Tag: weaning

Weaning from a Nipple Shield

- Julie Matheney
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Nipple shields are a commonly used tool in the lactation world. They may help a premature baby latch to give the baby time to mature and learn how to suck, prevent nipple damage from a tied baby, or be used when a nipple is flat/inverted (either from normal anatomical variations or because the breast is fluid overloaded from interventions during birth).  While there are many benefits to using a shield, are also risks, like the potential for decreased milk supply. Hopefully if you were given a shield, you were also given an exit strategy for weaning off of it. With any tool, make sure the reason you were given one has been addressed (giving a premature baby time to grow, doing oral motor exercises and a tie release, education that fluids during labor and delivery can temporarily make breast tissue swell and make nipples look shorter or flatter than they naturally are, etc). When you are ready to wean from one there are multiple strategies to help:

  • 💡Start with the shield on and take it off after the first let down once baby is not as hungry/use it on the first side and not on the second side
  • 💡Try without the shield once a day during daylight hours when baby is happy and not too hungry. Catching early hunger cues is imperative. If they’re crying, try a different time 
  • 💡Start in skin to skin. Taking a bath together can help. Try to be as relaxed as possible
  • 💡Try to erect and evert your nipple. Use reverse pressure softening (RPS, see highlight reel), a pump or stimulate your nipples with your hands before attempting to latch
  • 💡Help baby latch with laid back nursing, supporting the breast in a “C” or sandwich hold, or the flipple. Make sure baby’s chin and cheeks are physically touching the breast as much as possible
  • 💡Hand express to get milk flowing to keep baby interested 
  • 💡Relax and be patient. Babies can feel your energy. The more you can see it as fun practice, the less pressure you’ll put on yourself and your baby
  • 💡Try a different shield like the Lovi or Dr Brown’s which are thinner and give you more stimulation 

How to properly place a nipple shield: CLICK HERE

Weaning blues: why do I feel so emotional from weaning baby from the breast?

- Julie Matheney

If postpartum depression weren’t enough, it’s also possible to be depressed and have mood shifts from weaning from breastfeeding. During breastfeeding, oxytocin, the cuddle hormone, is released every time milk lets down. This feel good hormone helps reduce the risk of postpartum depression. Prolactin, the hormone that actually makes the milk, also brings a feeling of well-being and relaxation. There is very little research on the subject, but it’s hypothesized that when you wean, the decrease in prolactin and oxytocin can make some feel moody, sad or even angry. The faster the weaning process the more abrupt the shift in hormone levels, and the more likely to experience feelings such as being tearful, sad or mildly depressed. Some also experience irritability, anxiety, or mood swings. These feelings are usually short-term and often go away once hormones stabilize. Some will also feel relieved and happy once it’s over and they can move on into the next stage of parenting. And that’s OK, too!!

If you are weaning and experiencing mood swings, you’re not alone! Remember, it takes at LEAST a full 40 days for those with an established milk supply to no longer see milk when they hand express or stimulate the breast. Your milk making cells are going through a cellular death called involution where they literally change from milk making cells back into breast fat cells. Some find it takes 1-3 period cycles after weaning for their hormones to reset and feel “back to baseline” which coincides with when this process is complete. It will get better!!

Some times being aware that this is a hormone shift and not something in your head is enough to bring peace in the process. Find your coping mechanisms. Reflect on your journey. There are herbs and supplements that can help in the process (set up a consultation to discuss which ones are right for you as they are NOT one size fits all). And if needed, seek professional counseling. 

