Weaning

Weaning can be a challenging time, and there is no wrong or right time to wean. It is best to start the process when you are ready! Here are some tips for making the weaning process a little smoother:

Gradually decreasing how often you breastfeed/pump is ideal - as this gives your body time to adjust and decrease supply accordingly. This can help you avoid problems such as engorgement, clogged ducts and mastitis. Dropping a feeding or pumping session every 3-5 days, or even waiting more than a week before dropping the next feeding can be a great way to do this gradually.

If you are breastfeeding directly (not pumping):

There are generally two approaches to weaning:

• Baby led weaning: only breastfeed when baby asks

• Parent led weaning: getting rid of one nursing session at a time - starting with the least favorite (usually one of the middle of the day feedings)

Here are some tips for starting the weaning process:

• Avoid being in the same area baby usually nurses if possible - consider getting outside or to a different part of the house than where baby usually nurses, especially if there is a certain place baby tends to breastfeed like a rocking chair

• When it’s coming up to the time the baby usually has a nursing session, consider offering a snack, drink or bottle in it’s place. Or consider doing a fun activity during this time in order to distract them from the expected nursing session! This may include getting out of the house and away from where baby likes to breastfeed.

• If baby is really struggling with dropping nursing sessions and is getting frustrated - consider shortening the feedings first before moving on to dropping an entire session. You can try setting a timer, playing a song or show, etc., explaining to them that when the timer/song/show is over, the nursing session will end. This may only work if they have a sense of time.

If you are an exclusive pumper:

You again want to gradually decrease the amount of milk you are removing. This will help prevent engorgement, clogged ducts and mastitis.

Here are some tips for starting the weaning process:

• Gradually increasing the time between pumping sessions can be an effective way to wean. Still doing this gradually is ideal, waiting 3-5 days, if not a week or longer between changes to your pumping schedule (if starting with 3-4 hours between pumping sessions, move to 5-6, then 7-8, etc)

• Another way to can gradually wean from pumping is by slowly shortening the pumping sessions. If you normally pump for 20 minutes, try decreasing the time to 18 minutes, then 16, then 14, etc. Again waiting at least a few days if not a week between changes. You can even try larger increments of time if you are not experiencing any issues related to weaning (engorgement, clogged ducts, etc.)

How does weaning work?

The weaning process works by telling your body less milk is demanded, and to decrease the amount that is produced. When you start dropping nursing or pumping sessions, pressure from the milk that was left in your breasts will tell your brain that this milk is not being used and to start producing less. Issues arise when there is too much pressure in the breasts, leading to inflammation and clogged ducts. This is why weaning is best done gradually.

What to do if you get a clogged duct

Engorgement and clogged ducts are a direct result of inflammation in the breasts from the extra pressure that is being built up by milk that is left behind. They typically feel like a tender, hard lump in the breast and the skin of the breast may be reddened on that side.

How to treat a clogged duct:

• Ice, ice, ice!

• Consider taking an NSAID like ibuprofen for pain management and to help reduce swelling

• Light breast massage to encourage lymphatic drainage (your breast tissue is fragile, be sure to do this very lightly) - you can do this by lightly stroking your breast from nipple to armpit

• Maintain your current pumping or nursing schedule and do not deviate from it (either by increasing or decreasing sessions) until the clog is gone

• Breast gymnastics are another gentle way to encourage lymphatic drainage - grab your breast with both hands and gently lift it up and down and move it side to side

• Consider having baby start feedings on this side - typically at the beginning of a feeding baby will be the most efficient at removing milk

• Consider changing baby’s position when feeding at the breast - if you typically feed in football hold try cross-cradle or vice versa - trying to target milk removal from other milk ducts

• Light massage while pumping or breastfeeding - again tissue is very delicate and aggressive massaging can worsen the inflammation and the clog

• If the clog does not clear within 24-48 hours or you develop a fever or any other symptoms of illness, please reach out to your medical provider

• The clog may come out as stringy, clumpy milk - this is not harmful to baby

Throughout the weaning process if you ever get uncomfortably full and are worried about developing a clogged duct, consider hand expressing or using a manual pump - removing just enough milk to relieve the pressure without emptying your breasts.