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Breastfeeding - Pulling The Plug


A beachside holiday prompted Lynn, 27, to think about weaning her then five-month-old daughter off breast milk. "We were going to Phuket and I could not imagine taking my pump and cooler box everywhere. I would end up being holed up in the hotel room all day," says the sales and marketing director, who did not nurse directly but fed her daughter, Reynna, expressed breast milk. 

With the holiday two months away, she felt she has fulfilled a good part of her feeding duties - Reynna would be completely breastfed for a full six months, in accordance with the World Health Organisation's minimum guidelines. The transition went smoothly for Lynn - all she had to do was to cut down on her expressing schedule (from four times a day to three and so on) and not have to deal with a stubborn baby.

It took her 10 days to get to a day when she did not have to pump at all, but still had a month's worth of expressed breast milk in the freezer. For a direct nursing mum like Riana, 34, weaning took a much longer time - two months, to be exact. Her two-year-old was a champion nurser who would suckle 10 times a day even though Mummy works full-time.

"That works out to be about every waking hour!" Riana says. She adds that the minute she got home from work, her daughter, Norah, would immediately clamour to sit on her lap for a feed. When the weaning started, the frustrated girl would jab at her mum's breasts, bite through her T-shirt, and even try to lift her shirt up, but Riana gently pushed her off.

She was also able to talk to her toddler about it, making the change easier. "I told her that I'm not a cow and she should drink from the real thing instead. She eventually got the message that I wasn't going to budge." Riana also compensated by giving her yummier food like raisins and no-sugar cornflakes in the day.

At night, when the feeds were purely for comfort, Norah would whimper, but thankfully, she did not bawl. Another reason is that some children become Cutting back on the daytime feeds followed by the night ones is a good strategy in mother-led weaning, says Doris, a lactation researcher and consultant. "You can distract a child in the daytime easily. Weaning off night feeds is harder," she says.

The older the child, the less feeds there are to cut down, hence weaning can be less problematic for both mother and child. "A two-month-old has about eight feeds a day, a six-month-old has six to seven. A one-year-old has just three to four feeds a day," she explains.

Whatever age your child is, Doris encourages mums to wean before their child reaches the big developmental milestones (at 15, 18 and 24 months). "An I8-month-old is entering the `terrible two' stage and you don't want weaning to become an extra issue to clash over," she says.

Another reason is that some children become especially needy when they are getting ready to go through a major milestone. Their need for connection, reassurance and touch will be high, and nursing gives that kind of comfort. Indeed, researchers have found that babies between 13 and 18 months experience more negative emotional reactions to weaning than any other time.

They also develop intense separation anxiety. Once the daytime feeds are dropped, the last and most difficult hurdle is the night feed. "It's good from the onset for parents to share responsibilities, so that the baby can be comforted by someone other than the mother," says Doris. It can be disconcerting for a child to be held by mum at night but not given access to nurse.

Doris suggests taking a hard-line stand and for mum to take a weaning vacation - that is, disappear altogether at night, such as sleeping in another room. Her last word of advice is: be prepared to stick to your guns if you want to wean successfully. "In mother-led weaning, it can be a battle of the wills - yours against baby's," she adds.

Shutting Down Milk Production

Engorgement will be a problem especially if you wean abruptly or go cold turkey instead of gradually cutting down. Abrupt weaning is not advised unless there is a medical problem. Gradual weaning also allows your breasts to adjust accordingly and gives you more comfort. If your breasts feel engorged, Doris' advice is to express the milk until they feel comfortable.

Do not empty them completely as your body will then produce more (the milk left in your breasts will be re-absorbed). Cold cabbage leaves or a cold compress placed over the chest will provide relief. Don't try to suffer through engorgement or you may risk infection.

Doris recalls some cultural practices to deal with engorgement: "Some Malays who practise abrupt weaning wear a piece of cork around the neck. It is believed that the mother's milk dries up as the cork becomes smaller and smaller." It was common practice 20 years ago for mothers to bind their chests tighter in a bid to stop the milk production.

This does more harm than good as it can lead to blocked ducts, mastitis and damaged breast tissue. Many mothers find themselves gaining weight following weaning. This likely because the extra calories that earlier went into supporting milk production are now being converted into fat. So adjust your diet accordingly.

Breastfeeding Reducing Tips

  • Time Weaning Carefully, Don't let it coincide with other major changes in baby's routine like a new caregiver or an illness.
  • For starters, cut back on the feeds that you child shows the least interest in.
  • Offer a bottle, cup or a snack before the breast. If the child still wants the breast, at least he won't be as hungry.
  • Make bottle-feeding as warm and comfortable as nursing was. Allow for plenty of cuddle time. Bottle feeding gives fathers and older siblings a chance to feed and bond with the baby.
  • Terminating a pre-bedtime feed can be hard on your child. Offer a distraction like a new book, cuddly toy or massage.
  • Wean babies under 12 months should drink iron-fortified formula, never whole cow's mile. Once a child is one, he can have full cow's milk. Low-fat milk can be given only to children over two.
 

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