Weaning from a nipple shield

- Julie Matheney

Did you use a nipple shield to help your baby latch? Want to transition baby off the shield? First, weaning from the shield is your choice. If you like it and it’s comfortable for you, don’t feel pressured to get rid of it before you and your baby are ready. There are risks associated with shield use, like the potential for decreased milk supply. But if that’s the only way your baby will latch right now, give yourselves time and grace to keep trying as baby gets older and more proficient at the breast. As always, if you’re really struggling to get off the shield, find a knowledgeable lactation consultant to help you with the process to make sure something else isn’t going on with baby’s latch.
💡You can always start with the shield on and take it off after your first let down once baby is not as hungry or use it on the first side and offer the second side without it
💡Start by trying without the shield once a day during daylight hours when baby is happy and not too hungry. Catching baby with early hunger cues is imperative. If they’re crying and really hungry, try a different time
💡Start in skin to skin. Taking a bath together can help. Try to be as relaxed as possible
💡Try to erect and evert your nipple. Use reverse pressure softening (RPS, see highlight reel), a pump or stimulate your nipples with your hands before attempting to latch
💡Help baby latch with laid back nursing, supporting the breast in a “U” or sandwich hold, or the flipple. Make sure baby’s chin and cheeks are physically touching the breast as much as possible. A baby that can’t feel the breast can’t latch to the breast.
💡Hand express to get your milk flowing so baby gets instant satisfaction and reduce the work
💡Relax and be patient. Babies can feel your energy. The more you can see it as fun practice, the less pressure you’ll put on yourself and your baby
💡If baby becomes frantic or upset during trials, using the shield is not a sign of defeat but continued practice.
💡If at first you don’t succeed, try, try again.

Weaning from breastfeeding

- Julie Matheney

Deciding to wean your child is a choice only you can make. Some people make it for medical reasons. Some make it because they have to go back to work. Some make it because they simply are done with nursing. Whatever the reason, it is that person’s and that person’s alone.
If you decide to wean, here are some tips for gentle weaning:
⭐️ Start at a time when your baby has already naturally started to wean, i.e. only a quick snack before nap? Try cutting that out first. Waking up at 2am just to pacify to sleep? Maybe that one would be a good one to cut out first.
⭐️ Offer water in an open cup as an alternative.
Don’t offer, don’t refuse
⭐️ Wear clothing that makes accessing the breast/chest more difficult.
⭐️ Distract child with favorite activities or offer alternatives like a favorite snack
⭐️ Change your routine
⭐️ Postpone: “Let’s wait until after dinner” “After we play with the blocks”
⭐️ Shortening the length of feeding or strategically distracting baby when they want to nurse can help
⭐️ Talk to your baby and let them know how you are feeling, why you need to wean, and that you understand their feelings. Older children (2 years and up) can be part of the process by talking to them about what is happening.
⭐️ Be consistent – this is a hard one but it can be even more confusing to your baby if you allow them to nurse one time and not the next.
⭐️ Offer lots of cuddles, hugs, kisses. For some babies, this is a hard time. Your breast/chest is more than just food but also a great source of comfort. Showing them you are still a source of that comfort despite not nursing is incredibly important.

There will be tears, mostly likely from both of you. Some children decide on their own that they are done but it often doesn’t make it any easier for parents. Know that if you feel like it is time to wean then you are making the right decision. Also be prepared that some may experience mood changes and feelings of depression when weaning as your oxytocin and other hormones are dropping to stop milk production.

Tips for weaning under one:
Sometimes, it is necessary to wean a baby under one. Physical and mental health of the birthing person, medical situations, or a number of valid reasons can be the cause for needing to wean under one.
👍🏼 Aim for slow and steady to ensure breast/chest health and you/your baby’s emotional readiness
👍🏼Prepare for potential “booby blues”. Hormones shifts during weaning can make you feel a whole range of emotions.
👍🏼If you’re ready to wean but your baby isn’t, the process may be two steps forward one step back as you dance and compromise with your baby.

Do I need to give my breastfeeding toddler cow’s milk or switch to cow’s milk when they turn one?

