Version July 2025
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INTRODUCTION —
Breast milk is the optimal source of nutrition for virtually all babies. It meets essentially all of the nutritional needs of full-term babies until approximately six months of age. After six months, solid foods (also called "complementary foods," such as infant cereal and soft puréed meats, fruits, and vegetables) are usually added to their diet while continuing partial breastfeeding. If possible, experts suggest that babies continue partial breastfeeding until they are at least 12 months old and thereafter for as long as they and their parent(s) choose to continue. Cow's milk (nonformula) and fruit juice are not recommended until the baby is at least 12 months old. (See "Patient education: Starting solid foods with babies (Beyond the Basics)".)
In this article, we use the term "breastfeeding" to refer to feeding a baby at the breast/chest or feeding expressed (pumped) breast milk. "Weaning" refers to the gradual process of stopping breastfeeding or pumping.
More information about breastfeeding and pumping breast milk is available separately. (See "Patient education: Deciding to breastfeed (Beyond the Basics)" and "Patient education: Breastfeeding guide (Beyond the Basics)" and "Patient education: Common breastfeeding problems (Beyond the Basics)" and "Patient education: Pumping breast milk (Beyond the Basics)" and "Patient education: Health and nutrition during breastfeeding (Beyond the Basics)" and "Patient education: Medicines and breastfeeding (The Basics)".)
THE WEANING PROCESS —
Weaning is defined as the gradual replacement of breast milk with other sources of nutrition for your baby. Weaning also involves some physical and emotional changes for you. As you breastfeed or pump less often, your body will gradually adapt by producing less breast milk and your baby will adapt by learning new ways of feeding.
When should I wean? — Weaning may be initiated by you or your child, or it may be a shared decision. Most children who "self-wean" do so between two and four years of age; it is uncommon for a baby younger than 12 months to self-wean. The duration of the weaning process varies from child to child. Some wean quickly, while others take months to completely wean.
Weaning is different from a "nursing strike." Weaning is a planned and gradual process, whereas a nursing strike is a sudden and temporary refusal to nurse, often due to illness, teething, or discomfort. A nursing strike typically resolves on its own once the cause is addressed.
Do I have to wean? — There are many possible reasons for wanting to wean, although it is rarely necessary to do so. The American Academy of Pediatrics recommends providing breast milk for the baby's first year and as long as mutually desired. There is no particular age by which weaning should be complete. In fact, providing breast milk past one year provides your baby with key nutrients, immune support, and factors to support brain development. Continued breastfeeding or pumping may also reduce your risk of certain types of cancer (breast, ovary, and uterine). The benefits of breastfeeding persist for as long as it is continued. Some of the benefits persist even after you stop breastfeeding or pumping. The benefits of breastfeeding for both you and your baby are discussed separately. (See "Patient education: Deciding to breastfeed (Beyond the Basics)".)
Pregnancy and breastfeeding — Breastfeeding is not a reliable method of birth control. Most people are able to get pregnant, even while breastfeeding, within the first three months after giving birth.
If you do get pregnant, you will probably be able to continue breastfeeding if you wish. However, you will need to consume extra calories to meet your body's needs and those of your developing fetus and breastfeeding child. This is especially true if you get pregnant while you are still exclusively breastfeeding (meaning that your baby is not eating or drinking other foods). Also, your milk supply might decrease a bit because of the hormonal changes during pregnancy. (See "Patient education: Health and nutrition during breastfeeding (Beyond the Basics)".)
Weaning and feelings of guilt — You may find that weaning is an emotional time for you and your child. It is not just a transition to another feeding method but is the conclusion of a special relationship. Even if you and your child are both ready for the weaning process, you might have unexpected feelings of sadness.
Some people struggle with feelings of guilt when they wean. Although this is a normal reaction, you should feel proud of any breastfeeding you have done, knowing that you provided a wonderful start to your child's health and well-being.
During the weaning process, your child may need more attention and cuddle time to take the place of nursing time. You may find that, some days, your child needs to nurse after having nearly weaned completely. Being flexible and understanding will go far in the weaning process and help make it more comfortable for everyone involved.
HOW DO I WEAN?
General approach — When you are ready to start weaning, one option is to gradually eliminate one breastfeeding (or pumping) session every two to five days. Another option is to shorten breastfeeding sessions slowly or lengthen the time between sessions.
Some parents choose to wean a child from breastfeeding during the day and continue breastfeeding at night; this may be a good option if you need to be away from your child (for example, while working or attending school) and are unable to pump breast milk. Eliminating the midday feeding may be a good first step because children tend to be most interested in breastfeeding at the first and last feedings of the day, when they are particularly looking for comfort. When you choose to eliminate a feeding at the breast, you should replace with feeding either previously stored expressed breast milk, formula (if your baby is younger than 12 months old), or whole cow's milk (if they are older than 12 months of age). It is OK for your child to have some breast milk and some formula or milk (partial breastfeeding) during the phase of weaning. Pre-bedtime or nighttime feedings are usually the last to wean completely.
