When and how to stop breastfeeding

“If you leave a child to just wean when they’re ready to wean, most children will wean somewhere between the age of two and seven.”

Lyndsey Hookway, Lactation consultant

My New Life host Jessica Rolph breastfed all three of her children, but weaning the last has been an emotional experience. It’s hard to say how many mothers breastfeed beyond that first year or two, but often those mothers feel judged for choosing to continue.

Lyndsey Hookway joins us to help demystify “extended” breastfeeding and offer tips on weaning for those who are ready. She is an Internationally Board Certified Lactation Consultant for The Maternity Collective, based out of the UK.

Highlights:

[1:14] Why do we refer to breastfeeding beyond age 2 as “extended”?

[3:15] Jessica shares her personal experience feeding her daughter, even though it’s clearly not a nutritional experience anymore.

[5:14] What are some of the benefits to the nursing mother?

[7:02] Can breast milk lose some of its nutritional value over time? As volume decreases, why does the child still want to suck? 

[8:30] If a mother wants to continue breastfeeding her toddler when a newborn arrives, is there any reason why she shouldn’t nurse both children simultaneously? What does the science say about this? 

[11:20] Tender breasts are common with pregnancy and often initiate a natural weaning process.

[13:11] Is there an optimum period to wean your child?

[16:13] Lyndsey talks about hormonal fluctuations that can cause sadness after weaning, as well as temporary difficulty sleeping.

[18:09] How to handle a toddler who keeps asking to be breastfed at night?

[21:03] What is step one for a mother who wants to start the weaning process?

[23:21] Lyndsey shares some additional tips for weaning during the day.

[26:10] What to do if you’re feeling anxious about the weaning process. 

[28:54] Jessica shares takeaways from her conversation with Lyndsey Hookway.

Transcript:

What is extended breastfeeding?

Jessica: I asked her to tell us why she thinks extended breastfeeding should just be called breastfeeding. 

Lyndsey: Well, so my opinion, it is my opinion here. But I think calling it extended breastfeeding immediately is quite othering. And it makes people feel like they’re doing something that is a little bit taboo or a little bit deviant. It’s sort of outside the parameters of, in inverted commas, normal. And that’s why my personal opinion is that we shouldn’t really be calling it extended breastfeeding, we should just be calling it breastfeeding, because there’s plenty of research from anthropological data that suggests that the normal duration of breastfeeding is somewhere between two and seven years for most human mammals. So if you leave a child to just wean when they’re ready to wean, most children will wean somewhere between the age of two and seven. So when we start talking about extended breastfeeding, we’re making mothers and parents who are doing something that actually falls within the parameters of the biological norms, we’re making them feel like they’re doing something a bit weird and a little bit crunchy. And yeah, all of those things. So for me, it just feels really othering. Does that make sense? 

Jessica: It really does. And I have to admit, this is very vulnerable for me. But my youngest is still, she’s seven. And she is kind of finally not wanting, “Mama Milk” anymore. And it’s embarrassing to talk about. It’s something that I don’t share often. And I find that there are other secret parents of other kids that are my daughter’s age. Occasionally, I’ll uncover that they too are having this experience. And I will tell you, there’s no milk left. I mean, I had Bea when I was 40. So there’s no milk left. And it’s just a, it’s a comfort for her. And we’ve kind of been on and off, we’ve tried to stop. I would say that, you know, maybe it’s a boundary thing for me or just lack of clarity of just why I needed to stop. It just felt like, it just feels so weird. It feels like everybody, I would not want to share that broadly, even though I’m actually sharing this right now on this podcast.

But I guess you saying that made me feel comfortable. 

Lyndsey: You know, you’re right, that is quite a vulnerable thing to say because of the societal norms, dare I say it, and the fact that it does sort of seem to go a bit underground. So you do find that there are lots of families out there who are nursing well beyond infancy, and they just tend to conceal it. In fact, there are multiple research studies that have found that when mothers are breastfeeding, particularly beyond the age of a year, but definitely when we’re talking about toddlers, preschoolers and school aged children, people don’t really talk about it. So I’m really glad you brought that up, because there are going to be thousands of other families who are thinking, Oh, thank goodness for that, I’m not doing something that’s really weird and gross and wrong, or anything else that they might be feeling.