- Julie Matheney

If you’re still breastfeeding into toddlerhood, no. The World Health Organization recommends breastfeeding until 2 years old. After 2, you can wean to water and table foods or to any kind of milk per your family’s choice. If you’ve decided to wean between 1-2 years, yes and no. Cow’s milk provides a convenient source of a lot of nutrients, including calcium, protein, potassium and vitamin D that are important for building bone and brain development. But if your toddler won’t drink it, has an allergy or intolerance, or your family follows a vegan lifestyle, a well-planned diet can provide these nutrients too. According to the USDA, children ages 2-3 need two servings of dairy per day (milk, yogurt, cheese, or calcium-fortified non-dairy beverage), children age 4-8 need two and a half, and kids 9+ need three. Can you use a milk alternative such as soy, almond or oat? Yes, but they’re not one-for-one swaps. For instance, almond and rice milk have only 1 gram of protein per serving, compared to 8 grams in cow’s.

When choosing a non-dairy milk, make sure it’s fortified with calcium and vitamin D. Homemade versions won’t have this fortification. Shake milk substitutes well before serving, the calcium settles on the bottom. Look for varieties labeled “unsweetened” as many milk alternatives contain lots of added sugar! If you’re choosing not to offer your toddler cow’s milk, make sure they’re getting a wide variety of fruits, vegetables, beans, grains and protein to get them the vitamins, minerals, fats and protein they need for growth. When in doubt, discuss nutrition with a pediatric dietician

Milk is a very convenient source of calcium, but not essential. It is recommended that a 1-3 year old child have 700mg (2-3 servings) of calcium per day. Eating a diet rich in beans, tofu, spinach, kale, broccoli, kiwi, figs, brown rice, oatmeal and certain fish such as salmon can give your child just as much calcium as drinking milk. No one ever “has” to drink milk. Human milk contains less calcium than cow’s milk, but the calcium in human milk has over twice the bioavailability of the calcium in cow’s milk. Increasing your calcium intake does not increase the calcium in your milk – your milk always has the right amount of calcium for your baby. Getting adequate calcium in your diet is recommended because if you’re not getting enough, your body will take calcium from your bones to provide to your baby, making you more prone to bone fractures. However as soon as you wean, your body regains bone mass and your bones will actually be stronger than before. 

Human milk averages 5.9-10.1 mg/oz calcium. 67% of this calcium is absorbed by the body. 

Whole milk contains 36.4 mg/oz calcium. 25-30% of cow’s milk is absorbed by the body.

Infant formulas contain 15.6 mg/oz calcium; toddler formulas contain 24-27 mg/oz calcium. Extra calcium is added to infant formulas because of the lower bioavailability of the calcium from formulas as compared to human milk (they aim for baby to absorb the same amount of calcium as would be absorbed from breastmilk).

Toddler formulas have come on the market in recent years touting that they’re great nutrition for the 12+ month group. In reality, it’s all clever marketing. If you supplement baby with formula, there’s no need to switch to a toddler formula at 12+ months. In the second year of life, growth slows. Your toddler doesn’t gain weight or length as quickly as they did right after birth.

If you’re still breastfeeding, your milk adjusts to this based on how toddler nurses; how the breast is emptied tells your body what kind of milk to make. When breast milk is the primary diet, like in the first 6 months, your milk is made for growth and immunity. When your toddler is taking lots of table foods and nursing, your milk is made for development and immunity.

At 1 you don’t need a fancy toddler formula or cow’s milk. If you’re exclusively formula feeding, switching to whole cow’s milk is fine. While cow’s milk is a convenient source of calcium, protein, fats, and vitamin D, there’s no need to switch to that, either. As long as your child takes a wide variety in their diet and has a good source of calcium (yogurt, cheese, dark leafy greens like spinach, fortified cereals or juice, soybeans, etc), just choose what you offer your child wisely. If you’re still breastfeeding, know your child is getting good nutrition from your milk suited to their growing needs. If you’re concerned about your toddlers diet or they don’t eat a wide variety, consult your pediatrician or a pediatric nutritionist for advice and help.

Breastfeeding weaning

- Julie Matheney

There is no right or wrong age, it is completely up to you. Breast milk does not lose nutritional value (ever), so you get to decide how long you want to breastfeed. You also get to decide when you stop and all reasons for wanting to stop are valid. It is OK to wean for your emotional or mental well being and you do not have to justify your choices of how you feed your baby to anyone.

