How – and when – to stop breastfeeding

Some of the most common reasons to decide it's time to stop breastfeeding include:

• Your child's of an age when they are ready to stop
• You’re really struggling to breastfeed
• You're pregnant again
• Your baby's ready to wean onto solid food and you want to combine that with a move to formula milk
• Your child's approaching their 1st birthday and you want to move them onto cow's milk
• You're going back to work
• You need to stop breastfeeding to have medical treatment
• You’ve decided it’s the right time for you to stop

Unless you have to stop immediately and suddenly (perhaps for medical reasons), lactation consultant Jackie Hall, IBCLC, founder of The Breastfeeding Companion, says that, once you've made the decision to stop, it's best to stop very gradually over several months or tapering down over several weeks. She explains:

If you have made an informed choice and you have decided that you DO want to stop, give yourself a few weeks to prepare, if possible. This allows time for you to gradually reduce supply in a way that is kind to your body

How do I stop breastfeeding gradually?

If you're in no special rush to stop, just cut out 1 feed and see how you go (remember, if your baby is under 12 months old, you'll need to replace the feed you've cut with a formula-milk feed; see Formula milk or cow's milk?, above.) You can drop the next feed in a week or a month or so – whatever feels right to you.

Lots of mums drop 1 or 2 feeds, then carry on with mixed feeding (a combo of breast and bottle) for a good while. The NHS advice on stopping breastfeeding notes that it's good for your baby still to have some breastmilk if they're weaning onto solid foods, as breastmilk can help their digestive system deal with first solids.

If you'd like to go at a faster pace, you can, as long as it keep it gradual: Jackie suggests you start by cutting out 1 feed for 2 to 4 days, and then cut out another feed for another 2 to 4 days – and so on. Eliminating feeds at a faster rate than 1 every 2 to 4 days can cause engorgement, which can be very painful for a while.

Katie, a member of our MadeForMums community, went for the 4 or 5-day approach, after taking advice from her health visitor. "I dropped a breastfeed every few days," she says. "I had tingly boobs at what would have been that feeding time for a couple of days, but nothing more than that. I carried on with just the bedtime feed for a couple of months and, when I decided to stop completely, I had no problems either: my supply had got used to just providing that feed, and I literally felt tingly at bedtime the next day but after that it was fine. Doing it slowly is definitely better for you: your supply will cope much better."

If your breasts do become a little engorged as you're reducing feeds, Jackie says that expressing – by hand – can help. "In the process of reducing your milk supply," she says, "use small amounts of hand expression as a means to keep yourself comfortable, because it’s possible to get engorged as your supply and demand goes out of kilter. Hand expression will help also to prevent a blocked duct and mastitis."

• Mixed feeding: how to make it work
• How to express by hand

Which breastfeed should I stop first?

There's no hard and fast rule about this (the NHS says it doesn't really matter which one) but lactation consultant Vanessa Christie recommends, in her The Baby Feeding Book (Little Brown, £14.99), stopping the feeds your baby is least bothered about first – which usually means the 'sleepy' feeds are the last to go.

Can I start breastfeeding again if I change my mind?

Yes, says Jackie. "Your milk supply works on a 'supply and demand' basis," she explains, "and so is always in a state of flux. If your baby starts to take more milk off the breast again, your body will start to make milk again. Many women have relactated after days or weeks, or even months."

Saying that, it may not be a doddle – especially if you've completely or almost completely stopped. You will need to focus hard on increasing your milk supply, using a breast pump to express and stimulate your breasts and spending lots of time to have skin-to-skin contact with your baby to promote lactation. If you do want to start again, it's really worth find a qualified lactation consultant and asking for some specialist help.

What do I do if I have to stop breastfeeding suddenly?

If you have to stop breastfeeding suddenly and completely, your new best friend is a breast pump.

