Weaning

What is weaning?

Weaning is the term used to describe the process of switching a baby from:

• Breast-feeding to bottle-feeding.
• Breast- or bottle-feeding to a cup.
• Breast- or bottle-feeding to solid foods.

Your baby will go through one or more of these weaning processes. All types of weaning usually work best when they are done gradually—over several weeks, months, or even longer.

Weaning a baby from the breast is a big change for moms as well as babies. Besides affecting you physically, it may also affect you emotionally.

Some moms feel a little sad to lose some of the closeness that breast-feeding provides. But you will also have more freedom, because others can feed your baby. Don't be surprised if you feel both happy and sad that your child is becoming more independent.

How do you know if your baby is ready to wean?

Signs that a baby is ready to wean often appear after the baby has learned to crawl or learned to walk. Your breast-feeding baby may suck a few times and then stop nursing. He or she may just start to lose interest in your breast.

Bottle-fed babies who are ready to wean may start spitting out the nipple, or throwing or hiding the bottle before it is empty. Your baby may show more interest in drinking from a cup.

When is the best time to wean?

There is no right or wrong time. And there is no correct length of time that it should take. It depends on how ready you and your child are to start weaning.

Some moms wait longer because they are not ready to give up the closeness that breast-feeding brings. Others are ready to wean sooner or have responsibilities or life changes that make it necessary.

Choose a time when your child is ready. Try not to start weaning when your child or your family is under stress. Stress can range from cutting a new tooth to moving to a new house or starting a new day care program.

What is the best way to wean a baby?

Gradual weaning is best for both babies and moms. One feeding is dropped every few days, giving the mother and baby time to adjust. If you are breast-feeding, this helps keep your breasts from becoming too full, a problem called breast engorgement. It also lets the baby learn other ways of eating.

How do you meet your baby's nutrition needs while weaning?

The American Academy of Pediatrics recommends the following:¹

• Breast-feed babies for at least a year and as long after as mother and child desire. Introduce iron-enriched solid foods at 6 months of age to complement the breast milk.
• For babies who were weaned from the breast or the bottle before 12 months of age, give iron-fortified formula, not cow's or goat's milk.

What if your baby does not want to be weaned?

Sometimes a mother wants to stop breast-feeding, but her baby seems to want to keep it up. If you can, keep breast-feeding a while longer. Try offering your milk or formula in a cup before you breast-feed or between breast-feedings. There are also different bottle nipples you can try.

Some babies grow attached to the bottle and do not want to give it up. Don't let your baby crawl, walk around, or go to bed with a bottle. Nighttime feedings are often the hardest to give up. Try replacing that feeding with new habits, such as reading a book or looking at the stars together.

Frequently Asked Questions

Weaning is a gradual process. It starts when you begin giving solid food to your baby and ends when the child no longer breast-feeds or takes a bottle. This process may last a few months or more than a year.

A rough outline of this process is as follows:

• Your baby begins eating solid foods at 4 to 6 months of age.
• At this point, introduce cup-feeding to supplement breast- or bottle-feedings. Over the next 6 months, your baby may show signs that he or she is ready to wean.
• Your bottle-fed baby should continue to get nutrition largely from formula until he or she is 12 months old. After that, allowing your child to continue drinking from a bottle may lead to problems such as baby bottle tooth decay.
• The American Academy of Pediatrics recommends that you continue breast-feeding your baby until at least age 1 while gradually supplementing the diet with iron-fortified foods. By the age of 1 year, your baby may only breast-feed twice daily. Your baby continues to benefit nutritionally if you decide to breast-feed beyond the first year

It is important to switch gradually to the cup. Although some mothers stop breast- or bottle-feedings abruptly, the baby may not be ready. Babies find comfort from sucking and also may need the closeness and comfort breast- or bottle-feeding provides. Always consider your baby's emotional needs, age, and readiness, as well as your own needs, when switching from breast- or bottle-feeding to a cup. Toddlers (ages 1 to 2) may tolerate abrupt weaning better than babies.

