Written by : Helina Teshome, RN, IBCLC

The month of August marks Breastfeeding Awareness Month, which is an initiative started by the US Department of Health and Human Services with the purpose of bringing more awareness to the importance of breastfeeding.

In 2012, the Black Breastfeeding Week initiative was started, with awareness campaigns that take place during the last week of August. Statistically, black mothers breastfeed 66% of the time, in contrast to white mothers who breastfeed 85% of the time. This contrast is proof that black mothers fall victim to the systemic racism in our healthcare system, which also shows staggering numbers of pregnancy-related deaths among black women. According to the CDC, black women are 3-4 times more likely to experience pregnancy-related death than white women, regardless of income and education level.

For this reason, the need for Black Breastfeeding Week and more push to educate and support black women with breastfeeding and their breastfeeding goals, is critical.

Breastfeeding is a popular topic in our Habesha Moms Community on Facebook, and, at the same time, the process of weaning from breastfeeding is also popular. Weaning from breastfeeding can be as difficult and as uncomfortable as starting the breastfeeding process, and requires adequate support and education as well.

In this article, Helina Teshome, a Registered Nurse and International Board Certified Lactation Consultant shares tips on how to wean your baby from breastfeeding.

Introduction by: Beri Gebrehiwot

The recommendations from the American Academy of Pediatrics, World Health Organization, and UNICEF are to breastfeed exclusively for the first 6 months and to continue breastfeeding for 1 year or longer with the introduction of complementary foods. Breastfeeding is about much more than just providing milk to baby – it has many benefits for both mom and baby. In addition to providing nutrition to the baby, it also delivers protective immune factors that can keep illnesses at bay or help babies recover from illness more quickly. Breastfeeding is a source of emotional comfort, security, and bonding for both mom and babies, as well as also providing many health benefits for moms including protective factors from certain types of cancers, and decreased risk of postpartum depression.

Eventually, every breastfeeding dyad will wean from nursing, and that decision comes at different times for each family depending on their circumstances. Weaning can be viewed as a milestone that babies reach when they are ready to do so, similar to sleeping through the night, crawling, and walking. Following baby’s cues for weaning is called baby-led weaning. This approach may not be possible for everybody, and some moms may choose to wean earlier for various reasons; this is generally referred to as mother-led weaning.

No matter the reason for weaning, there are ways to make this transitional time easier for both mom and baby.  Here are a few suggestions that can make this time easier for both parties as they go through the process.

Weaning should be done gradually to avoid putting mom at risk for blocked duct or mastitis. This is true whether a mom is directly breastfeeding or exclusively pumping. Blocked ducts can happen any time that mom goes for a longer period than usual without emptying her breasts. Mom should check for knots and/or lumps on her breasts and massage and soften those firm areas during feedings or pumping. If blocked ducts are not resolved, they can progress to become mastitis, a more serious condition that often requires antibiotic treatment – ideally gradual weaning will help to avoid this complication.

The general recommendation is for mom to drop one breastfeeding or pumping session every 3-7 days, thus allowing her body to adjust and reduce her milk production slowly. If mom is feeling engorged and her breasts become painful in the process, she can manually express or pump for a short time (2-3 minutes) for immediate relief.  It is very important to avoid draining the breasts completely, as the milk production may increase again with frequent and/or complete emptying of the breasts.

For older children, start by talking to them in preparation for what’s about to happen. They understand more than we think! There are several good children’s books that address weaning – reading aloud can be a nice bonding time to help children feel secure even as they are preparing to wean or in the process of weaning.

Once you are both emotionally ready, you can start by dropping the feeding session that the toddler is least interested in and continue to drop one feeding every 3-7 days. Don’t readily offer the breast, but if baby wants it, don’t refuse. Children are very astute to mom’s emotions, and if they sense mom’s resistance or feel that she is pulling away, they will sometimes become more demanding and may want to nurse more often. Offering alternative activities or changing some of the routines that the baby associates with nursing may also help. For example, if they typically like to nurse at night, try having your partner put them to bed instead of you, etc.

Remember that you don’t necessarily have to wean entirely. Some moms find that they can maintain sufficient supply even if they drop down to one or two breastfeeding sessions per day. This allows them the benefits and bonding of breastfeeding while providing greater flexibility. Allow yourself the freedom to find the routine that works best for you and your family.

Depending on the age of the baby at the time of weaning, missed breastfeeding will need to be substituted with a bottle feeding.  The baby may refuse to take a bottle from mom early on so it may help to have a support person offers it. For toddlers, offering regular meals, snacks and drinks will help reduce hunger and thirst as well as distract them from wanting to nurse.

Weaning can be an emotional time for both parties so it should be done from a place of love, understanding, and patience. It should be postponed if mom or baby are having any challenges or stress that would make this transition difficult - such as illness or teething. This is a process that often takes several weeks – being prepared for that can help to make it go more smoothly.

If there is a medical reason for weaning abruptly, be sure to seek the guidance of an International Board-Certified Lactation Consultant (IBCLC) to minimize the risk of complications due to abrupt weaning.

Helina has been a Registered Nurse since 2005 and a Board Certified Lactation Consultant since 2011.  She brings experiences from a variety of areas to this line of work, including Postpartum Care, Neonatal Intensive Care and Post Anesthesia Care. Helina became a DONA trained postpartum doula and founded Mommy’s Angels Postpartum Care Services LLC to fully pursue her passion for working with and supporting parents and their newborns. Helina originally started her company to provide postpartum care to families by providing extra support, nurturing and skilled home care.  She still feels that this support is very important to families so that they can fully enjoy the changes in their family dynamics.  However, over the last few years, her focus has changed to solely providing lactation consulting and teaching mothers the art of breastfeeding.

Born and raised in Addis Ababa, Ethiopia, Helina has been living in Austin since 1994.  She enjoys traveling and spending time with her husband and three children. Prior to becoming a nurse, Helina received her Bachelor’s of Business Administration in Accounting from St. Edward’s University and worked at Dell Computers Corporation.

*Source: https://www.breastfeedingaustin.com