The pressure to wean

Image credit: Rachael Towne via Flickr Creative Commons

The moment you begin on the journey that is breastfeeding, you know that you will sometime reach the destination called weaning. (Since I’m an American, we’re talking about the weaning-from-the-breast kind of weaning, not the less-US-centric introducing-to-food weaning.) How long you breastfeed depends upon many different factors, but all breastfeeding will come to an end eventually.

Some nursing relationships that are otherwise going well end because of pressure to wean. I have no investment in trying to convince you to breastfeed longer than you feel is appropriate for you and your family, but I do have an investment in helping you reach whatever your breastfeeding goals may be. Keep that in mind when reading what I write below; I’m not trying to convince you to keep breastfeeding as long as possible. (I’ll let you in on a little secret: I’ve yet to let one of my own children self-wean, so you will find no pressure to do so from me.) You get to decide when breastfeeding ends. Truly, it should be the decision of the breastfeeding parent and the baby (or babies) involved, and no one else.

Weaning and medication

Sometimes we’re encouraged to wean based on information that may not be entirely accurate. You may hear that in order to take a certain medication, you’ll need to wean. If you’re told this by a doctor, pharmacist, or anyone else, but want to continue to breastfeed, it is worth taking the time to check with the InfantRisk Center or look up the conclusions drawn in Medications and Mother’s Milk by Dr. Thomas Hale (lactation professionals should have a copy). Even drugs that may not be safe in some circumstances could be safe in others (such as with an older baby, or with care taken in regard to timing taking the medicine and feeding a baby). In the cases where a medication is truly contraindicated, there are often alternatives. It doesn’t hurt to double check to ensure you’re basing your decision on the most recent research available. There are legitimate medical reasons to cease breastfeeding, but anyone who wishes to continue breastfeeding should feel empowered to seek a second opinion.

Weaning and mental health

Since perinatal mental health is one of my big interests, I end up reading about people telling or encouraging moms who struggle with depression or other mood disorders to give up breastfeeding, whether to go on medication (see above) or get more sleep (which is such a good thing for postpartum mental health). I worry about the moms who want to keep breastfeeding, but experience a profound lack of support to keep doing so. Breastfeeding is considered by many to be expendable. But breastfeeding is partly an emotional experience, and we need to find ways to help moms deal with postpartum mood issues without sabotaging breastfeeding in order to help mothers (and babies) in the longer term.

Consider, also, that for some moms, breastfeeding may be the only thing that is going right. Don’t take that away. Another thing to keep in mind is that breastfeeding is also a hormonal experience. Whether you wean at six days or six years, your body will experience hormonal changes that can exacerbate depression and anxiety.

See also: Breastfeeding and sanity are not mutually exclusive.

Pressure from other people

Sometimes pressure from family, friends, or employers helps drive the decision to wean. It is my hope that each breastfeeding relationship starts, and stops, on its own terms, but that is not always the reality. If you feel pressured by family or friends to wean, it will take some strength to resist. Sometimes it’s not worth the battle; please know that you are allowed to make the decisions that are right for you and your baby at any given time. Unfortunately, I can’t tell you the magic words to make other people accept or encourage breastfeeding if they’re not supportive, but I can tell you that it’s not uncommon to experience pressure from outside sources to stop breastfeeding. Most of this comes from a lack of knowledge of what normal breastfeeding looks like, or from someone’s own experiences that are being projected upon you. The best advice I can give is to maintain your confidence, and keep your goals in sight.

If you’re thinking of weaning because of your job, here are some things to keep in mind:

  • Your baby will probably do just fine switching between breast and bottle if a bottle is introduced after breastfeeding is established. You don’t need to switch entirely to bottles just because you will be away from your baby on a regular basis.
  • Under the Affordable Care Act, employers are required to provide break time and a non-bathroom space for expressing milk to mothers for a year after a baby’s birth. 
  • It is possible to find time and space to pump in a wide variety of work situations. The U.S. Office on Women’s Health recently launched a “Time and Space Solutions” website, with suggestions on how to accommodate breastfeeding moms, aimed toward employers. Expressing milk while away from your baby doesn’t require a lot of fancy tools; just privacy, a way to store milk, and a bit of time.
  • It is also possible to combo feed, giving a baby formula while you’re away and nursing while you’re together. You’ll need to take care to avoid plugged ducts, mastitis, and other problems that might pop up if you’re not expressing milk (leaking breasts, anyone?), but some breastfeeding/breastmilk is always better than none. Plus, nursing is more than just about food, and you’ll have a good excuse to cuddle and connect with your baby when you’re together.

So how long should you breastfeed?

The most-often-cited sources when it comes to recommendations for breastfeeding duration (in the United States) are from the American Academy of Pediatrics (AAP) and the World Health Organization (WHO). The AAP recommends “exclusive breastfeeding for about the first six months of a baby’s life, followed by breastfeeding in combination with the introduction of complementary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby.” The WHO says, “Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond.” These statements reaffirm that babies should be breastfed exclusively until six months of age, and that breastfeeding still has value in the first and second year of life, and beyond. The AAP statement includes the recommendation to continue breastfeeding past a year for as long as it is mutually desired; a mother counts in this equation.

The first thing to consider when thinking about weaning is: Do you want to keep breastfeeding? Will you feel good about the decision, or not? Think not only about the present, but the future, and let that inform your decisions.

Dealing with outside influences on breastfeeding is a challenge that many women face; you are not alone there. With so many things in life, we try to make the best choices we can with the information, goals, support, and resources we have at the time. And, if you do wean before you or your baby are ready, and wish you could try again, relactation is an option. Breastfeeding is never all or nothing, and the breasts’ drive to feed babies is a strong one.

I’d love to hear about your experiences with pressure to wean. What did you do? What support do you have to offer others who are going through a similar situation?