And I’ve challenged myself actually, about how I talk about it. Because I nursed my youngest until she was nearly six. But I used to kind of go, Oh, but you know, the last three years of that she had cancer and you know, maybe I wouldn’t have breastfed her that long if she hadn’t been immunocompromised and whatever. But I’ve really challenged myself in saying that, because it almost, I realized when I was saying that that it’s almost like, well, the only reason I breastfed her till she was nearly six was because she was unwell. Whereas the reality is, there were multiple reasons why we nursed that long.

Benefits of breastfeeding for mom

Jessica: Yeah, and I will say that there were a lot of DMs in preparation for this, there were so many questions. And you know, there was sort of a safety in being able to have a one on one conversation. So you know, the benefits to the baby are well known. But can you tell us some of the benefits to the nursing adult or mother?

Lyndsey: So there are lots of reasons why mothers breastfeed beyond infancy. Some of the health benefits include reduced risk of certain cancers. So for example, invasive breast cancers, there’s less evidence that breastfeeding reduces the risk of some of the less invasive breast cancers. But the great news is that it actually reduces the risk of the more nasty cancers. So that’s obviously a really good thing. But also ovarian cancer. And some of the other reduced risk factors include things like diabetes, having cardiovascular disease, stroke. There are some research studies that suggest that you’re less likely to have significant postnatal depression. But there is a little bit of a caveat with that one, because it does depend on whether breastfeeding is going well. What we know is that when breastfeeding is going well, it’s protective of your mental health. When it’s not going very well, that can obviously exacerbate any mental health problems or actually be the cause of them.

So there is a little bit of nuance to be understood with that. But in general, it is mood protective. And one of the more recent findings is that we now think that breastfeeding may actually improve your cognitive functioning post menopause, which is really topical because a lot of us, me included, are kind of in that 40 something perimenopausal phase. And we’re perhaps thinking about memory and cognitive functioning, learning, executive functioning skills and all of that. And there is some evidence to suggest that women who breastfeed for longer durations have more cognitive protection.

Does breast milk lose nutritional value?

Jessica: And what about the actual breast milk itself that can lose some of its nutritional value over time or frankly, just really decline in supply, but then the child still wants to suck? 

Lyndsey: So I mean, the first part of that, there is just no evidence at all that breastfeeding loses its nutritional value. In fact, there are a lot of studies that suggest that the primary function of human milk is actually immunological and that anthropologically speaking, it’s thought that actually the nutrition is a secondary benefit of the milk, which is pretty fascinating to me as somebody who researches breast milk in very sick children, because we know that there are a whole load of immune factors that actually increase in concentration into the second year of breastfeeding and beyond. And there are lots of other components of breast milk that are protective of infant gut functioning. So there are things like glutamines and leukocytes that actually optimize gut function. There are, there’s a new component that’s been isolated recently that might actually reduce gut damage during chemotherapy. So this is sort of mind blowing stuff, really, because we’re now sort of working out how some of these components of breast milk might fit into the bigger picture of health.

Breastfeeding while pregnant

Jessica: A lot of times the question is about wanting to continue to breastfeed, but then being pregnant. And so one Lovevery parent asked me a question over DM. She wants to continue breastfeeding her toddler while pregnant, but then the newborn will arrive. What do you say about this? Any reason why she shouldn’t nurse both children simultaneously? Or what is the science on this? 

