm, moist washcloth on your breasts or take a warm shower for 10-20 minutes.
- Massage your breasts before and during feedings, moving from the chest wall to the nipple.
- If your breast is hard, hand express or pump a little milk before nursing. That will soften your breast and make it easier for your baby to latch. Be sure to only express enough milk to soften your breasts or provide comfort. If you express too much milk, you may encourage milk production and keep getting engorged.
- Between feedings, put cold compresses on your breasts to help reduce swelling and pain.
Oversupply of Milk
Some moms make more milk than their baby needs. This is called oversupply. It can cause frequent engorgement and fast milk flow. It can make it hard for your baby to nurse.
If you think you might be making too much milk, talk to your doctor or your WIC breastfeeding expert.
Where to Find Help
Your local WIC breastfeeding staff can help you relieve engorgement. They can also give you tips to prevent it.
What is breast engorgement? | Engorged breasts
Some new mums experience breast engorgement when their milk starts ‘coming in’ a few days after the birth. It’s usually temporary and easily treated – read on to find out how
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Sioned Hilton, health visitor, neonatal nurse and lactation consultant:
Mum-of-three Sioned has been supporting families with babies and young children for more than 30 years. As well working with breastfeeding and expressing mothers, both in hospitals and the community, she contributes to parenting magazines and conferences, and delivers workshops for healthcare professionals.
When you first start breastfeeding your baby, your breasts produce colostrum in small amounts that gradually increase over the first few days.
But after around two to four days they start making much larger quantities of milk – a change known as your breast milk ‘coming in’.1
One of the signs milk is coming in is your breasts become fuller and firmer. This swelling is not just caused by the greater quantity of milk, but also by increased blood flow and extra lymph fluids in your breast tissue.2
For most new mums, if their baby is feeding well and frequently, these feelings of heaviness pass without problems. But some produce almost more milk than their breasts can hold, which makes them feel rock hard and uncomfortably full – a condition called engorgement. While this is usually only temporary, the 24 to 48 hours it typically lasts for can be painful.
What do engorged breasts feel like?
Engorgement can happen in one or both breasts. It may cause throbbing and swelling, sometimes extending as far as your armpit, and could make your breasts feel fairly hot or lumpy – this is because of all the activity going on inside.
You may notice other breast engorgement symptoms, including the skin of your breasts looking shiny and feeling stretched, and your nipples becoming hard and flat. Engorgement may even cause your body temperature to rise to around 37.5 to 38.3 °C (99 to 101 °F).3
As well as being painful, breast engorgement can cause breastfeeding difficulties – which can, in turn, worsen the problem. Your baby might struggle to latch if your nipples are flatter and your breast tissue is harder, which can cause sore nipples. In addition, if your baby’s latch is poor she’s less likely to drain the breast well. This means that, if left untreated, engorgement can lead to blocked ducts, mastitis and reduced milk production.
What causes breast engorgement?
Engorgement usually occurs because a baby is not feeding frequently enough (at least eight times every 24 hours). It can happen to any new mum, but is more common in women who’ve had previous breast augmentation or other breast surgery.
2 Pressure from a badly fitting bra or tight clothing can make the discomfort worse, and may lead to blocked ducts and possibly mastitis.
Breast engorgement can happen to women who don’t or can’t breastfeed, as well as those who do. The hormonal changes that follow delivery of the baby and placenta, which cause an increase in milk production, occur whether you breastfeed or not. Engorgement can also happen if you suddenly cut breastfeeds, perhaps because your baby is sick, sleeping longer, starting solids, or going into childcare.
How can I treat engorged breasts?
2The most effective breast engorgement treatment is a hungry baby! You should try to empty your breasts as much and as often as possible to help keep milk flowing – so feed on demand, between eight and 12 times every 24 hours.
