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041BABY columnist Odette Parfitt, dives into the complexities of breastfeeding and weaning, providing guidance and emotional support for mothers at every stage of the journey.

From the minute a baby leaves your body (in whatever method of delivery you choose), your primary job is to breastfeed. Within the first hour, a nurse appears to guide you (and by “guide you” I mean manhandle you) to breastfeed. Over the next few days you will hear relentless mantras about how breastfeeding is the best and healthiest thing for your baby – a truly miraculous act.

But nobody tells you this miracle comes with an expiry date.

The first time I was on the receiving end of a funny look, my son had just turned a year old and I mentioned in conversation at another child’s birthday party that I was still breastfeeding. Over the next couple of months, those looks became more frequent and less subtle. It didn’t take long to realise that, past a certain age, the “most natural thing in the world” was suddenly weird and frowned upon.

So I did what I’ve done every other time I’ve had a breastfeeding question in the past year and a half: I turned to Diaan Jooste, local physiotherapist and lactation consultant, to find out: when – and how – should you stop breastfeeding?

“The World Health Organisation suggests exclusive breastfeeding for the first 6 months of a baby’s life, after which supplementary foods can be introduced. During that time, the breastmilk remains the baby’s main source of nutrition until 1 year of age and even then, the

WHO encourages mothers to continue breastfeeding until the age of 2 years,” explains Diaan. “This is the ideal scenario, but in practice, we see a wide variety of scenarios, which makes it difficult to answer – breastfeeding does not always start out smoothly for every mom and some mothers are faced with the possibility of weaning much sooner. Ultimately, the right time to wean will differ for each mom, based on her unique and individual journey, and hopefully based on the fact that she was given the opportunity to weigh up all her options and make informed decisions.

How can you tell if you child is ready to stop breastfeeding?

Babies will typically wean themselves if you allow them to follow their own natural rhythm. Some babies wean themselves before a year and others will continue to breastfeed long after 3 years of age. They will start drinking less and less and eventually just one day stop asking for the breast. This is however not everyone’s journey and many moms choose to initiate the weaning process. In the case of mother-led weaning, one needs to consider the following factors to determine if a baby is “ready” to wean:

• the baby’s age: if the baby is 1 year or older and is otherwise healthy and

accepting a supplementary diet well, then this falls within the WHO’s guideline; if

the baby is less than a year old, then an AFASS (acceptable, feasible, affordable, sustainable, safe) assessment needs to be conducted. Basically, this assesses if the family is set up in such a way that formula is accepted, they have the financial stability to purchase formula, it is readily available where they live, and the family can sterilise bottles and teats.

• Baby’s overall health: it is not recommended to start a weaning process when a baby is sick, as breastmilk provides so many health benefits to the baby. Also, if a baby falls sick during a weaning period, it might be worth considering to put the baby back on the breast and wait for a time again when the baby is healthy.
• Whether the baby is physically able to drink milk from a bottle
• Big changes in the family dynamics like a birth of a sibling, or a toddler who transitioned to their own bed/room, or moving house. Any big life moments would not be a good time for mom or baby to initiate weaning; wait a bit until the dust has settled.
• The mother’s mental health: if the mother finds herself in a situation where it will be more harmful to both mom and baby to continue breastfeeding, then it is in the baby’s best interest to wean, and it ensures the mother’s mental wellbeing will benefit. We see this for example in cases where the mother is struggling with severe breastfeeding complications or untreated cases of post-natal depression.

Can you give any general advice on weaning that should apply to most moms?

For the mother-led weaning scenarios, my best advice is to find your “why?”, as in “why do you want to wean?”. Once the reason is clear, there is less chance for a mother to be influenced by outside opinions as to why it is or isn’t the right decision. Baby-led weaning or circumstantial scenarios can catch a mom off-guard, if it happens at a time when she did not plan to stop. My advice to any mom who feels caught off-guard is to recognise the situation as a loss and treat it as a loss. You are allowed to feel deeply affected and sad or mad or frustrated. Give yourself time to grieve and if needed consult with a professional to help you process the loss in an optimal way.

Finally, whether the weaning is baby- or mother-led, it is wise to consult with a certified lactation consultant to guide you and educate you on what your options are to manage your milk production in a safe way, with the least amount of risk for developing weaning-related complications.

What physical effects might a breastfeeding mother experience during weaning?

There are a few complications that mothers could experience if the process is not done wisely. This includes blocked segments that can lead to engorgement, which can then lead to mastitis. This can cause unnecessary pain and suffering. 

What about the emotional side effects?

For many moms, the act of breastfeeding is linked to a deep sense of connection between mom and baby. When a mom weans, especially if she wants to continue breastfeeding but her circumstances force her to take a different route or the baby is naturally weaning, this can be a very sad time. It is very common to feel sadness and I encourage mothers to embrace their emotions during this time. I do want to mention that when weaning a breastfeeding baby, the connection and bond don’t have to be broken; there are lovely ways to still stay connected, such as skin-to-skin time, which releases the same love hormone (oxytocin) as breastfeeding. Lots of cuddles, kisses and chatting can replace that bonding time.

What do you wish more mothers knew about breastfeeding and weaning?

There is so much pressure on mothers to perform, not only in the breastfeeding scene but in all aspects of parenting. I find many mothers who decide to stop breastfeeding at an early stage often feel a sense of failure and the need to justify their decision, but I want to say to those mothers that when you know why you are doing something and you have weighed up the pros and cons for your individual family setup, to own your decision and not feel obligated to justify your decisions to anyone. Let us rather celebrate the number of seconds, minutes, hours, days and weeks you were able to breastfeed. 

Any closing thoughts?

Breastfeeding can be one of the most wonderful experiences a mother can have, but in the same breath, it can be one of the hardest things to initiate and establish. Not everyone has the same support system and backing that it takes to help a breastfeeding journey succeed, so mothers should stay kind and patient with themselves and, in the end, know that the decisions they make are usually made with the best intentions. Whether you breastfeed for two weeks or two years, you are still an amazing mother who is trying to be the best mother she can be with the resources available to her.