How to wean from breastfeeding when you — and baby — are ready

The first thing certified nurse-midwife Kara Simpson wants moms to know about weaning is: It’s your decision.

If you’ve breastfed at all — for the first few hours, days, months or years — you’ve given your baby a gift, Simpson said.

And whether you’re having too many challenges to continue, you’ve reached your breastfeeding goal, or you’re just done sharing your body, “Give yourself grace and do what’s best for you,” Simpson said. “Your provider is on your side, not holding you to a standard above you that you can't reach.”

Her advice isn’t just clinical, but personal: Simpson breastfed her baby for 2 1/2 years and loved it, until the day she felt “touched-out and overstimulated” and began her weaning journey.

Here’s what she wants you to know as you contemplate yours.

Editor’s note: While use of the word “chestfeeding” has become common in some circles, this story is using “breastfeeding.”

How do you know when it’s time to wean?

It’s deeply personal, and it’s a call that only you can make.

Some patients come in and say that breastfeeding is hindering their mental health. They feel so attached to making sure their baby is getting enough to eat, pumping enough, doing enough, feeling like they are enough, that they’re dealing with stress, anxiety or depression.

Patients facing supply issues may be worried and exhausted, feeling like their entire day and night revolves around feeding or pumping. Patients who exclusively nurse may feel like they can’t be away from their baby for long, even for activities that would fill their own cup, and may feel empty, numb or burned out.

Some patients have to stop breastfeeding because they need to take medications that aren’t compatible with breastfeeding.

Some patients stop because of going back to work: Some jobs make it more challenging to take those pump breaks as often as they’re needed.

And some patients just want their bodies back. Breastfeeding is something you have to be dedicated to. It’s time-consuming and it requires a lot of you, so everybody doesn’t have the capacity to continue to do it.

Sometimes women feel shame around the decision not to breastfeed or not to have a prolonged journey of breastfeeding, but I always emphasize: You're not wrong in whatever you decide — and your reasons are valid.

Are there ever times when the baby makes the decision?

Sometimes after six months or so, some babies are no longer interested, don’t want to nurse as much and take more interest in food. Usually this is temporary (often called a “breastfeeding strike,”) but other times, these babies are self-weaning.

Once babies get teeth, biting can also become an issue. With some redirection most babies realize they shouldn’t do it, but some start to treat the nipple as a plaything, and that can be a sign that their interest in breastfeeding is ending.

The American Academy of Pediatrics and the World Health Organization recommend exclusively breastfeeding for 6 months, then continuing to breastfeed until 2 years old (and beyond if desired). What do you say to moms who are ready to wean earlier than that?

These aren't requirements you have to meet — they’re recommendations.

You’re not a failure if you don’t meet that two-year mark. Any breastfeeding is considered to be beneficial, even if you just nurse and give baby colostrum during the first few days of life. Any breastfeeding is a success.

Look at the context and nuance of the recommendations, too: They’re based on ideal conditions. For example, the World Health Organization recommends breastfeeding “on demand” without bottles for the first six months, but in the United States, a lot of people have to go back to work after six weeks.

This may mean you have to pump — not exclusively latch — and that your employer has to give you the time and also a clean space to pump. In other countries, maternity leaves may be a lot longer, children are raised in differently-structured households and women may be able to be with their babies longer. Those are all important things to consider.

How do I wean my baby?

After you decide you’re ready, your first step is to tell the people who matter to you: Your partner or spouse, a supportive family member or a friend. You don't have to explain or justify your decision, but it does help you when people know what your goal is.

Call or send a MyChart message to your child’s pediatrician telling them your decision, especially if your child is younger and will need to start using formula. They can help you make sure your baby’s nutritional needs are met in this process.

Then, look at your circumstances and decide how you're going to go about it. If your baby is older and only breastfeeding once a day, you can go cold turkey and just drop that feed, graduating them to solids-only.

But if they’re younger and feeding multiple times a day, I recommend dropping one pump or feed — say, the mid-morning feeding. Then take cues from your baby: If you’re able to drop the feed and three days later the baby is happy and doesn’t seem to have skipped a beat, you can drop another. Make sure to allow at least three days in between dropping feedings to avoid engorgement (more on that below).