Keep your baby in skin-to-skin contact with your chest for as long as possible throughout the day, and when you’re awake at night. This way she can smell the tempting aroma of your milk, has easy access to your breasts, and you’re more likely to spot her early hunger cues so you can ensure she feeds frequently.
Let her take as much milk as she wants from one breast before offering the other.
It’s also well worth getting your baby’s latch and positioning checked by a lactation consultant or breastfeeding specialist, to make sure she’s feeding effectively and draining your breasts properly. The tips below may also help relieve symptoms.
Tips for engorgement relief2
- Ensure you’re breastfeeding a minimum of eight times every 24 hours.
- Check that your baby has a good breastfeeding latch.
- Try breastfeeding in different positions.
- Massage your breasts gently while feeding to help the milk drain effectively.
- Express a little milk, either by hand or with a breast pump before breastfeeding to help soften your nipple so it’s easier to latch on to.
- If your breasts are still very firm and full after a feed, express again until you feel comfortable.
- If your baby is unable to breastfeed, replace the feeds with expressions.
Pump your breasts until they feel much softer – a minimum of eight times every 24 hours. - Try ‘reverse pressure softening’, a technique that can move excess fluid from the breast. A lactation consultant or breastfeeding specialist can show you how to do this.
- If your breasts are leaking milk, try a warm shower or applying a warm, wet flannel just before breastfeeding or expressing to soothe them and help milk flow. Don’t do this for more than a couple of minutes, as too much heat may worsen swelling.
- If your breasts aren’t leaking, apply a cold compress, chilled gel pad, or even frozen peas wrapped in a cloth, to your breasts for ten minutes after a feed to reduce swelling and relieve pain.
- Tuck clean cabbage leaves inside your bra. Yes, really! Many mums find they help reduce swelling and discomfort, and there’s scientific evidence to back this up.4
- Take anti-inflammatory painkillers. Paracetamol and ibuprofen can be used while breastfeeding, although ibuprofen has contraindications for asthmatic mums.
Always consult a healthcare professional and follow the manufacturer’s and pharmacist’s guidance. It’s generally best to avoid aspirin – for more on which medicines you can take while breastfeeding, read Breastfeeding while sick. - Wear a properly fitted nursing bra and avoid underwires, or you may prefer not to wear a bra.
- Don’t skip feeds or stop breastfeeding suddenly as you could make the engorgement worse.
Seek medical advice if you develop a fever5 of around 38 °C (101°F) or above, or if your baby is unable to breastfeed because of the engorgement.
Finally, try to be patient. Your body is still getting used to making milk and feeding your baby. The engorgement should soon subside as you both get used to breastfeeding.
References
1 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia. 2007;12(4):211-221.
2 Berens P, Brodribb W. ABM Clinical Protocol# 20: Engorgement, Revised 2016.
Breastfeed Med. 2016;11(4):159-163.
3 Affronti M et al. Low-grade fever: how to distinguish organic from non-organic forms. Int J Clin Pract. 2010;64(3):316-321.
4 Boi B et al. The effectiveness of cabbage leaf application (treatment) on pain and hardness in breast engorgement and its effect on the duration of breastfeeding. JBI Libr Syst Rev. 2012;10(20):1185-1213.
5 NHS Choices. How do I take someone’s temperature? [Internet]. UK: NHS Choices; updated 2016 June 29. Available from: www.nhs.uk/chq/pages/1065.aspx?categoryid=72
Breastfeeding after 1 month: what to expect
Do you know when breast milk production stabilizes? And how does the frequency and duration of feedings change as the baby grows? You will find answers to these questions in our recommendations for breastfeeding after the first month.
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Congratulations: You made it through the first month of breastfeeding.
Your breast milk has reached full maturity 1 , its production stabilizes, and it leaks almost or not at all from the chest. Don't worry, it's not getting less milk, it's just that your breasts are better able to produce and store it now. 2 At the age of six weeks, your baby will begin to please you with his charming toothless smiles, and by two months you will already have 500-600 feedings behind you. With a favorable development of events, problems with latch on by this point will already be resolved, and you can simply enjoy the convenience and benefits of breastfeeding.
