It is fairly common for a woman to say “my baby woke up one day and didn’t want to breastfeed anymore”, especially around the seven or eight month mark. However, Lourdes M. Santaballa, IBCLC, CD, HC discusses the process of selfweaning and how it can commonly be mistaken for a nursing strike.
The World Health Organization recommends exclusive breastfeeding for the first six months of life, and then breastfeeding with complimentary foods until the age of two or beyond.1 The health benefits of exclusive breastfeeding are well documented and there is strong evidence that breastmilk provides the primary source of nutrition in the second year of life (from 13-24 months).2 But we don’t actually have many models of women who breastfeed that long. It may be becoming more commonplace than in past decades, or we may see it within certain circles of attachment parenting mothers, but it is much more of the norm for us to see women who, even if they planned to comply with the recommendations, find themselves struggling with breastfeeding in the first weeks and quickly switch to formula, who combine formula/breastmilk and eventually but swiftly weed out the second, or who once complimentary feeding starts in a short period of time go off breastmilk and find their baby weaned before their baby turns one.
IS IT REALLY WEANING? Weaning is actually a process. It starts with the introduction of the first morsel of food, sometime around the second half of the first year, and in the ideal world is a slow and mutually beneficial decision between the mother and her baby. Some mothers favour spoon feeding at 6 months (or earlier although this goes against the recommendations of the major paediatric associations and the WHO), particularly if the paediatrician is pressuring her because of the theory of low iron in breastfed children.3 Other mothers prefer child-led weaning, where the baby is offered the foods that the rest of the family eats at age-appropriate intervals. Either way, it is important to start solids when baby shows signs of physically being ready, to read baby’s body language and what s/he communicates about the food being offered, and to offer each food item in a conscious manner to rule out any food intolerances or allergies. The breastfeeding mother should also take special care to make sure she offers the breast before she offers food, so that she can assure that baby gets all of the necessary nutrients from the breastmilk. Though nutrient dense and super foods can offer sustainable nutrition, no other food can compare to the nutrition and antibodies or is a living organism as is human milk.
‘There is technically no such thing as sudden weaning. Although there are circumstances that can force it, for example, maternal death and forced separation of mother-baby, as mentioned previously, weaning is a process.’
BABY WEANING VS. NURSING STRIKE When I was invited to write this article, I was asked to mention specifically the seven month mark as critical in the commencement of self-weaning and the possibility of a nursing strike confusing the mother into thinking that her child was giving up the breast. Just as a reminder for me, this week I happened to attend two consults, one from a fellow health coach, and the other from a client who I oriented during her pregnancy, whose babies are seven months old and who are suddenly rejecting the breast more often. In both cases, the babies’ first teeth are erupting and they are experiencing mouth discomfort (pain). In both cases, the babies have already begun to experiment with solids and the frustrated mothers have succumbed to solids when their babies have rejected the breast to “make sure that they eat something”. In one case, the client’s father was a paediatrician who urged her to give the baby solids if he didn’t want the breast.
Can self-weaning be instant? There is technically no such thing as sudden weaning. Although there are circumstances that can force it, for example, maternal death and forced separation of mother-baby, as mentioned previously, weaning is a process. Solids are introduced and feedings are slowly reduced. The baby begins to walk and becomes more interested in play than in feeds. Teeth erupt and baby breastfeeds all night to ease the pain. Another growth spurt kicks in and baby breastfeeds all day at around the year and a half. If the mother-baby continues the breastfeeding relationship beyond the age of two (and the worldwide average age of weaning is anywhere between 2.5 and 4.2) , the child can begin at a school or day-care, mother can return to work or study, the parents may separate and the child spend days and/or nights with the father, so that feeds become less and less. In my case, with a 4.8 year old and 6.5 year old who still breastfeed but only in the mornings and before bedtime, sometimes they ‘forget’ or are too busy. My longest stretch during the Christmas holidays was 36 hours, and I suspect that these will become more and more common. My case is how child-led weaning happens. When a mother wants to lead the weaning, she is recommended to drop one feed every 4 to 7 days so that her body adjusts and she doesn’t develop mastitis, and so both she and the baby can adjust emotionally (plenty of cuddling and talking can substitute the breastfeeding). Many mothers who choose this route can give testimony that what they thought would take less than 2 months suddenly drags into 6 or 9 as the child starts waking suddenly in the night, an illness happens, or anything that makes both of them realise that they need to take it slower. But mother-led weaning can be swift and respectful; it just can’t be instant if she doesn’t want physical or emotional repercussions.
But what if my baby doesn’t want the breast at all? Weaning isn’t instant. A sudden rejection of the breast is called a nursing strike. For example, a woman may go to breastfeed her baby and the baby refuses to take the breast. This may happen for one feed or up to a few days. It is generally caused by some external factor that causes the baby to suddenly reject normal feeding. Seven months is common because of the introduction of solids, developmental issues (crawling and standing—baby becomes too entertained to be tied down to breastfeeding for long periods of time), and teething (while some babies may want to breastfeed all night, other babies mouths HURT and don’t want to suck on anything); but a strike can happen at any time. Many mothers become confused and hurt to see that their baby doesn’t want the breast. They feel personally rejected. They become worried because they want their babies to eat and they want their babies to be comforted. If the baby takes milk from a bottle, she may start expressing and bottle feeding, which is twice the work, and creates a vicious cycle of not wanting the breast since the bottle is ‘easier’. If the baby doesn’t bottle feed, the mother could offer food to make sure that her baby “eats something” and skip a breastfeeding session. Food then also becomes a viable alternative and the breast is less appealing. The mother can accept the strike as weaning (“One day she just didn’t want the breast anymore.”) or decide that she is going to work through the strike and coax baby back to the breast. She needs to use information, support, patience, and love for her child.
If a nursing strike happens, the important thing is to identify the cause. For example, a cold which makes it difficult to breathe and suck at the same time, a preference for bottle over breast for working mother,s or the seven month markers. However, you can reverse the cause so that breastfeeding is not a burden to the baby. Un-clog the nose with breastmilk and saline. Learn how to pace feed with a bottle or go back to basics with cup feeding. Offer the breast frequently when playing. Breastfeed before giving solids and not after. Use homeopathic remedies like belladonna, camila and Baltic amber necklaces and rub frozen breastmilk over the gums to alleviate teething discomfort. And then go back to basics. Enamour your child and try skin to skin again like you did when they were newborn. Get in the bath, read a book, sit in a quiet room to feed so that distractions are minimised. Breastmilk provides essential nutrients, but it is also a warm and tender relationship between mother and baby that both of you know how to cultivate and enjoy.
Don’t give up! Wean at a respectful pace and don’t confuse a strike with weaning. You can make it to the two year mark and beyond with a good support network and by arming yourself with information and determination.
Lourdes Santaballa is a tandem nursing mother of two children, a La Leche League Leader, International Board Certified Lactation Consultant, Certified Birth and Postpartum Doula, and Health Coach. She lives in Puerto Rico where she is in private practice doing what she loves.