The age of your baby and how quickly you want to wean can play a role in how you wean.

Be prepared that some may experience mood changes and feelings of depression when weaning as your oxytocin and other hormones are dropping to stop milk production. If you need a specific plan to help you quickly wean, schedule a consultation with me to develop a plan that works for you.

Tips for gentle weaning:

✏️Start when your baby has already naturally started to wean, ex. only a quick snack before nap or waking up at 2am to pacify to sleep

✏️If transitioning from breast milk to formula, you can add formula to your breast milk bottles in slowly increasing amounts to make the transition easier on baby’s tummy (ex mix 2oz of breast milk with 1oz of prepared formula for several days, then mix 1.5oz each if breast milk and formula for a few days, then 2oz of formula with 1oz of breast milk)

✏️Don’t offer, don’t refuse

✏️Wear clothing that makes accessing the breast/chest more difficult.

✏️Distract child with favorite activities or offer alternatives like a favorite snack

✏️Change your routine

✏️Postpone: “After we play”

✏️Shortening the length of feeding or space feedings out

✏️Talk to your toddler about weaning. Older children (2 years and up) can be part of the process by talking to them about what is happening.

✏️Alternate between offering bottles and the breast

✏️Be consistent – this is a hard one but it can be even more confusing to your baby if you allow them to nurse one time and not the next.

✏️Lots of cuddles. Your breast/chest is more than just food but also a great source of comfort. Showing them you are still a source of that comfort despite not nursing is incredibly important

Ways to quickly wean:

⚓️Empty the breast only to comfort, trying not to stimulate the breast to make more milk

⚓️Breast gymnastics/“milk shakes” often to keep milk from sitting in the breast and clogging the ducts

⚓️Epsom salt soaks of the entire breast for soothing

⚓️Drinking 2-4 cups of sage or peppermint tea per day

⚓️Green cabbage leaves in the bra until they are soggy and then replacing the leaves

⚓️Cabocream (an alternative to the cabbage leaves

⚓️Cold packs on the breasts after feeding or pumping to reduce swelling

⚓️Starting on a hormone based birth control, especially The Pill (estrogen based) will drop supply

⚓️A last resort would be to take an antihistamine like Benadryl or Claritin-D as these are also notorious for dropping milk supply. This should be done with caution and under the direction of your primary care physician

True SELF-weaning by the baby before a year old is very uncommon. In fact, it is unusual for a baby to wean before 18-24 months unless something else going on (work, inefficient feeding, tongue tie, etc). A self weaning child is typically well over a year old (more commonly over 2 years) and getting most nutrition from solids, drinking well from a cup, and has been cutting back on nursing gradually.

Reasons a baby under a year may be perceived to self wean:

🔑Solids were introduced too soon

🔑Scheduled feedings/sleep training/pacifier use (all decrease time a baby would naturally want to be at the breast/chest)

🔑Lactating parent loses a lot of weight fast which can decrease milk supply

🔑Medications or hormonal birth control which will decrease supply

🔑Lactating parent is pregnant

🔑Baby taking lots of solids before one (human milk should be the primary nutrition source through one year of age)

Depression with weaning

- Julie Matheney

Weaning blues. If postpartum depression weren’t enough, it’s also possible to have depression and mood shifts from weaning from breastfeeding. During breastfeeding, oxytocin, the cuddle or love hormone, is released every time milk lets down. This feel good hormone helps reduce the risk of post partum depression and aids in bonding with baby. Prolactin, the hormone that actually makes the milk, also brings a feeling of well-being, calmness and relaxation. There is very little research on the subject, but it’s hypothesized that when you wean, the decrease in prolactin and oxytocin can make some feel moodiness, sadness or even anger. The faster the weaning process the more abrupt the shift in hormone levels, and the more likely that you will experience feelings such as being tearful, sad or mildly depressed. Some also experience irritability, anxiety, or mood swings. These feelings are usually short-term and often go away in a few weeks. Dropping no more than one feeding per week is a gentle way to wean and adjust to shifting hormones. People who are forced to wean before they are ready (or for reasons beyond their control) and those with a history of depression are also more likely to experience depression after weaning. Even for those who are ready to wean and doing so gradually, there may still be a sense of loss and sadness. Your breastfeeding relationship has been a major part of your parenting journey and it is understandable that you’ll feel a wide range of emotions.