When does breastfeeding decrease?
"Normal" feeding frequency for babies aged one to six months varies considerably, with some needing four feedings a day, others asking to be breastfed 13 times a day. 3
“From the age of one month, the amount of milk a baby consumes per feed increases, so that he can go without food for longer,” explains Cathy Garbin, a recognized international expert on breastfeeding, “A baby’s stomach grows, so he eat more at one time.
In addition, mature milk allows him to stay full longer.”
Feeding can last from 12 minutes to one hour -
the habits of babies vary so much! 3 But if the child is gaining weight and falls within this range, there is no cause for concern.
What is most surprising, no matter how often the baby eats, he consumes approximately the same amount of milk per day - both at one month and at six, when it is time to start complementary foods with solid food. 4
“However, sometimes the baby eats more and sometimes less, especially when he is unwell. It’s better to just listen to his needs,” Katie explains.
Is breast milk enough for the first six months?
Yes. Breast milk contains everything a baby needs for the first 90,023 six months of life—exclusively breastfed babies don't even need to drink more water! 5 Until about six months of age, a child's digestive system is simply not adapted to the digestion of solid food, and he will be able to drink cow's milk only after a year.
In addition, breastfeeding during this period prepares the child for further development. It strengthens the muscles of the mouth, develops the jaw and helps straighten the teeth 6.7 . All this will come in handy when the baby begins to eat and talk. And because what you eat and drink affects how your breast milk tastes, your baby discovers new tastes even before he starts eating solid foods. 8
In addition, when your baby is sick, your body produces breast milk that is
rich in antibodies that help fight infection. 9 In other words, milk continues to protect the baby for many months as he grows and becomes more active.
Breastfeeding is also very comfortable once you get used to it. Claudia, a mother of two from the UK, notes: “No need to sterilize a mountain of bottles, prepare formula, carry it all with you, warm it up - in general, breastfeeding turned out to be very convenient, especially when my babies grew up and we began to leave the house more often.
".
At what age does a breastfed baby start sleeping through the night?
Waking up at night is normal for babies. Most babies between the ages of one and six months consume a fifth of their daily milk requirement at night, so nighttime feedings should not be neglected if you want your baby to get the required amount of calories. 3
"It really depends on what you mean by 'sleep through the night'," says Cathy. "And it's better than waking up every two hours anyway! I have met infants who, starting at six weeks old, fell asleep at 19:00 and woke up at 7:00, but most continue to wake up frequently at night after this age. All children are different."
In Wales, a study of more than 700 infants showed that almost 80% of children aged 6 to 12 months wake up at least once a night, and 25% of them wake up three times or more. And it did not depend on what type of feeding the child is on - breastfeeding or artificial. 10
And if nighttime awakenings are unavoidable anyway, breastfeeding is at least comfortable! Maina, a mother of two from Australia, agrees: “You can even take a nap while feeding in the middle of the night - both the body and the baby do their job on autopilot.
No need to plan, measure, sterilize anything - ready-made food at the right temperature is right in your chest. I think it's ideal."
My child wakes up more often. Perhaps he is hungry?
Around four months of age, a baby's sleep patterns change as they develop deep and light sleep phases like an adult. Because of this, he may wake up more often at night. “At four months, sleep is more of a problem than feeding,” Cathy admits. “It can be exhausting, but try to adapt and be patient.”
Some call this " a four-month sleep regression ", but "progress" is more appropriate here. From the outside it may look like a step back, but in fact the child is approaching an important stage of development. He learns quickly, begins to become aware of the world around him, his perception is sharpened and, perhaps, there is anxiety about being separated from his mother. Crying when waking up and being able to eat milk while cuddling up to your mother’s breast is a way for a baby to calm down.