Lyndsey: Yeah. So the second part of an earlier question was, you know, what happens when they want to feed but there isn’t much milk there? And that feeds in a little bit to this question. We know that in pregnancy, if you are already lactating for an older child, your milk supply will reduce because the hormonal changes that are taking place mean that essentially your breast is basically prioritizing the baby on the way rather than the toddler who’s still nursing. So your milk will become more colostrum like. Some toddlers will naturally wean while you’re pregnant with their younger sibling because either they don’t like the taste, it can be quite salty when it’s very low in volume. It can also have quite a strong taste. Colostrum tastes different to mature milk. And obviously the volume is lower. So some toddlers don’t like the fact that there just isn’t very much milk there. Whereas other toddlers are quite happy to dry nurse because as you say, breast milk is not just about nutrition or immunological function, but it’s also about comfort and connection and relationship and familiarity and all of that other stuff.

In terms of whether there’s any reason why you shouldn’t nurse throughout pregnancy or nurse two children, no, unless the pregnancy is considered very high risk, there’s normally no contraindication to continuing to nurse throughout your pregnancy. So most people will kind of use the benchmark of, you know, if sex is contraindicated during pregnancy, then breastfeeding maybe as well, because it’s related to oxytocin and how likely it is that you might stimulate contractions, essentially. And then when we’re talking about nursing a baby and a toddler, again, there are very few reasons why that’s not okay. Most of the time it’s completely fine. Obviously the main piece of advice, particularly in the early days, so that, particularly the first week, is to make sure the newborn has fed as much as they want to and need to before allowing the toddler to nurse, because clearly we need to make sure that newborn gets the milk that they need.

It’s usually quite an intuitive process to let that newborn go on first and then the toddler can have a go after their little sister or little brother has finished.

Jessica: Yeah, I will say that your breasts can become very tender when you’re pregnant. And so that happened for me and it was sort of a natural weaning process where I was like, oh, do not want older child on as soon as I became pregnant. Is that something that you’ve heard of? 

Lyndsey: Yeah, absolutely. And again, that’s to do with the hormonal changes. So I mean, in fact, that’s one of the first symptoms of pregnancy, isn’t it? But you know, the girls feel tender. You feel like, oh, they might look good, but they are for looking and not touching right now because they are sore. Your nipples can be quite sensitive and they can become a bit swollen and tender. Now, some of those changes are harder to discern when you’re already breastfeeding. But certainly that nipple sensitivity and tenderness is really marked. And some women actually develop nursing aversion when they’re pregnant as well. So this is a horrible sensation, almost like skin crawling. You can feel quite angry, quite irritable all of a sudden with your nursing toddler while you’re feeding them. There are lots of theories about why that might be. And hormones are kind of high up on the list of probable culprits there. But yeah, it’s really common for that to be the primary reason why parents want to wean their toddler, because they just can’t stand the sensation of breastfeeding, either because of pain or because of that aversion that I was mentioning.

Want to stop breastfeeding?

Jessica: And so let’s switch gears and talk about weaning. So is there an open, a sensitive period to wean your child? I felt like it was around one maybe, but I wasn’t sure. So talk to me about that.

Lyndsey: Well, it’s an interesting question because, for me as a lactation consultant, I feel like this is a complicated issue because we have to be thinking about the biological norms in terms of the duration of breastfeeding and the sort of relational comfort and connection issues for the little one. But also we have to think about issues around bodily autonomy for the mother as well. And for me, this is really important because breastfeeding is a relationship. And if the nursing mother does not want to breastfeed as frequently or at all, then for me, that’s a really important issue because doing something that doesn’t kind of fill your cup at all and it’s purely for the benefit of somebody else can make you start to feel resentful and it can make the relationship change in terms of the dynamic. So for me, the best time to wean is always a complicated discussion around what the mother needs, what the family needs, what the child needs. And then we need to kind of layer on top of that the child’s ability to be able to understand. So we know that, you know, obviously children develop more and more cognitive awareness and understanding and verbal communication skills the older they are.