How can I help my milk dry up?

• To stop breastmilk production, you can pop a head of cabbage in the fridge, take out the cold leaves, and put them in your bra — it sounds strange, but it works. Peppermint also helps to dry up your milk, so eating Altoids breath mints, drinking peppermint tea or putting peppermint essential oils on the cabbage leaves or a washcloth and holding it to your nipples can help. Some women use medications that dry up mucus in the body, like Sudafed. (Talk to your provider before trying this.)

• Any stimulation of your breasts or nipples can trigger your breasts into producing more milk. Face your breasts away from water in the shower and avoid unnecessary touching of your nipples or breasts as you’re going through the process.

• Wear a lightly supportive bra, preferably without wires. A low-impact sports bra or bralette is perfect — you want gentle compression, not “unbearably tight.” Don’t bind your breasts; that is outdated advice.

• Don't pump: It triggers your body into thinking you have to produce more milk. You’ll be on a never-ending hamster wheel if you pump.

Once you have dropped the last feeding, it takes about 10 days for your body to stop making new milk. That doesn’t mean that all milk has left your breasts completely; some women can still squeeze some milk out over a year later.

What are some common problems during weaning?

If you’ve been feeding or pumping multiple times a day, engorgement (painful swelling of both breasts) is quite common as your body goes from being a milk factory to closing up shop. I love the Haakaa, a silicone tool you can put on your breast. If you’re engorged and in pain, you can put warm water and Epsom salts in the Haakaa and attach it to your breast and it does a great job of soothing. Ibuprofen or acetaminophen can also be used for pain relief.

Watch out for lumps or red, painful, tender spots, especially if they’re only on one breast, as that can be a clogged duct. You can often hand-massage them out. Some women buy a lactation massager to help; if you do, isolate and rub out the clogged duct only and try to avoid stimulating any other area of the breast.

Lactation consultants are fantastic resources to help with problems you may be experiencing.

If you feel like you're having flu-like symptoms, those can be early signs of mastitis, which is breast swelling that is often caused by infection. So contact your provider immediately.

What can I expect emotionally when weaning?

Breastfeeding is a moment of connection for both moms and babies.

Some babies will have a hard time with weaning — they may cry, and if they’re older, they may have some tantrums. The best thing you can do is to find other ways to connect: Cuddling when you normally have a feed, for example. Distraction can also work: “Here’s a fun toy” or “Let’s read a book.” Some women cover their nipples with bandages so if baby’s going for it, they’re like, “Oh, the nipple’s gone” — out of sight, out of mind.

Some moms will also experience emotional withdrawal since that boost of oxytocin — that chemical that hits when that letdown happens — is no longer happening. Women may struggle mentally while weaning, and may think they're sad for other reasons, not recognizing that there’s actually a chemical process happening in their body.

Be aware that those changes are happening, acknowledge those feelings, and let those who love you know how you’re feeling. Also be open with your provider so you can talk about interventions that are possible.

Is there a mindset that can help moms during weaning?

First, don’t let anyone shame you for doing what is best for you.

And give yourself grace. Things don’t always shape up to be how we want them or expect them to be. Being flexible and not so rigid definitely helps you cope better.

Women who are like, "Let's see what happens with breastfeeding; let's play it by ear" tend to have an easier time when that journey is over, compared to women who may have had a goal and didn't quite reach it.

We always have plans in mind, but you can't become so attached to a particular outcome that you miss the journey.

How can moms celebrate the end of their breastfeeding journey?

Commemorating is very important. I've seen women who get someone to take pictures of them nursing. There’s also breastmilk jewelry, where you can send some drops of your breastmilk off to a company and they make it into a ring or a necklace.

There are also women who struggle to breastfeed who feel better after they stop, and they also deserve celebration for doing what’s right for them. If that’s your partner or loved one, tell them they’re doing a great job — maybe in a card, or over a special meal.

There are all types of ways to commemorate your journey. And you should definitely celebrate it.