11–13
Resist the urge to “supplement” your baby with formula or start solid foods early
in an attempt to improve his sleep. Breast milk contains
hormones that make you sleepy and help you both relax
. Research shows that breastfeeding mothers actually sleep longer at night than mothers of formula-fed or mixed-fed babies
. 14
How does teething affect breastfeeding?
Teething usually begins around four months of age. When a baby has gum pain, he becomes restless, throws his chest and cries. All this, of course, is unpleasant.
However, breastfeeding can be an excellent sedative.
Studies have shown that babies who are breastfed
during the vaccination period cry less and forget pain more quickly. 15 Breastfeeding during teething can have the same calming effect.
An unpleasant side effect may be the child's attempts to try out his new teeth on the mother's breast. “Sometimes children flirt and bite their mother’s nipples.
This can be felt in advance by how the behavior of the child changes when feeding: before biting, he removes his tongue, explains Cathy, “Usually this is not a problem and only happens a couple of times. It is enough to stop feeding, affectionately say that biting is not good, and the baby will soon leave this fun.
How to continue feeding if you have to be separated from the baby?
It happens that during the first six months, when the baby is still fully breastfed, the mother needs to be away for several hours - or even longer if she has to go to work or go away on business for a couple of days.
But this does not mean that you should stop breastfeeding. You can still feed your baby healthy breast milk - just express it and have someone give it to your baby when you're away. Here's Katie's advice:
“Start expressing milk a couple of days in advance, in small batches, 40-60 ml at a time. So you will have the necessary supply for the time of your absence, but at the same time the amount of milk produced will remain the same.
If you have to return to work, check with your employer about your daily schedule. Many mothers breastfeed their babies in the morning, evening and night, and pump milk at lunchtime to relieve discomfort and create a reserve for the next day.
This usually turns out to be much easier than one might think, and today many companies are well placed to do this, notes Cathy. “Breast pumps make it easy to solve this problem.”
Natalie, mother from the USA, shares her experience: “I feed Dylan as soon as he wakes up, and sometimes again before leaving for work, in order to maintain milk production and not lose contact with the child. At work, I pump twice the next day (in my absence, he eats two bottles of breast milk), and after work I rush home for the evening feed. I don't pump on the weekends - we resume regular breastfeeding."
Can breastfeeding continue after the introduction of solid foods?
When your baby begins to show interest in food and can sit up on his own - usually around six months of age - it's time to start solid foods.
However, it is not necessary to stop breastfeeding, Cathy explains: “A baby’s iron stores during pregnancy are depleted by six months, so he needs additional sources of this element.
Start complementary foods with solid foods, but remember that breast milk remains a more important source of calories and nutrients until the baby is eight to nine months old. By this time, he will be eating much more solid food, but he will still need to breastfeed four to five times a day. By 12 months, the frequency of feeding may be two to six times a day. All babies are different, and many of them at this age are still getting half their daily calorie intake from breast milk.”
Don't forget that breast milk can be added to solid foods, such as cereals and purees, so that the baby can taste the familiar taste. If possible, use milk expressed just before feeding (not thawed) and add just before serving to keep bacteria and nutrients alive. 16
You may be pressured by others to stop breastfeeding when your baby is six months old, but the longer you breastfeed or pump milk, the better for you and your baby.
How long can I continue breastfeeding?
“The World Health Organization recommends breastfeeding along with solid foods until at least two years of age because it plays an important role in supporting immunity,” says Cathy. feels bad".
At eight months, the baby sometimes breastfeeds four times a day, but by one year old, the frequency of feedings can be reduced to two times a day. You yourself will understand which feeding regimen is more suitable for you and your baby. For example, Jane, a mother of two from the US, breastfed until the age of two: “I breastfed when I was at home - in the evenings and on weekends, when the children wanted to be close to me,” says Jane, “It helped a lot when they were sick . Breastfeeding has become my favorite form of comfort."