So a lot of people will report that it is easier to wean their two or three year old purely because they can converse with them, they can prepare them, they can read books with them about weaning and whatever. But you’re right. On the other hand, as they get older, they can be really, really persistent as well. And having weaned a toddler myself, a preschooler, really, I definitely can sort of relate on a personal level that it can be pretty intense, you know, when they’re not just fussing and crying a little bit, but they’re saying things like, please, mummy, five minutes, Mummy, tiny bit milk, Mummy, you know, when they, when they’re really kind of bringing out all of their verbal skills to tell you how much they want the milk that you’re trying to deny them. That can actually be really emotionally difficult for the mother as well as the child.

Hormonal changes after you stop breastfeeding 

Jessica: One thing that I think that you brought up on the emotional side that we don’t talk about a whole lot, that I often tell friends, is that every single step down in milk supply seems to have a hormonal shift that can also make me feel just for a couple of days a little bit blue, weepy, whatever. And it happens in the beginning, it happened when my child, you know, my baby started solid foods, and then it happened at one when they stopped drinking as much, and it can really catch you off guard if you’re not aware and prepared that, okay, this will end quickly. But I just need to get through this day or two of feeling a little bit sad.

Lyndsey: Yeah, you’re not making that up. That’s, again, that’s physiological, and it’s to do with those fluctuations in hormones. And one of the other things that not everybody knows, and certainly isn’t discussed very much, is that there’s this weird little relationship between prolactin, which is the milk making hormone, and dopamine, which is an alertness hormone. And what happens when you drop your milk supply, either, you know, naturally, as they eat solids, or they naturally have a longer stretch of sleep, or whether you’re actively part of that in terms of limiting or weaning, is that the prolactin levels will drop, and consequently, dopamine levels will rise. And one of the things that can do, is make it hard for you to go to sleep. So it’s temporary. But one of the things that parents need to be aware of, and just not be alarmed when this happens, is if they are trying to do some, you know, some limiting of feeds or night wean, they might actually find that temporarily, they find it harder to go to sleep, because prolactin actually helps you to fall asleep, whereas of course, dopamine makes you feel quite alert. So, yeah, there are all sorts of really weird hormonal shifts that take place when you begin to limit, reduce or cut out feeds completely.

Night weaning

Jessica: And speaking of sleep, night weaning, this was such a challenge for me, it seems like, toddlers, you know, around, I don’t know, a year, 18 months, they just start to actually want to feed more at night. And they ask for it more. And it’s just so exhausting, because you can quickly take care of it and get them back to sleep. Or you can kind of suffer some protests and some crying, which is so much more exhausting for you. But then if you feed them, you can create this bad habit. And then they just keep coming and asking for more, more frequently during the night. How do we handle this? 

Lyndsey: Yeah, it’s a great question. I mean, first of all, it will spontaneously resolve, right. So if there’s anyone listening who thinks, Oh, I just don’t, I literally don’t have the energy to do anything that’s even harder than what I’m doing right now, it will get better spontaneously. And looking at studies of older children, we know that at some point between the age of two and four, most children will spontaneously reduce and then ultimately stop night feeding. So you don’t have to fix it if it’s not a problem for you, or if you haven’t got the energy to fix it. However, if it is driving you nuts, then it can be very difficult to get the balance with this because, as you say, feeding them back to sleep is probably the easiest, quickest, most reliable way of getting them, getting everybody frankly back to sleep as soon as possible. And doing anything else can be quite hard. On the other hand, as you say, you know, sometimes little ones can just come to decide that, yeah, do you know what, nothing else really cuts it for me quite like getting some warm milk in the middle of the night. And you know, you can rub my back or you can stroke my face.

But honestly, I just want the breast. And then we can end up in this situation where women can kind of feel trapped into continuing breastfeeding for a really long time and feeling resentful and exhausted and all of that. So I wish there was an easy way of reducing or making night feeds more sustainable. And just getting little ones to understand that, yeah, do you know what? One or two night feeds is okay, six, or every two hours or whatever it is, is not okay. I wish there was an easy way, but really, there isn’t. It’s about that context of limit setting in general. So there’s really no rocket science with it. It is literally explaining really gently and kindly to them: ‘No, my darling, we’re not going to have milk right now.’ But I’ll hold you and I’ll rub your back and we can have cuddles and you can stay in the bed with me or whatever. So it’s about being firm and kind about being really consistent and gentle at the same time. And it’s just really hard because probably they’re going to get upset. They might be frustrated. They might be angry.