"Pump your milk as often as your baby would have been feeding at the breast," says Jackie, "and then gradually drop the pumping sessions, 1 every 2 to 3 days, in the same way as you would have dropped feeds, if you'd been able to stop breastfeeding gradually." (See How do I stop breastfeeding gradually?, above)

"Another strategy," adds Jackie, "is to reduce the actual pumping time at each pumping session, so that, instead of dropping pumping sessions, you're taking less milk off the breast each time.

"Once again – with either strategy – it’s really important to keep yourself comfortable with hand expression in between pumping sessions, to prevent blocked ducts or mastitis."

Will stopping breastfeeding affect me emotionally?

It may well do. However considered and thought-through your decision to stop is, you may still feel sad when it ends. Or maybe guilty that you stopped earlier than you originally planned or hoped.

That's certainly how it felt for Nicola, a member of our MadeforMums community, "I felt really, really guilty when I stopped breastfeeding, I even got quite tearful for a few days. It's normal: us mums put so much pressure on ourselves."

And then there's your hormones: although there's been little research to back it up, breastfeeding 'gurus' such as Kellymom (a US-based IBCLC-certified lactation consultant who runs a website full of evidence-based breastfeeding resources) think that your body's shift in levels of the hormones prolactin and oxytocin, caused by stopping to breastfeed, can cause lowness of mood, anxiety and irritability.

"A lot of women feel quite emotional about stopping breastfeeding completely," says Jackie. "I'd say it's important, first of all, to congratulate yourself on the breastmilk that you’ve given to your baby up to this point.

"Then, keeping your baby close, skin to skin, and feeding your baby responsively with a bottle, will help. All that lovely responsive feeding and closeness is a wonderful thing – irrespective of the origin of the milk your baby's drinking – and will continue to develop your baby’s brain."

We also really like this take, from Kellymom:

Remember that your child’s strong need for your presence continues, even if it is now expressed in other ways

How do I stop breastfeeding if my child is a toddler (or older)?

Stopping breastfeeding an older child can bring its own challenges. Occasionally, a child will 'self-wean' before you're emotionally ready to stop yourself – although this is usual a gradual process, so you should have some time to adjust. More often, when it's purely your own decision to stop, the added complication is that your child is much more able than a younger baby to understand that something's changing and, whether they're verbal yet or not, make it clear if they're not happy.

With an older child, Jackie advises taking a very flexible and gradual approach to the end of breastfeeding. "Think about you and your child as being on a journey where there is great flexibility," she says. "And, at the right time and in the right way, you can bring gently breastfeeding to a close.

"If at all possible, try to wean gradually over a several weeks or a few months, dropping first 1 feed and then, after a while, another, so that your milk supply can reduce very gradually and it won’t be as traumatic for you both."

Some good strategies to use when dropping a feed include:

• Don't offer but don't refuse. "This is one of the simplest, most common and most gentle approaches," says Jackie.
• Start by shortening the feed first. Gradually reducing the time of the feed, especially if you combine this with a follow-up snack, can work really well. Some mums count outlaid to prepare their child in advance for the length of the feed: "let's count to 50!", for example, followed next time, or some days later, by "let's count to 45!" and so on.
• Provide a distraction. Play a game, go the park – anything that involves you giving your child your full attention as you do something absorbing together. "Give your child something positive in place of the positive time at the breast," says Jackie.
• Offer a snack – just before you would have breastfed. And sit with your child, sharing the snack yourself.
• Change routines to remove feeding 'triggers'. So, if you always sit to breastfeed in a certain chair, sit somewhere else. Or if you always breastfeed in bed before breakfast, try getting straight up and making breakfast instead.
• Postpone, rather than refuse. This can work with older children who can cope with the idea of waiting, especially when combined with a distraction.

As with stopping breastfeeding for a baby, do take steps to ease any discomfort in your breasts. "If you become overly full at any point (with pain)," says Jackie, "you can hand express a small amount of milk. This will keep you comfortable and prevent a blocked duct or mastitis."

Pics: Getty

Read more...

• How to relieve engorged breasts
• Mixed feeding with breast and bottle: how to make it work
• How to breastfeed when you're ill
• Mastitis: signs, symptoms and how to treat it