Common concerns

• I'm pregnant. Should I stop breast-feeding my first child? No, you can continue to breast-feed your first child while you are pregnant. But talk to your doctor about your nutritional needs and other issues you should be aware of. For more information, see the topic Breast-Feeding.
• I want to become pregnant. Should I wean my child? You can continue to breast-feed, but breast-feeding may make it more difficult to become pregnant. For more information, see the topic Breast-Feeding.
• When I wean, should I be concerned about my baby's teeth? As you wean your baby from the breast or the bottle, avoid giving him or her liquids with a high sugar content, especially at bedtime. This can cause dental cavities. After 12 months of age, stop night breast- and bottle-feedings. You must also be sure your baby is getting adequate nutrition to build healthy teeth. For more information, see the topic Teething.
• What can I do if I want to stop breast-feeding, but my baby does not? If possible, continue breast-feeding a while longer. If this is not possible, offer breast milk or formula in a cup or give extra hugs.
• What can I do if my baby does not want to give up the bottle? Offer a stuffed toy or blanket for comfort instead.
• Are there times when I should not wean my baby? Do not try to wean your baby before he or she is 6 months old or during times of stress, such as when starting a new day care.
• What if I develop pain and tenderness in my breasts (breast engorgement) while trying to wean? Breast engorgement is less likely to develop if you gradually wean your baby rather than suddenly stop breast-feeding. The pain and discomfort from breast engorgement improves as your breasts stop producing milk; you will usually feel better in 1 to 5 days. Home treatment, such as applying cold packs to the breasts, may help relieve some of your symptoms. For more information, see the topic Breast Engorgement.

The weaning process

The American Academy of Pediatrics recommends that babies be breast-fed for at least a year and as long after as mother and child desire.¹Weaning from breast- or bottle-feeding can be done gradually or abruptly.

• If you are not breast-feeding and your baby is younger than 12 months of age, use iron-fortified formula. Do not offer your baby cow's milk.¹ The iron in cow's milk is not well-absorbed, and iron is necessary for healthy development. Also, some babies may be more likely to react to the protein in cow's milk.
• If your baby is older than 12 months, you can give your baby whole milk. Do not use skim milk or 2% milk before your child is 2 years old. These types of milk provide too few calories, too much protein, and inadequate essential fatty acids.²
• Switching from breast milk to formula may cause differences in how often your baby feeds and a change in the color and consistency of your baby's stools.

The first step in the weaning process, giving your baby solid foods, can generally be started at 4 to 6 months of age. Feed your baby at the table with the rest of the family. Follow your health professional's advice on when and what to feed your baby. At 6 months of age, iron-enriched solid foods should be introduced.¹ Usually, the more solid foods a baby eats, the less breast milk or formula he or she needs, and the easier it will be to wean.

When your baby is about 6 months old, offer the cup. Over the next 6 months, watch for signs that he or she is ready to wean (give up the breast or bottle). Pay close attention to whether your baby is sucking for comfort or hunger. If your baby uses a pacifier, consider replacing it with a blanket or stuffed toy for comfort.

When you have decided that you and your child are ready to give up breast- or bottle-feeding, develop a plan for what you will do. Talk with other family members and get their help.

If you plan to gradually wean your baby from breast- or bottle-feeding, eliminate the least important feeding first, which is usually the midday one. Then stop the late afternoon and morning feedings. Stop the most important feeding (the one that provides the baby the greatest emotional comfort) last; this is usually the first or last feeding of the day. Whether you are weaning or not, the last feeding should gradually be moved up so that by 4 months it is no longer at bedtime and other soothing rituals can be established.

Gradual weaning

A gradual weaning slowly reduces the number of breast- or bottle-feedings. One feeding is eliminated every few days, giving the mother and baby time to adjust. Gradual weaning helps maintain emotional attachment, prevents breast engorgement, and allows the baby to learn other ways of eating. It is generally planned to suit both the mother's and child's needs.