And this is one of the reasons why I recommend doing it in the context of continuing other loving, responsive ways of parenting them back to sleep, whether that’s bringing them into the bed or staying with them or perhaps having them on a floor bed and kind of loving them through it with your comforting presence right there with them, because it’s a bit much to expect a child to do without their favorite way of falling back to sleep, but also do without the emotional scaffolding that your presence and your reassurance provides.

Steps to start the weaning process

Jessica: So then let’s say you are in that situation. You’re just really, really exhausted and you just want to be done. What is step one for a mother wanting to start the weaning process? 

Lyndsey: Oh, well, I mean, it’s always okay to involve somebody else. So if you have a partner who is willing to get involved, it can really help to get them involved. Like if you want to be completely done, I would start with the feed that you find most difficult. I would always go for that one first, because sometimes when you eliminate the feeds that are really driving you nuts, you can begin to see the value in maintaining other feeds. So you don’t want to completely throw the baby out with the bathwater, so to speak, and stop breastfeeding completely necessarily. It might just be that once you get a bit of balance and sustainability back, actually you think, oh, do you know what, I actually quite like the bedtime feed or I quite like the first feed of the morning or whatever. It’s always okay to just decide which ones are feeds that you feel resentful about and start with those. And that would always be my advice. The other thing that I would recommend is that you start setting some limits at a time of day when limit setting feels more manageable.

And for a lot of people, that’s the daytime, obviously, because setting a limit in the daytime is a heck of a lot easier than two o’clock in the morning. And that doesn’t just have to be around breastfeeding as well. I always would recommend that you think about limit setting in a much broader context. So we’re thinking about limit setting around behavior as well. So it might be, no, my darling, you can’t play with that saucepan or that sharp knife or no, love, you can’t throw that dumper truck or whatever it is. Just think about all of the boundaries, not just the breastfeeding boundary. Because again, once children start realizing, oh, okay, there are actually things that I can’t do and I can do other things instead, then it becomes easier to understand the breastfeeding boundary when it comes in.

Jessica: That makes sense. And I remember just it can get kind of awkward because they just, they want the breast throughout the day. So they want to kind of hop on, hop off. And it just it gets really, so I think that limit setting can be really important. Any additional tips on how to do that during the day? 

Lyndsey: Yeah, there are lots of ways that you can do that. So you can either limit the location. So for some families, especially when little ones are exactly as you say, they’re on off, you’re using the breast almost like a pause, you know, like a comma. And every single time they don’t know what to do with themselves, you know what, I’m just going to breastfeed. So you could start just by introducing limits around the location. So we’re only going to feed in this chair. So we’re just playing right now. And when we go and sit in the chair, that’s when we can nurse or it might be we’re only going to feed in this room. So we’re not going to feed in here because this isn’t the nursing room. We’re going to go into another room and nurse. Again, just putting a limit on that feels manageable. Or you might say you might set a limit around timings. So you might say we’re not going to nurse now because we’re about to have lunch or we’re going to have a snack and we’ll have milk after our snack.

And then the other way you can do it is by being out. So you might say, well, we’re only going to nurse in the house, and then just make sure you have a really fun day outside of the house. Distraction is not always the best way because, you know, I often say around the age of toddlerhood, sometimes it can be easier in a way to distract kids out of feeling sad or feeling any kind of negative emotion. But we’re not necessarily helping them manage that emotion if we just distract and avoid the situation. So there are, there’s a time and a place to use distraction. Like if you’re in a wedding, that is absolutely the time to use whatever tools you have up your sleeve so that they don’t kick off in the middle of the ceremony. But if you have another opportunity to allow them to experience something that’s kind of tricky or uncomfortable, but with your emotional scaffolding around it, then that can actually be a really good learning opportunity. So that might be an argument for not going out sometimes and actually just persevering.