“When my son got a little older and bolder, he still often asked me to breastfeed him - as if to calm down and gain strength,” recalls Amy, a mother of two children from Canada, “When he happened to hit or skin his knee , breastfeeding was a wonderful way to comfort him.
”
If your baby is over a year old and you are still breastfeeding, people around you will probably tell you that this way he will never wean. But if children are not pressured, they usually refuse to breastfeed themselves between the ages of two and four. 17
“I didn’t intend to breastfeed for so long, but as a result, I still breastfeed my four-year-old daughter and 22-month-old son,” says Suzanne, mother of two from the UK, “I breastfeed my youngest before and after work, and in I express milk on business trips. The eldest daughter likes to breastfeed a little before bed or when she is upset - this is a great way to make contact. When I get tired of it, I remind myself what great benefit and comfort it brings them. I now plan to pursue a baby-initiated end breastfeeding strategy — let them decide when to stop.”
For more information on what to expect and lots of tips and tricks, see our guide Breastfeeding Problems After the First Month.
Literature
1 Ballard O, Morrow AL.
Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am . 2013;60(1):49-74. - Ballard O., Morrow A.L., "Composition of breast milk: nutrients and biologically active factors." Pediatrician Clean North Am. 2013;60(1):49-74.
2 Kent JC et al. Principles for maintaining or increasing breast milk production. J 2012;41(1):114-21. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol and Neonatal Nurse. 2012;41(1):114-121.
3 Kent JC Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics).
2006;117(3):e387-95.
4 Kent JC et al. Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Breast Med . 2013;8(4):401-407. - Kent J.S. et al., Longitudinal changes in breastfeeding patterns between 1 and 6 months of lactation. Brest Med. 2013;8(4):401-407.
5 Almroth S, Bidinger PD. No need for water supplementation for exclusively breast-fed infants under hot and arid conditions. Trans R Soc 1990;84(4):602-604. - Elmroth S., Bidinger P.D., "No need for supplementation of exclusively breastfed infants in hot, dry conditions." Trans R Sots Trop Med Hyg. 1990;84(4):602-604.
6 Victora CG et al . Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490.
- Victor S.J. et al., "Breastfeeding in the 21st century: epidemiology, mechanisms and long-term effects". Lancet 2016;387(10017):475-490.
7 Peres KG et al. Effect of breastfeeding on malocclusions: a systematic review and meta - analysis. Acta Paediatr. 2015;104( S 467):54-61. - Perez K.G. et al., "The impact of breastfeeding on malocclusion: a systematic review and meta-analysis". Akta Pediatr. 2015;104(S467):54-61.
8 Mennella JA, Beauchamp GK. Maternal diet alters the sensory qualities of human milk and the nursling's behavior. Pediatrics. 1991;88(4):737-744. - Mennella, JA, Beauchamp, GK, "Maternal nutrition influences the organoleptic properties of breast milk and infant behavior." Pediatrix (Pediatrics). 1991;88(4):737-744.
9 Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk.
Clin Transl immunology. 2013;2(4). - Hassiot F. et al., "Infectious diseases of the mother and child stimulate a rapid leukocyte reaction in breast milk." Clean Transl Immunology. 2013;2(4).
10 Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breast Med . 2015;10(5):246-252. - Brown A., Harris W., "Night feedings and infant sleep in the first year of life and their association with feeding frequency, daytime supplementation, and infant weight." Brest Med (Breastfeeding Medicine). 2015;10(5):246-252.
11 Infant sleep information source. [Internet]. Normal Infant Sleep Development; December 2017 [cited 2018 Feb] - All about baby sleep. [Internet] "The development of normal sleep in a child", December 2017 [cited February 2018].
12 Baby sleep science. [Internet]. The-Four-Month-Sleep-Regression-What-is-it-and-What-can-be-Done-About-it. March 2014 [ cited 2018 Feb ] - The science of baby sleep. [Internet], "Four-month sleep regression: what it is and what to do about it." March 2014 [cited February 2018].
