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35 years
Hi drs. how can i stop breastfeeding without beeing painfully engorged? does the medication have any undesirable side effect? Thk u.
Sep 7, 2014

Dr. Zakia Dimassi Pediatrics
For the first 6 months of life, The American Academy of Pediatrics (AAP) recommends exclusive breast milk for babies. Thereafter, a combination of solid foods and breast milk should be given until a baby is at least 1 year old.
Expert opinion on the optimal time to wean off breastfeeding: after the first birthday is considered to be the best time to begin weaning because kids are more adaptable to change at that age. If delayed further, the child would be much more attached to breastfeeding and less willing to give it up. At 1 year of age, a toddler’s diet relies mainly on solid foods, so he/she may naturally grow less interest in nursing. Engorgement will have less impact on the mother by that time because milk production decreases in parallel with the decrease in demand for breast milk (remember, one of the most powerful stimulant for breast milk production is the baby’s suckling).
Weaning is made easier if done gradually and if the child receives milk from another source. You can begin the process by allowing an occasional bottle of breast milk to your baby while maintaining breastfeeding, in order to facilitate weaning later.
One way to initiate the weaning process is to omit one feeding session a week until the child is consuming all of the feeds from a bottle or cup. If you wish to continue to give your child pumped breast milk, you will need to pump in order to keep up your milk supply. If you are weaning your child off breast milk, gradually dropping feeds can help avoid engorgement. What you can do is to start by skipping the midday feeding which is usually the smallest and most ill-timed, especially if you’re a working mother.
Another approach is to leave the decision of when to wean completely up to your baby. Children gradually require less milk soon as they have an established diet routine of three meals of solid food a day (plus snacks in between). Your milk will thus dry up from lack of demand, and pumping may be necessary if you want to keep the milk flowing.
If your child is breastfeeding less, make sure he or she is getting enough formula or milk appropriate for age.
You need to recognize that some babies may feel rejected during the weaning process, especially if co-sleeping was part of breastfeeding time.

This is because no more breastfeeding means your baby is now sleeping on his/her own and they may feel a sense of rejection, so they become fussy or experience difficulty sleeping for sometime.
To make the transition less cumbersome, here are a few tips:
• Cuddle your baby often
• Make eye contact with your baby
• Coo at your baby
• Generally keep your baby close to you

• Play with your baby or dedicate time to go out during times when you would usually nurse.
• Avoid sitting in your usual nursing spots or wearing your usual nursing clothes.
• Try not to coincide weaning with adapting to some other change. Trying to wean when your little one is just beginning child care or during teething is not advisable.
• If your baby is less than 1 year of age, try to introduce a bottle or cup when you would typically be nursing. For an older child, try a healthy snack, offering a cup, or maybe even just a cuddle.
• Try adjusting your daily routine so that you're otherwise engaged during breastfeeding times.
• If your baby is old enough and you notice that he/she is having trouble learning to suck on a bottle (babies suckle at the breast, a different mouth action), you might proceed directly to a sippy cup
• If your child begins to pick up a comforting habit such as thumb sucking or becomes attached to a security blanket, it’s OK to allow for it as it is a coping mechanism with the emotional changes of weaning.

How to deal with breast engorgement
To avoid having your breasts become very tight, hard and uncomfortable (engorged) when weaning, you are advised to pump enough milk to keep comfortable., even of this will delay your breast milk from completely drying up. In fact, it's better for your breasts to do so slowly. You do not have to empty all of the milk from your breast, but an occasional full expression of both breasts may give a lot of relief. Wear a firm bra to give good support. Paracetamol for discomfort (when needed) and cold packs may help your breasts feel more comfortable.
In the event you sense lumps in your breasts, try to gently massage those away when you are expressing. A tender lump +/- redness could be the result of a blocked duct. It's worth trying to clear this as sometimes mastitis can develop. A hot pack on the breast, followed by massaging and expressing, and then a cold pack after, are useful.