Usually it’s possible to end breastfeeding gradually. However, a mother may find herself in a situation where she needs to stop breastfeeding straight away, for example to start treatment for a serious medical condition such as cancer, or, sadly, if her baby has died.
Stopping breastfeeding suddenly can lead to potential problems— weaning gradually allows time both for milk production to reduce and stop, and for a baby to adjust to other ways of feeding and comfort.
It’s normal to feel overwhelmed and under pressure if it’s been suggested that you stop breastfeeding without delay. Enforced weaning is not easy on either mother or child, but you may have more options than you think.
In the ﬁrst year
In the first year, even if your baby has started eating solid foods, milk will remain his main source of nutrition and energy. Unmodified cows milk is unsuitable as a main drink for babies under a year old. For guidance on preparing infant formula see the NHS leaflet Guide to bottle feeding: http://www.unicef.org.uk/BabyFriendly/Resources/Resources-for-parents/Department-of-Health-bottle-feeding-leaflet
Whether you choose to use a bottle, an open cup or a spouted beaker when replacing breastfeeds will depend on your individual circumstances. Introduce bottles only if your baby seems to need the comfort of sucking from one. An older baby or toddler may prefer to drink from an open cup anyway.
Weaning an older baby or toddler
The following ideas may be useful if you need to wean quickly.
• Change your daily routines so your child is less likely to ask to nurse.
• Offer drinks and snacks before you expect your child to want to nurse.
• Do what you can to keep your child happy—whether by using lots of distractions or by keeping things calm.
• See tips in our post Thinking of Weaning.
Is weaning really necessary?
Mothers may be told they need to wean their baby from the breast for a variety of reasons. Before starting to wean, it’s worth double-checking that the test, medication or other treatment you need really does mean you shouldn’t breastfeed. While any situation or drug needs to be checked individually, many medications are compatible with breastfeeding. If a medication is incompatible with breastfeeding, an alternative may be available that is compatible. So it may be possible to continue breastfeeding after all. More information on this can be found in When a Breastfeeding Mother is Unwell and an LLL Leader can help locate information on speciﬁc medications.
When a short-term test, or a medication or other treatment is incompatible with breastfeeding, temporary weaning is always an option. You can maintain your milk production by expressing your milk and then discarding it. Once the test or treatment is completed you can return to breastfeeding as before—an LLL Leader can share information on getting your baby back to the breast and increasing your milk if necessary.
Find local LLL support here.
How quickly do you need to wean?
If you have a few weeks, cutting out one daily feed no more often than every two or three days allows your milk production to decrease slowly with little or no fullness and discomfort. The rate at which feeds can be dropped without discomfort varies from mother to mother.
If you need to stop nursing your baby immediately, you can use an automatic or semi-automatic electric breast pump or hand expression to relieve discomfort while you decrease your milk production. This will mean the hormonal changes are more gradual (see overleaf). If you haven’t expressed your milk before, you may need a little practice.
Breastfeeding is more than just a method of feeding. It’s also a familiar source of closeness and comfort, so your baby will need lots of extra love and attention when you stop nursing. If you are coping with illness this may not be easy—practical support from others will be a big help.
Looking after yourself
Breastfeeding can make life easier if you are coping with illness. If you have to stop breastfeeding quickly, you’ll need to devote lots of time and energy to your baby to keep him happy while he copes with the changes.
Look after yourself by:
• Reducing unnecessary outside commitments and limiting housework to essentials.
• Enlisting the help of your partner and any older children with housework and entertaining your little one.
• Using any outside help you can.
• Resting whenever possible, including lying down with your baby or toddler to sleep in the day.
• Having a quiet time, with quiet activities in a safe room. You may be able to rest, even if you can’t sleep.
• Getting to bed a little earlier to have a longer period of uninterrupted sleep.
Slow Milk Production Gradually
If you suddenly stop nursing your baby, your body continues to produce milk. A good way of slowing milk production gradually is to pump or hand express just enough milk at regular intervals to avoid discomfort. In this way milk production will slowly decrease. Keeping a little milk ﬂowing prevents your breasts becoming overly full and engorged, which could lead to a blocked duct, mastitis or even a breast abscess. It also makes it more comfortable to hold, carry and cuddle your baby if you need to distract him from nursing.