13 The Myth Of Baby Sleep Regressions – What’s Really Happening To Your Baby’s Sleep? [Internet]. Pinky Mckay ; December 2017 [ cited 2018 Feb ] - "The Myth of Baby Sleep Regression - What's Really Happening to Your Baby?" [Internet]. Pinky McKay, December 2017 [cited February 2018].
14 Kendall - Tackett K ET Al . The effect of feeding method on sleep duration, maternal well-being, and postpartum depression.
Clinical Lactation . 2011;2(2):22-26. - Kendall-Tuckett K. et al., "Influence of feeding pattern on sleep duration, maternal well-being and the development of postpartum depression." Clinical Lactation. 2011;2(2):22-26.
15) Harrison D et al. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database Syst Rev . 2014;10. — Harrison D. et al., "Breastfeeding for Relief of Medical Pain in the Neonatal Period." Cochrane Database of System Rev. 2014;10:CD11248
16 Czank C et al. Retention of the immunological proteins of pasteurized human milk in relation to pasteurizer design and practice. Pediatr Res . 2009;66(4):374. - Zhank S. et al., "Retention of immunological proteins in pasteurized milk depending on the technique and practice of pasteurization".
Pediatrician Res. 2009;66(4):374.
17 Weaning from the breast. (2004). Paediatr Child Health, 9(4):249–253. - "Weaning from the breast" (2004). Pediatrician Child Health, 9(4):249–253.
Termination of breastfeeding | Cessation of breastfeeding
When is it time to stop breastfeeding and what is the best way to do this? Read our article for useful practical tips on weaning.
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How long should breastfeeding continue? Three months? Six? Year? Or maybe a few years?
The World Health Organization (WHO) and other authorities recommend that infants be exclusively breastfed for the first six months and then continue to be breastfed along with other foods (complementary foods) for at least two years. 1
The fact is that breast milk is not just food. It is a natural sedative if the child is anxious or tired. In addition, milk contains immune-boosting components, the amount of which increases dramatically when the baby gets sick.
2
According to anthropologists, the natural age of a person to stop breastfeeding is even more than two years. Given factors such as tooth development, body weight, comparison with other primates, and historical evidence, some scientists believe that breastfeeding may last up to two to four years. A number of researchers even believe that our ancestors breastfed children up to six or seven years of age. 3
Today, more than 60% of mothers in developed countries start giving their babies formula or complementary foods before six months of age, 4 although WHO does not recommend this.
When is it time to stop breastfeeding?
Weaning means that you gradually stop breastfeeding your baby. Ideally, the first step in this process is the gradual introduction of complementary foods, starting at about six months of age. In this case, breastfeeding continues. The weaning process continues until the mother's milk has been completely replaced by other foods and drinks.
“After six months, the baby needs higher doses of certain nutrients, such as iron, zinc, vitamins B and D, that he cannot get from breast milk or from his own reserves,” says Sarah Beeson, health visitor from Great Britain.
“But solid food should at first only supplement the main diet with breast milk and gradually replace it. Mother's milk remains the main source of nutrition for the baby for many months to come.”
On average, a seven-month-old baby gets 93% of its calories from breast milk. And even between the 11th and 16th months, milk provides him with about half of the daily calorie intake. 5
“Sometimes moms think that breastmilk is not so important once the baby has started solid foods, but in reality, no matter how many months old the baby is, there is nothing better for him than your milk,” continues Sarah.
In fact, the process of finishing breastfeeding can take as long as mother and baby want. “When to stop breastfeeding is up to you,” says Sarah.
The only thing that matters is what you think is right for you and your child.”
How to wean
Whenever you decide to start weaning your baby, it is best to do it gradually. An abrupt cessation of breastfeeding can lead to lactostasis, blockage of the milk ducts and mastitis, and in a child such a sudden change can adversely affect the state of the digestive and immune systems. In addition, it will be difficult for both of you psychologically.
