Thursday, September 23, 2010

Weaning and the Ways it Happens

044.jpg Lilly in her carseat picture by Xakana
So, the World Health Organisation (WHO) and UNICEF recommend a minimum of two years of nursing 'or beyond'. A lot of people don't know that. The American Academy of Pediatricians (AAP) and American Academy of Family Physicians (AAFP) recommend a minimum of one year and then 'as long thereafter as mother and child desire.' Both recommend no other substances in the first six months of life.

So, according to the experts, babies should be nursed at least a year. We all know that this isn't usually the case in the US, though in other countries, the time varies both in modern times and historically. In UK Europe, nursing only through infancy has been a pattern for quite a while, while in Japan the norm was 2 years and China was recorded as children nursing until up to 5 years. The worldwide average for weaning is 2.8-4.2 years (depending on the study and if the US is included--it drags the worldwide average down due to its low breastfeeding rate, premature weaning tradition and large population).

Okay, so that's all the recommendations and the average and yada yada. Now, one question I was once asked as my still non-verbal toddler nursed was, "Don't you have to wean soon?"

It was asked in complete innocence and I answered honestly, "No. Children will wean on their own. I don't actually have to do so."

It's true! While rarely, children will nurse 6-7 years, the average age of children weaning on their own is much earlier--about the range of the worldwide averages, actually. Somewhere between ages 2 and 5. Children will not typically wean without some sort of encouragement (even if not deliberate) before 18 months of age.

Does that mean every family has to wait until their child is ready? Of course not! Waiting at least the minimum 2 years is best for baby and mom, but people wean in many different ways for many different reasons. Some women wean earlier than they would like due to work, lack of support, medical conditions, peer pressure, etc. Some women nurse longer than they actually want because they aren't sure how to wean; and some women are simply "done" before their children. Nursing IS a two way street.

I'm not going to tell you how to wean. I have no clue. It's not something I'm interested in. But I will now tell you about the different kinds of weaning. Oh, and a child after the age of 6 months who nurses, starts eating food just like bottle fed babies between 6-14 months and eats the same stuff ;) They drink from cups (mine started drinking water from cups at 6 months with my first taking pumped milk as early as 4 months in a Nuby Softspout--we mostly skipped sippies and went with straw cups for better oral development--until my second decided that they were more fun upside down, so we switched back to sippy cups for her--though she and her sister both can drink from open cups easily... I even prefer straw cups for me for minimizing spills) at the same ages and nothing changes except that they still take nourishment from their mother directly.

Parent-led weaning: This is the most common. This is when the mother chooses to wean and institutes a weaning strategy, such as "Don't offer/don't refuse," gently replacing nursing sessions, going out of town, pretending her breasts are broken, etc.

Influenced weaning: This one isn't talked about very much and is one of the main reasons that I'm writing this entry. Influenced weaning is when a child is weaned due to circumstances such as milk drying up, accidental parent-led weaning (such as a mother instituting "Don't offer/don't refuse" without knowing that it's a weaning technique, refusing to nurse so often that the child gives up or giving cues that they don't want to nurse anymore which the child picks up on), or societal pressure (such as the father or a nosey grandparent or auntie making rude comments that shame the child or parent, disparage the nursing relationship or attempt to make the child feel bad for nursing--like saying 'Big girls don't nurse! Don't you want to be a big girl?'). Nursing strikes would also fall into this category (more explanation on this later).

Mutual weaning: This is pretty rare and comes from the mother and child making a deal that they will stop nursing at a certain point. This is usually in a full-term nursing relationship (2+ years) when the child is old enough to be reasoned with and the parent no longer desires to nurse.

Child-led weaning: This is when the child is given support to nurse but slowly and gradually stops doing so on their own time.

Sudden cessation of nursing is not child-led weaning, it's a nursing strike. Nursing strikes happen for a variety of reasons and at different ages in life, but usually in the first two years. Nursing strikes are often used to wean children without trauma, but if they occur in the first year of life, they should be reversed if at all possible, unless the mother needs to stop nursing for some reason.


So there you have it. The different ways that children wean. For extensive information on weaning, "How Weaning Happens" by Diane Bengson is considered the best book by all the friends I know, on explaining the subject (warning: this is NOT a book on how to wean!).

Happy nursing (and weaning)!



Some resources I used (outside of several books):

http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496
http://www.aafp.org/online/en/home/policy/policies/b/breastfeedingpolicy.html
http://www.wpro.who.int/media_centre/fact_sheets/fs_20070801.htm
http://www.amazon.com/How-Weaning-Happens-Diane-Bengson/dp/0912500549

2 comments:

  1. Interesting! I'd never heard of influenced weaning - thanks for teaching me something new :)

    ReplyDelete
  2. I coined the term as far as I know to give a name to the phenomenon, since it is its own form of weaning in its own right. It's typically as gentle as CLW.

    ReplyDelete

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