Pediatric Advisor 10.0: Normal Weaning

Children & Adolescents Clinic

Clinical Reference Systems: Pediatric Advisor 10.0
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Normal Weaning

Description

Weaning is the replacement of bottle or breast-feedings (nipple feedings) with drinking from a cup and eating solid foods. Weaning occurs easily and smoothly unless the breast or bottle has become overly important to the child.

How to Prevent Weaning Problems

If you have a choice, it is best to wait until your baby is at least 6 months old before you wean from the breast. Your baby's digestive system is better able to tolerate a change in food after this age.

If you discontinue breast-feeding before 9 months of age, switch to bottle feeding first and introduce your child to a cup at approximately 6 months of age. If you stop breast- feeding after 9 months of age, you may be able to go directly to cup feeding.

Children normally show less interest in breast and bottle feedings between 6 and 12 months of age if they are also taking cup and spoon feedings. Many children start weaning themselves by 12 months. After the age of 12 to 18 months, the parent often has to start the weaning, but the child will be receptive. After 18 months of age, the child usually resists weaning because she has become overly attached to the breast or bottle.

If your child shows a lack of interest in the breast or bottle at any time after 6 months of age, start to phase out these nipple feedings. You can tell that your baby is ready to begin weaning when she throws the bottle down, takes only a few ounces of milk and then stops, chews on the nipple rather than sucking it, refuses the breast, or nurses for only a few minutes and then wants to play.

The following steps encourage early natural weaning at 9 to 12 months:

Keep bottle feedings to four times a day or less after your child reaches 6 months of age.
Some breast-fed babies may need five feedings a day until 9 months of age.
Give older infants their daytime feedings at mealtime with solids.
Once your child is having just four formula or breast- feedings a day, be sure three of them are given at mealtime with solids rather than as part of the ritual before naps. Your child can have the fourth feeding before he goes to bed at night.
After your baby is 3 to 4 weeks old and breast-feeding is well established, offer him a bottle of expressed breast milk or water once a day.
This experience will help your baby get used to a bottle so you can occasionally leave him with a baby sitter. This step is especially important if you will be returning to work or school. The longer you wait to introduce the bottle after your baby is 2 months old, the more strongly your infant will initially reject it. If you wait until 4 months of age, it may take up to 1 week for your baby to accept the bottle. Once your baby accepts bottle feedings, you should continue them at least three times a week.
Hold your child for discomfort or stress instead of nursing her.
You can comfort your child and foster a strong sense of security and trust without nursing every time she is upset. If you always nurse your child in such situations, your child may learn to eat whenever she is upset. She may also be unable to separate being held from nursing, and you may become an "indispensable mother."
Don't let the bottle or breast substitute for a pacifier.
Learn to recognize when your baby just needs to suck. At these times, instead of offering your child food, encourage him to suck on a pacifier or thumb. Feeding your baby every time he needs to suck can lead to obesity.
Don't let the bottle or breast become a security object at bedtime.
Your child should be able to go to sleep at night without having a breast or bottle in her mouth. She needs to learn how to put herself to sleep. If she doesn't, she will develop sleep problems that require the parents' presence during the night.
Don't let a bottle become a daytime toy.
Don't let your child carry a bottle around as a companion during the day. This habit may keep him from engaging in more stimulating activities.
Don't let your child hold the bottle or take it to bed.
Your child should think of the bottle as something that belongs to you; hence, she won't protest giving it up because it never belonged to her in the first place.
Offer your child formula or breast milk in a cup by 6 months of age.
For the first few months your child will probably accept the cup only after he has drunk some from the bottle or breast. However, by 9 months of age your child should be offered some formula or breast milk from a cup before breast or bottle feedings.
Wean a baby younger than 6 months to a bottle and not to a cup. Babies cannot drink well enough from a cup at this age to get enough nourishment.
Help your baby become interested in foods other than formula or breast milk.
Introduce solids with a spoon by 4 months of age to formula-fed babies and by 6 months to breast-fed infants. Finger foods can be introduced between 9 and 10 months of age or whenever your child develops a pincer grasp. As soon as your child can use finger foods, include her at the table with the family during mealtime. She will probably become interested in the foods that she sees you eating and will ask for them. As a result, she will become more interested in having other foods as well as formula or breast milk.