Frequently Asked Questions
2nd Principle: Feed with Love and Respect

My one-year-old nurses every 1 to 2 hours, 24 hours a day. Should I be doing something to encourage my baby to nurse less often?

First, we highly recommend that you talk to a La Leche League International Leader when you have a specific question about breastfeeding. These leaders are highly qualified to address the issues raised in this question. A one-year-old obviously still needs to nurse, but there could be many issues at work (for example, starting solids, teething, food allergies, or high-need temperament), which the leader is trained to explore with you.

As far as Attachment Parenting goes, we suggest looking at the attachment needs of the baby. Has something happened in the baby's life that might cause her to want to nurse more frequently? Something like moving to a new home can be emotionally unsettling for a baby, even though she is loved, held, and nurtured. A new environment takes quite a bit of adjustment, and a baby wants the comfort and security of nursing. After you've explored every angle and it seems your baby is physically and emotionally healthy, you might find ways to decrease the frequency of nursing by actively engaging the baby in play or getting your partner or other trusted loved one to take a more active role in occupying her.

Some parents worry about setting up an unhealthy habit, but you will find that your baby will naturally decrease her nursing over time, especially when she is taking in more solid food and becoming more interested in the world around her.

My three-year-old still nurses to sleep, and I'm pregnant. Should I be looking for alternative methods to parent my toddler to sleep? Do you have any suggestions on tandem nursing at night?

This will be a real balancing act. It will be very helpful to have your partner's help and cooperation during this time of transition for your three-year-old. It never hurts to try other methods to help your older child to sleep if he is ready for them. Reading stories, rubbing his back, and singing softly are all good things to try before the new baby comes, and may work on occasion, especially if it's someone else besides mom who is doing them!

It's also important while you're pregnant to tell your older child stories of when he was a baby and how helpless he was, that you met his every need quickly, and that he was too small to eat anything fun like he's eating now. Let him know that the baby will only be able to drink mommy's milk and perhaps decide together on a healthy big boy drink that he will be able to enjoy while the baby nurses. Also talk with him about the baby's need to nurse first so that her tummy is sure to be full, and let your son know that he will be able to have a turn after the baby is finished. Assure him that you will have plenty of milk for him after she's finished.

There may be times when only mommy's milk will do, and you will have to think about nursing two at a time or just reassuring him that he will be able to nurse in a few minutes. If you choose to tandem nurse at night, you will need to assess which child can be most patient at that given moment. Perhaps your partner would be able to sing to or rock the baby while her brother settles back to sleep, or perhaps your toddler would be willing to listen to a quick, simple story while his sister nurses back down. Every mother and child is unique, so you will have to see what works for you. The La Leche League book Adventures in Tandem Nursing by Hilary Flower is a wonderful resource that you might enjoy.

My one-year-old toddler wants to nurse a lot at night, and I'm extremely tired. How can I encourage him to stop nursing at night?

There can be many reasons why a one-year-old toddler wants to nurse a lot at night. For instance, he may be going through a normal developmental stage, such as when learning to walk or talk. During these times, he needs reassurance and extra touch before he can begin this gradual separation process toward greater independence. If a child is frequently waking during the night, it may be wise to rule out physical causes for the waking such as teething, earache, reflux, or other illnesses.

You may want to consider what the easiest way to meet your child's needs are and whether it is easier to cut back on nighttime nursing and nurse once in the middle of the night, sleep with the child so that he can nurse without waking you, or night wean. What is best for you may not be best for another mother. Consider what feels right to you.

If you have already tried everything possible to take care of your needs for rest, like waking later in the morning, napping with your child, or going to bed earlier, and decide that you want to proceed with nighttime weaning, know that it can be very difficult if your child isn't ready to do so on his own. It requires finding substitutes for every need breastfeeding meets for your child. You will also need to find other ways to help your baby get back to sleep.

The key to omitting night nursing is to continue to be responsive to your child's needs. We know of wonderful mothers who do not nurse at night, but they get up and respond to their baby, no matter how many times that might be. Nighttime weaning may work for some families, and not for others.