And if they get upset going, I’m sorry, I hear that you’re sad. I know you’re disappointed, but we’re still not going to have milk. And just let them express whatever it is they want to express. We don’t always need to distract and eliminate those negative feelings because negative feelings are kind of part of life and kids need to learn in an age appropriate way that those feelings are okay to have as well. And there’s somebody there who can support them through them.

Jessica: Yeah, that’s so helpful to hear because, you know, so many parents we heard are feeling just anxious about the weaning process. And so what can you say that will give them some peace of mind? Like are there any psychological effects to the baby if they’re not yet ready to wean or… help us feel less worried, honestly, about this? 

Lyndsey: I think you’re right. It’s really common, especially parents who would kind of align themselves with a gentle parenting or attachment parenting or responsive parenting kind of philosophy. They often feel really uncomfortable with the idea of doing anything that’s going to make their little one feel sad or upset or disappointed or any of those big feelings. But as I said, you know, a lot of those big feelings increasingly become part of life and they’re important to allow children to experience within the safe framework of our loving, responsive relationship with them. I’m not saying we have to deliberately put them in positions where they experience discomfort in order for them to learn. I’m saying that we shouldn’t necessarily avoid doing things that we need to do because we’re worried about them getting upset. But I think we need to draw the distinction between responsive parenting and responsive feeding. Now, certainly in the early weeks and months, they’re kind of one in the same. So when you’ve got a three or four or six week old baby, responsive feeding is often your number one tool to be a responsive parent, because to be honest, if they get upset about anything, breastfeeding usually fixes it. Now, as they get older, there are lots and lots of ways to be a responsive parent that don’t have to involve feeding. And in fact, we don’t want to just respond by feeding every single time our littles get upset that there’s nothing wrong with it per se. But certainly we wouldn’t need to always respond with a feed. Sometimes we just need to be a responsive parent. And so I think when we separate out responsive parenting from responsive feeding, that can often help parents to understand that they can still be a loving, present, emotionally connected parent, but that doesn’t have to involve feeding them every single time they get upset.

It becomes more and more appropriate as they get older to expect that there might be other things that can comfort them and can reassure them and, you know, help them feel like, you know, it’s okay, this is hard. But as is often said, we can do hard things. We just can’t always do them on our own. But that’s okay, because I’m here and I can support you through it.

Jessica: That’s so helpful. This has been so wonderful. Thank you so much for being with us. I feel like we have so many more questions, we could continue on and on. But this has been really chock full of great advice. So thank you so much, Lyndsey.

Lyndsey: You’re so welcome. Thanks for having me.

Takeaway 1:

There is evidence that breastfeeding beyond the first year can benefit the mother in a variety of ways, including protection against more aggressive forms of cancer, and possibly better cognitive functioning post-menopause. 

Takeaway 2:

Lyndsey talked about the benefits to the baby’s immune system. Though the composition of the milk changes, the nutritional value of the milk is not diminished, and some of its components are protective of infant gut health. 

Takeaway 3: 

Sometime between the age of 2-4, most children will spontaneously drop night feeding, but if it is driving you nuts, start by cutting out those feeds that are most problematic. There is no easy way to do this. You’ll have to explain gently, but firmly, that there will not be a feeding at that hour. Lyndsey draws a distinction between responsive parenting and responsive feeding. 

Takeaway 4: 

To wean, start setting limits at a time of day when limit setting feels more manageable. Daytime limits are easier to uphold than nightime ones. Practice setting boundaries on other fronts, says Lyndsey, and it will spill over. Additional tips include limiting feeding to a particular chair or room, or a specific activity: For example, we’ll have milk after a snack. 

Hungry for more? Download my interview with baby-led weaning expert Jenny Best of Solid Starts from May of 2021. You can also find research on feeding and starting solids on our Lovevery blog.