When should I stop breastfeeding?
Sometimes mothers mistakenly believe that it is time to stop breastfeeding, when in fact there is no reason to. If you're returning to work, breastfeeding can be a great way to stay close to your baby during this difficult time for both of you. You can express milk at work, and morning and evening feeding sessions will give you the opportunity to spend time alone with your baby. If you need to leave without your baby, you can also express milk and bring or send it home.
If you get sick, this is not always a reason to stop breastfeeding.
Read our advice in the article on breastfeeding when sick and consult with your healthcare professional.
Weaning up to six months
If you cannot continue breastfeeding until six months and want to try weaning your baby, start by replacing one feeding a day with a bottle of formula.
“It's best to start with midday feedings. Babies are very alert and able to smell breast milk nearby, so ask your partner or relative to give your baby a bottle when you're in the other room,” Sarah advises.
“Be hygienic when preparing meals. Be prepared for the fact that the baby will take fewer servings of expressed milk per day than if he was fed directly from the breast. Don't make him eat more milk than he wants."
You will probably feel that your breasts are fuller and more tender. This is due to the fact that your body is rebuilding to produce less milk. If this creates discomfort, try expressing some milk—just enough to relieve the discomfort without stimulating extra production.
When your body adjusts to the new volume - usually after a few days - replace with formula for one more meal a day. Continue this until you have changed all feedings and your baby is completely weaned.
“I had complications after my first birth, as a result I lost a lot of weight very quickly, and besides, I developed mastitis. Lactation was very weak, and at three months I was forced to stop breastfeeding,” recalls Jennifer, a mother of two from the UK, “I gradually replaced one feeding, so physically it was easy, but mentally it was hard for me.”
If you want to maintain closeness with your baby and all the health benefits of breastfeeding, but still need to cut down on breastfeeding, try partial weaning, replacing only a few feeds a day with formula.
Weaning after six months
Once your baby starts eating solid foods (about six months old), you will notice that breastfeeding naturally occurs less and less. For a year, it can be reduced to just a couple of times a day, and feedings will be replaced by full meals and healthy snacks.
Anyway, if you intend to continue to reduce breastfeeding, do it gradually, replacing one feeding at a time. Use formula milk if your baby is under 12 months old. With cow's milk, you should wait at least up to a year.
“When I decided to wean my son, I breastfed him three times a day and gave him other foods three times plus light snacks. Gradually, I replaced all breastfeedings with formula. By 11 months, we only had one nighttime breastfeed left,” says Ruth, a UK mom.
There are various ways to distract a child from changes in his diet. Some mothers suggest that instead of breastfeeding something to drink and eat together to maintain a sense of closeness. You can also change your daily routine, play your favorite game, or replace feeding with caresses - from you or from your partner. Some children take longer to get used to the new food, but in the end everything falls into place. If you are having difficulty weaning, ask your healthcare provider for advice.
Ending breastfeeding naturally
Ending breastfeeding can be guided by the baby's wishes. This is called baby-initiated weaning, or the natural termination of breastfeeding. Such a process is likely to be long and gradual. Month after month, feeding sessions will become shorter and less frequent, until one day the child completely loses interest in the breast.
“My daughter stopped breastfeeding on her own when she was four years old,” says Sarah, a mother from the UK. And once, when we were on vacation, she seemed to just forget about her breasts. Now, six months later, she sometimes still asks for breasts, but she already knows that there is no milk there.
You will have a huge amount of time for the body to adapt, so there should be no discomfort or swelling of the breast. However, you may find it difficult emotionally, so spend more time petting and bonding with your baby.
“Child-initiated termination of breastfeeding was right for me because I never gave my son formula or a bottle.
I didn’t want to abruptly stop feeding and refuse him,” recalls Kelly, a mother from the UK, “He himself lost interest in breasts at the age of two and a half years. For us, it was the best scenario, although emotionally it was not very easy for me.”