Can I empty my breast?

- Julie Matheney

Did you know that you will ALWAYS be able to make milk? You’ve had the milk making glands in your breasts since puberty. They’re like little empty clusters of balloons at the back of the breast. Pregnancy activates your milk making hormones, allowing the glands to expand and start filling with milk between 16-20 weeks gestation. In the early days after birth, the more stimulation the breast has (from feeding or pumping), the more the milk making glands and their corresponding hormone receptors multiply. The milk balloons fill and empty milk multiple times per feeding.

After at least 40 days of not expressing any milk, once you completely wean, your milk making balloons deflate and become dormant, like before pregnancy. But they aren’t dead. Pregnancy and breastfeeding hormones caused a permanent change in your body. Your milk making glands will FOREVER remember how to make milk. They can ALWAYS make milk again, no matter how long it has been. They just need enough of the right stimulation to turn on and start filling again. Some times years after breastfeeding a mother may feel the tingle of let down if she hears a baby cry. Or she may leak if her partner does enough nipple stimulation. There are grandmothers in other cultures who bring back milk to breastfeed their grandchildren! Our bodies are AMAZING!! Now you know!

Natural Weaning from the Breast

- Julie Matheney

NATURAL WEANING

Natural weaning is the biological process of gradually decreasing milk supply as baby gets older. This process starts around 7-9 months as baby takes more solid foods and progresses toward sleeping longer stretches at night. It ends when baby finally weans (which may not be until 2-3 years old!!). Natural weaning doesn’t mean that you need to wean baby from the breast. Decreasing milk supply doesn’t mean you’re at risk of losing your supply, either. Your breast is designed to match the stage of development your baby is in. 

Milk supply iss highest from month 1-6 when baby is going through multiple growth spurts. They need to double their birth weight by 6 months. Milk is also the only food in their diet.  Therefore, your milk supply is supposed to be at its highest to meet their nutritional needs. From 6-12 months, weight gain slows but their need for milk volume needs remain stable. It is natural as baby transitions from a full milk diet to a milk+solids diet to then a solids+milk diet that breast milk supply will shift along with it. Your milk supply varies compared to baby’s solids intake and there is a wide range of normal based on your individual baby. Some babies love solids and eat them in large quantities many times a day. Other babies continue on a mostly milk diet until almost 1 year.  At 12 months, milk finally takes a back seat to solids, but still fills in nutritional gaps and acts like medicine against illness. From 12 months on there continues to be a wide range of normal for milk supply depending on your child’s eating and feeding habits. Some babies continue to nurse occasionally over night while others seem to become boob barnacles again and would happily stay on the breast all day, every day.

So what does this mean? If you’re exclusively breastfeeding you may not notice anything.  You can continue to bring baby to breast for as long and often as baby wants. You may notice baby spacing out feedings or not nursing as long. They may want the breast more when teething or going through growth spurts or developmental leaps. They have days with little interest in the breast. 

Moms who pump (either exclusively or because of work) report overflowing milk in the early weeks, often able to pump 4-6 or even 8-10 ounces in a morning pump session. By 4 months supply regulates and mom gets about 3-5 ounces per pump in place of a feeding. By 9 or 10 months it can feel like your trying to wring out a wet rag to get even 2-4 ounces a pump session. As long as baby has unrestricted access to the breast when your not working and you still have a regular pump routine in place no intervention is usually needed. Every journey is supposed to look different because it is your unique journey.

Photo Credit Jermaine Love
@jermainelove44