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Weaning and Combo Feeding
By Anne Smith, IBCLC

Anne Smith, IBCLCQ. I have been exclusively breastfeeding my 8.5 month old boy. He is a very active little boy and has always been way ahead on his developmental milestones. He has become increasingly disinterested in the breast the past couple of weeks. It is not like he has completely quit nursing, he is just cutting down drastically even though I know he is hungry. We have not increased his solids at all. We concluded that he was beginning to wean himself. After much conversation, my husband and I decided that we would begin weaning him to a bottle. My plan is to wean him to nursing only in the morning and at night by the end of the month when we go on vacation for 5 days without him. After I come back, try to nurse him at night only.

My questions are these:

  1. Can my body keep making milk with just one feeding a day?

  2. How long should I wait between each feeding replacement to try and avoid mastitis, etc? (I am already engorged because he has cut back so much.)

A. Babies who are going to lose interest in nursing and wean themselves early on usually start losing interest and cutting back on feedings around the time they start eating solids and becoming mobile - sometime between six and nine months. Usually these babies are self soothers (they have their thumb, a pacifier, or a security object to use when they want to go to sleep or when they are fussy, sick, or get hurt) so for them, breastfeeding is more of a way to get food than a comfort thing. Once they don't need to nurse for nourishment, they tend to start losing interest.

Babies who aren't self soothers tend to use the breast for comfort, and often wean much later. Early weaners are often very active, alert, and inquisitive babies, and are too busy to sit still and nurse for very long at a time. It sounds like your little boy may fall in the category of an "early weaner".

Usually the last feedings that babies give up are the first thing in the morning and the bedtime feedings. You can certainly work toward cutting back on feedings until he is only nursing a couple of times a day, but the problem with that is that your supply is going to drop dramatically if you are only getting stimulation twice a day, and even more if you only nurse once a day. Many babies are not willing to continue to nurse if they are getting only a tiny amount of milk at a feeding - they get frustrated and decide that it just isn't worth the effort, especially if they are used to the quick, easy, steady flow of milk from a bottle. Babies who aren't self soothers will sometimes continue nursing for comfort at bedtime even when your supply is way down, but babies who don't use the breast for comfort or to put themselves to sleep at night are often not willing to continue nursing once a day.

Another potential problem here is getting a baby this age to take a bottle. If he hasn't taken one on a regular basis already, he may resist taking it at this point and it may be easier to wean him to a cup. If he already takes formula in a bottle, then that will make it easier. When a baby this age is already losing interest in nursing, he will often refuse to return to the breast after a long period of not nursing at all. I would be surprised if he is willing to nurse again after your trip, but it is certainly possible. It won't hurt to try, but you would need to pump once or twice a day during your trip in order to maintain a minimal supply. That way, when you get back, if he wants to keep on nursing, he can, but if he is just about ready to wean himself, he won't show any interest and your milk will dry up quickly since you have been getting such minimal stimulation.

Since he has already cut back on feedings so much, you should have time to wean down to one feeding a day gradually before your trip. The process of mother-led weaning basically involves dropping feedings gradually in order to give your breasts time to adjust to the change. Try to do it as gradually as possible. Eliminate one feeding each day for several days to allow your milk supply to decrease slowly. After a couple of weeks, he should be down to nursing just a couple of times a day.

There is no exact timetable, because every mother's body responds differently, just as every baby is different. Some mother can wean "cold turkey" with minimal discomfort, while another mother may take weeks to get to the same point. Your body will let you know if you are going too fast -if your breasts get knotty and hard, then you need to pump off some milk to relieve the discomfort, and take it a little slower.

Another option for you would be to consider pumping several times a day and offering the expressed milk to him via bottle or cup. This would help maintain your supply in case he decides he's interested in nursing again (for some babies, the loss of interest in nursing is a temporary stage) and give him more breastmilk and less formula.

Since the AAP recommends nursing for at least a year, and since there is a good chance that he may not be willing to nurse only once a day and will wean completely by nine months, this might be an option to consider if you want to continue nursing for longer than nine months.

Whatever you decide to do, I'm sure that your baby will be fine. Congratulations on your happy, healthy little boy, and I think it's great that he has nursed for so long.

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