What if you need to stop breastfeeding quickly?
It is best not to stop breastfeeding abruptly, but sometimes it is necessary for medical reasons or because you cannot be near the baby.
If you have been breastfeeding your baby up to this point, you will most likely have to express your milk to avoid breast swelling. Some mothers prefer to use a breast pump for this, others find it easier to express milk manually. You only need to pump a little, just to eliminate the discomfort, otherwise your body will take it as a signal to produce more milk.
At first, the breasts may swell and become tender, but this will pass. Breast milk contains a so-called feedback lactation inhibitor. When breastfeeding is stopped, this inhibitor tells your body to slow down milk production, but it can take days or even weeks for your breasts to rebuild.
Certain medications can relieve pain and should be discussed with your doctor. Always follow your pharmacist's instructions or directions, and consult your healthcare professional before taking any medication.
“I had to abruptly stop breastfeeding when my daughter was eight months old because she had to take strong painkillers,” says Peggy, a mother from Switzerland. “It was very difficult because the baby was constantly looking for a breast and crying. I held her tightly to me as I gave her a bottle. This calmed her, and after a month everything was all right.
Can I continue breastfeeding if I want to get pregnant again?
Breastfeeding is a natural contraceptive. However, this method is not the most reliable, especially after six months or if you are not exclusively breastfeeding. This means that you can get pregnant even while you are breastfeeding.
Pregnant and breastfeeding mothers sometimes receive conflicting advice about whether to stop breastfeeding.
Consistent feeding of two children of different ages is of course possible, and with the advent of the second baby, your body will produce the kind of milk that both of them need.
It is not uncommon for an older child to refuse to breastfeed or skip feedings if the mother is pregnant. This may be due to changes in milk composition that occur during pregnancy. Milk can change the taste and become less sweet. 6 If your baby is under one year of age when he starts to stop breastfeeding, make sure he continues to gain weight.
Talk to your doctor if you want to continue breastfeeding during pregnancy, but have had a preterm birth or miscarriage, or have any bleeding in the past.
If you need medical help to conceive, certain drugs and procedures may not be suitable while you are breastfeeding. Discuss all possible options before deciding to stop breastfeeding.
And finally...
Whenever you decide to end breastfeeding, and whatever method you choose to do so, be gentle with yourself and your baby.
This is a huge change for both of you physically, hormonally, and emotionally, so proceed thoughtfully and carefully.
“Although my body responded normally to stopping breastfeeding, it was psychologically difficult for me. The thing that united us for so long is over, - Jane, a mother of two children from the USA, shares her impressions, - I worked long hours, five days a week, and breastfeeding made me feel that I occupy a special place in the lives of children. But when it stopped, we soon found other ways to be together.”
Literature
1 World Health Organization. [Internet] Health Topics: Breastfeeding: 2018 [Accessed: 02/08/2018]. Available from : http://www.who.int/topics/breastfeeding/en - World Health Organization. "Health Issues: Breastfeeding" [Internet]. Geneva, Switzerland: WHO; 2018 [Visit 02/08/2018]. Article linked: http://www.who.int/topics/breastfeeding/e
2 Hassiotou et al.
Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl Immunology. 2013;2(4): e 3. - Hassiot F. et al., "Infectious diseases of the mother and child stimulate a rapid leukocyte reaction in breast milk." Clean Transl Immunology. 2013;2(4):e3.
3 Dettwyler KA. When to wean: biological versus cultural perspectives. Clin Obstet Gynecol . 2004; 47(3)712-723. - Dettwiler KA, "Time to wean: weaning from a biological and cultural point of view". Klin Obstet Ginekol (Clinical obstetrics and gynecology). 2004; 47(3):712-723.
4 Victora CG Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490. - Victor S.J. et al., "Breastfeeding in the 21st century: epidemiology, mechanisms and long-term effects".