Here are some tips to begin omitting nighttime nursing sessions:

  • Consider whether a consistent bedtime routine would help. Some children prefer an earlier bedtime and others do better with a later bedtime. Some like baths and singing, while others prefer a book and rocking.
  • See how easy it might be for your baby to fall asleep without nursing. You could try not offering the breast immediately, and try walking with him, rocking, and rubbing or patting his back to help your baby fall asleep.
  • See if you can get the baby to "let go" of the breast before falling asleep. Some babies may be willing to let go and fall asleep near the mother, or in her arms without nursing. Consider that some babies will not like this, and may become very upset when you try to detach.
  • Be sure you nurse enough during the day. Many times active toddlers nurse throughout the night to make up for their lack of daytime nursing.
  • Try offering substitutes during the night when he first wakes. For instance, you could offer him a "sippy cup" with water in case he wants to nurse because he is thirsty. He may also be hungry and would be satisfied with a light snack.
  • You can try sleeping on your stomach or wear a gown that makes your breasts less accessible to your child at night.
  • If possible, involve your partner with the bedtime routine. Work on helping him to get your child to sleep. Some children are ready for this sooner than others; the key is to be responsive to your child's needs.
  • Let your partner try to handle getting your child back to sleep in the middle of the night. He may have an easier time of it than you, since your child knows that you could be nursing him.

Tips for a verbal child:

  • Help him learn how to wait a few minutes during the day when he wants to nurse. If he can do this during the day, then you can try to transfer the wait to the nighttime. When children wake at night and can wait a few minutes, they often will fall back to sleep on their own.
  • Encourage him to wait until morning by telling him that he can nurse when it is light outside. Make it fun by saying something like "when Mr. Sun goes to sleep, milk goes night-night too" and use the same for waking.
  • Talk to him about the fact that he will not always need to nurse to go to sleep or when he wakes during the night. Talk about this with him during a quiet, happy time during the day. Present it in a positive, matter-of-fact way as something that will naturally occur as he gets older. Do this daily before you begin night weaning so that you give him plenty of time to prepare for the transition.

These methods require time and effort and some loss of sleep on your part and may result in some unhappiness on your baby's part if you are not responsive to his needs. Take a month or two to accomplish this, if you can wait that long. After all, this is a big milestone for your child, and it is clearly best if done gradually. Thus, use the tips on cutting back the nighttime nursing, to begin with, and gradually help your child to sleep without nursing. While it may seem difficult, mothers have accomplished this without their child ever shedding a tear; however, a lot of patience is required!

At what age should I wean my child?

Weaning is a personal decision between each mother and baby. While at one time experts recommended that women wean by a certain age, this is no longer the case. Studies show that the longer a woman breastfeeds the more she reduces the risk of many illnesses to her child (such as childhood cancers) and risk of illness to herself (lower risk of breast, ovarian, and cervical cancer). The current recommendations in the United States and worldwide are to breastfeed a minimum of 12 months, and preferably until the age of 2 or beyond. The American Academy of Pediatrics recommends breastfeeding for a minimum of 12 months or as long as mutually desirable. They refer to a study that looks at the normalcy of extended breastfeeding in the United States through ages five and six and are in accord with other experts to allow them to wean naturally.

Some babies have a stronger need to nurse longer, and it still continues to be beneficial for the child. The World Health Organization (WHO) and UNICEF recommend that all children, in both developed and undeveloped countries, be breastfed a minimum of two years, or beyond, and acknowledge that the average age of weaning worldwide is about four years old. One study indicates that breast cancer in the United States could decline by 25% if all women would breastfeed their children for at least two years. Thus, the benefits are not just for the child. Because of the recent research showing the benefits of breastfeeding longer, mothers are now encouraged to engage in "child-led weaning," which means mothers will know from their child's cues when they are ready to wean.

We like to think of weaning as a cooperative process between mother and baby. Sometimes mother is ready to wean and baby is not. At this point, patience is a real plus. When you observe that your baby seems satisfied when you offer to do other things in place of nursing, like eating, drinking, holding, or being read to, then these may be signs your child is ready to wean. We do recommend that the weaning process be gradual and not traumatic for the baby. You may need to give your baby a lot of undivided attention during the weaning process before it is successful.