Express milk by hand, with a pump or both until your breasts feel comfortable and the milk ﬂow slows. The younger your baby is, the more care you will need to take to reduce your milk slowly and gradually. Aim to produce a comfortable fullness in your breasts by expressing less often than your baby was nursing. This fullness will then help slow your milk production. If your baby was breastfeeding about every two hours, you could try expressing milk every three hours or so at ﬁrst to relieve excessive fullness. You might need to express at night too to start with.
As well as cutting out a whole expressing session every two or three days, you can also reduce the time at each session. Expressing less milk each time will also help limit how much milk you produce.
Shorten sessions by a minute every few days, for example, but watch out for signs of engorgement due to insufﬁcient removal of milk. If your breasts become ﬁrm, hard, shiny or lumpy, take action without delay to relieve this. Hand express or gently pump enough milk to make your breasts comfortable. Make sure you drain milk from each part of the breast.
• Applying warmth for a few minutes, or having a comfortably hot shower or bath can make it easier to express milk as the warm water may help you relax and stimulate your let-down.
• Ice packs can provide relief from swelling. Use an ice pack large enough to cover most of the breast, wrapped in a lightweight towel to protect your skin. Leave it in place for 15-20 minutes. Crushed ice in a plastic bag or a bag of frozen vegetables can be used (the latter can be thawed and refrozen several times, before discarding).
• Breast pads can help with leaking. You may be more comfortable wearing a ﬁrm bra for support—possibly a size larger than usual. But note that any consistent pressure on the breast can cause a blocked duct, or mastitis.
• Drink according to your thirst. Since salt causes the body to retain ﬂuids, it may be helpful to restrict your salt intake until any feelings of fullness are gone.
• Pain and swelling can be relieved by a suitable over-the-counter anti-inﬂammatory medication from your pharmacist.
Symptoms of mastitis
If one area of your breast appears to be inﬂamed—tender, red and hot—and if you have a fever over 38.4°C or ﬂu-like symptoms, you may have mastitis or a breast infection. Continue to express milk focusing particularly on softening the inﬂamed area. If it does not improve contact your doctor who may prescribe an antibiotic. More information on dealing with mastitis
When you have stopped nursing or expressing
Once you have stopped breastfeeding or expressing milk and the feelings of fullness have gone, your breasts will continue to produce small amounts of milk for some time. Some mothers ﬁnd their breasts start to feel full and uncomfortable a few days or more after they’ve stopped feeding, or expressing. Treating this fullness by expressing small amounts of milk every so often will help prevent it getting worse.
It’s not unusual to be able to express drops of milk months or even years after weaning, although producing signiﬁcant amounts long afterwards could suggest a hormonal imbalance and is worth checking with your doctor.
Sometimes the sudden hormonal changes following an abrupt end to breastfeeding may bring on or worsen depression. Do talk to your GP or health visitor if depression intensiﬁes or lasts more than two weeks, as effective treatments are available.
Having no choice about ending breastfeeding may leave you and your child feeling frustrated, angry or sad, especially if your child still very much enjoys nursing. Neither of you want to wean but it’s the only option. It might help to say to your child something like, “It’s hard for you, I know. You’d really like to feed. I’d like to be able to feed you, too. But we have to stop now and I’m sorry. I still love you.”
Many people think nursing doesn’t matter once a baby can eat solid foods and that stopping breastfeeding is easy. They may ﬁnd it hard to understand the distress you feel. Seek out support from those who do understand how hard it is. You can ﬁnd this support from an LLL Leader or from mothers in your local LLL Group.
Written by Karen Butler, Sue Upstone and mothers of LLLGB
How Weaning Happens. Bengson, D. Schaumburg, IL: LLLI, 1999. (Out of print, but available from most LLL group libraries.)
Mothering Your Nursing Toddler. Bumgarner, NJ. Schaumburg, IL: LLLI, 1999.
Engorged Breasts – Avoiding & Treating
If You Leave Your Baby
Thinking of Weaning?
When a Mother is Ill
When Mum Can’t Be There
You can buy this information in printed form from the LLLGB shop.
Copyright LLLGB November 2017