Q&A: weaning a toddler

Michelle writes:

"So how am I ever going to stop breastfeeding? My daughter just turned one. In an ideal world, I'd let her until she was ready to stop. I certainly don't want to cause her any emotional harm -- she LOVES to nurse. But there are a couple of issues that make my world less than ideal.

Issue #1: We'd like another baby. I am 40 and moderately infertile. IVF worked well for us, but I assume she'll need to be weaned before we can start the process again. Clock is ticking.

Issue #2: She won't take a bottle and I am tired tired tired of being the only one who can care for he for more than a few hours at a time. I need a real break. She's in daycare 3x a week. She'll drink a few sips, once in a while as much as an ounce, from a sippy cup while there. I visit at lunchtime to nurse.

What we have been doing is trying to drop feedings gradually. She is down to a noon-ish feeding, a before-bed feeding and 2 feedings during the night (usually but not always 2 am and 5 am). She had been nursing 3-4 times during the day and 3-4 times at night up until about 2 months ago.

I am at my wits end trying to get her to drop the night feedings. The problem is that she really is hungry. If we let her FIO when she wakes (or rock her, walk her, etc), she'll go back to sleep but wake again in 15-20 minutes. And will repeat this for hours. I have tried to get her to feed later each night, ie FIO until 2:30 one night, then 3 the next, etc. hoping to gradually stretch this. What happens is that there is no regular pattern, she'll start waking up 12:30 or 1 for a couple of nights.

Any ideas? Its been a year since I've had a full night sleep. Am I crazy to want another baby when this one is giving me such a hard time?"

I think that you're correct in thinking that you'll have to wean before you do IVF again, depending on what your protocol is. There doesn't seem to be any evidence that some fertility meds (like Follistim or Gonal-F) cause any problems in breastfed babies, but they also haven't been tested. It sounds like other meds (Lupron, for example) are also untested but probably bad news. Better not to use your daughter as a guinea pig.

It sounds like your problem is that she's still getting a huge part of her calorie intake from nursing. This is completely normal and developmentally appropriate for her age, although it's not what you need at this point. IME, most kids experience a shift in the balance of breastmilk or formula vs. food in the period from 12-15 months. Once your daughter hits that shift it'll probably be easier to wean because she'll just be consuming more food in general and less milk.

I think your overall strategy should be the same thing you're probably doing all day long with her anyway--distraction. If you can distract her from nursing with other fun things to consume, she won't miss the nursing and it won't be hard on her.

What does she drink out of the sippy? Breastmilk? Cow's milk? Soy or rice milk? She may be pissed about drinking breastmilk in an "inferior container" (my dad's joke from the 70s--har har), but would drink other beverages more willingly. You might also try switching to a straw cup if the caregivers allow it, because it's an easier motion and might be more of a novelty for her.

It sounds like you might have better luck getting her to drop the noontime feeding first. I'm assuming you'll still drop in to daycare to see her at noon (unless you could get your husband to do it for you instead for a week or two, which would be the perfect way to break the nursing at noon habit), so you might have to create some new ritual to do with her then instead of nursing. I'm too lazy to think of anything to substitute that doesn't involve French fries. If any readers have any ideas, please put them in the comments.

Once she's willing to eat more within the next few months, I'd see if you could really stuff her with food at dinner. Then if she nurses at bedtime that'll top her off and she might end up dropping a feeding at night, or delaying the next feeding so she goes down from 2 middle-of-the-night feedings to just 1. You could also have your husband take a nighttime shift and offer her some easily-eaten food (like banana or oatmeal or yogurt) in the middle of the night instead of breastmilk. That would fill her tummy, but also eliminate a feeding (or two, if the food fills her up enough that she sleeps through until morning). Eventually she'll start sleeping longer stretches anyway, but this will help take you out of the loop before that happens.

This is one of those things that's just a logistical nightmare and resembles a logic puzzle from the LSATs. The annoying thing is that if you had the time you could just let it work itself out (which it would), but you don't have the time so you have to tax your brain with methods to outfox a 12-month-old's stomach. Yeesh. File that under Things You Don't Need.

Anyway, you're not crazy to want another child. Having two is not easy. Not easy at all. But it's waaaay easier than having one but wanting two. And the part that makes you want to lock yourself in the closet with a pint of Ben & Jerry's is over in a few years*, but you have two wonderful children for the rest of your life. And they have each other.

I hope some of this helps you, she weans within the next few months, your next IVF works easily, and you have an easy delivery and a healthy baby.

* I hear.