Gradual weaning is best for both you and your baby. It is recommended for babies unless the mother has a medical condition that does not allow it.

Abrupt weaning

Abrupt weaning is a sudden end to breast- or bottle-feeding and can be difficult for both the mother and the child. The mother may experience painful breast engorgement and has an increased risk for a breast infection (mastitis). Both the mother and the child may miss the emotional attachment and closeness of breast- or bottle-feeding.

Your child may respond to abrupt weaning by:

• Refusing to drink from a cup for a period of time. Prolonged refusal to drink from a cup can lead to dehydration and nutritional deficiencies.
• Sucking his or her thumb.

Weaning a toddler

Either gradual or abrupt weaning may work for 1- to 2-year-olds.

• A toddler who breast-feeds 3 or more times a day may do better with gradual weaning.
• A toddler who breast- or bottle-feeds 2 or less times a day may do well with abrupt weaning.

You may find the following suggestions helpful during the weaning process:

• Tips for weaning a baby from bottle-feeding may help you replace bottle-feedings with other comforting activities.
• Tips for weaning a baby from breast-feeding may help you switch from breast-feeding to bottle-feeding or using a cup.
• Tips for weaning a toddler from breast-feeding may help you use techniques such as distraction, postponing feedings, and not offering feedings.
• Tips for weaning a toddler from bottle-feeding may help you find substitutes and limitations for drinking from a bottle.
• Abrupt weaning for toddlers may help you wean a child who nurses 3 times each day or less.

Talk to your child's health professional about weaning if:

• Your baby refuses all solid food and is older than 6 to 8 months of age.
• Your baby has changed from sleeping through the night to waking up during the night hungry.
• Your baby develops dental cavities (caries).
• Your baby seems overweight for his or her age, size, or birth weight.
• Your toddler (1 to 2 years old) focuses on breast- or bottle-feeding and does not play with other children.
• Your toddler never wants to be away from you.
• Your baby is older than 12 months of age and is still drinking from a bottle.
• You are emotionally ready to wean your baby.

Who to see

Health professionals who can deal with your concerns about weaning include:

• Pediatricians.
• Family medicine doctors.
• Physician assistants with special training in the care of children.
• Pediatric or family nurse practitioners.
• Certified lactation consultants. Lactation consultants are sometimes on staff at hospitals.

A well baby checkup is a good time to ask questions about weaning. During this checkup, your baby's health professional will:

• Compare the baby's current weight, height, and head size with measurements taken at birth to see if the rate of growth is normal.
• Ask how well the baby is eating and sleeping and whether any problems have developed.

Online Resource

Organizations

• Bottle-Feeding
• Breast-Feeding
• Growth and Development, Ages 1 to 12 Months
• Growth and Development, Ages 12 to 24 Months
• Growth and Development, Ages 2 to 5 Years
• Healthy Eating for Children
• Teething

Citations

1. American Academy of Pediatrics (1997). Breastfeeding and the use of human milk. Pediatrics, 100(6): 1035–1039.

2. Eiger MS (2001). Weaning section in Feeding of infants and children. In RA Hoekelman et al., eds., Primary Pediatric Care, 4th ed., p. 196. St. Louis: Mosby.

Other Works Consulted

• Griffin IJ, et al. (2001). Iron and breastfeeding. Pediatric Clinics of North America, 48(2): 401–413.

• Hoffman DR, et al. (2003). Visual function in breast-fed term infants weaned to formula with or without long-chain polyunsaturates at 4 to 6 months: A randomized clinical trial. Journal of Pediatrics, 142: 669–677.

• Krebs NF, et al. (2005). Infant feeding section of Normal childhood nutrition and its disorders. In WW Hay et al., eds., Current Pediatric Diagnosis and Treatment, 17th ed., chap. 10, pp. 299–304. New York: McGraw-Hill.