As you wean, your breasts may become very full because your body is still making milk but it's not being removed as frequently. This is normal, but can be uncomfortable. Stopping breastfeeding or pumping all at once is generally not recommended, because it can cause your breasts to feel very full, swollen, and sore, called "engorgement." If you need to stop breastfeeding abruptly for medical or other reasons, it may help to hand express or pump milk a few times per day until your breasts feel comfortable (not empty) and milk production slows, usually over a few days (figure 1). Do not wait until your breasts are painful or very full to express milk. Wearing a well-fitting and supportive bra, using cool compresses, and taking ibuprofen may also help reduce discomfort. (See "Patient education: Pumping breast milk (Beyond the Basics)" and "Patient education: Common breastfeeding problems (Beyond the Basics)", section on 'Engorgement'.)
During weaning, and especially if your breasts become engorged, you are more likely to have breast complications, such as plugged ducts or mastitis. Watch your breasts carefully for any signs of pain, redness, or tenderness. If this happens, and especially if you have a fever, contact your health care provider to discuss treatment. (See "Patient education: Common breastfeeding problems (Beyond the Basics)".)
Bottle or cup? — You can wean your child to a bottle then a cup, or directly to a cup, depending on their age. Children under six months of age may prefer drinking from a bottle and still have a sucking need that can be met by giving them a pacifier (or "dummy"). Children older than 12 months can typically transition directly to a cup. Children between 6 and 12 months may use either a cup or a bottle. Weaning directly to a cup avoids the potential problems that can happen with bottle feeding, such as an increased risk of tooth decay and difficulty giving up the bottle (especially at night). A trainer cup with two handles and a snap-on lid with a spout may be easiest to manage.
Troubleshooting — If your baby is having difficulty with the transition, here are some tips:
●When introducing a bottle, it helps if the baby is not extremely hungry, so that they may be more patient. It also helps if a caregiver other than the breastfeeding parent introduces the bottle. You may also try directly breastfeeding in the beginning of the feeding and switching to a bottle or cup for the remainder.
●When transitioning to either a bottle or cup, try giving expressed breast milk at least for the initial feedings (and for as long as you want after that). Breast milk is sweeter than formula, and babies may be more willing to accept the bottle or cup if the taste of the milk is familiar. If the child is older than 12 months, you can typically give cow's milk instead of formula. (See "Patient education: Starting solid foods with babies (Beyond the Basics)".)
●When partially breastfeeding, try to offer your breast before your baby is hungry and impatient. After you start bottle feedings, your baby might get frustrated with breastfeeding because milk flow is not as fast from the breast as from a bottle. You can prevent this by selecting a bottle nipple with slow flow. Another suggestion is to pace the bottle feed by taking short breaks, so that a feeding takes at least 10 to 15 minutes, similar to a breastfeeding session.
Do not leave your baby with a bottle of milk, formula, or juice while sleeping. This is because falling asleep while bottle feeding can lead to aspirating (inhaling) milk and tooth decay.
LIFE AFTER WEANING —
As your milk production slows, your breasts might feel less full and may reduce in size. Some people will have stretch marks similar to those on their abdomen from pregnancy. These will fade to pale, silvery-colored areas over time.
Once you have stopped breastfeeding or expressing milk entirely, your breasts will stop producing milk, although you might notice drops of milk on occasion or may be able to express drops by hand for months or years after weaning.
As your breasts produce less breast milk, your body needs fewer calories. To maintain your body weight or lose some of the weight you gained during pregnancy, you might need to eat fewer snacks or reduce portion sizes. (See "Patient education: Health and nutrition during breastfeeding (Beyond the Basics)".)
FINDING HELP WITH BREASTFEEDING —
Resources for finding a lactation consultant, peer support (online or in-person), and other types of support are listed in the table (table 1).
WHERE TO GET MORE INFORMATION —
Your health care provider is the best source of information for questions and concerns related to your medical problem.
This article will be updated as needed on our website (www.uptodate.com/patients). Related topics for patients and caregivers, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below.
Patient level information — UpToDate offers two types of patient education materials.
The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.
Patient education: Weaning from breastfeeding (The Basics)
Patient education: Breastfeeding (The Basics)
Patient education: Pumping and storing breast milk (The Basics)
Patient education: Bottle feeding your baby (The Basics)
Patient education: Common breastfeeding problems (The Basics)
Patient education: Starting solid foods with babies (The Basics)
Patient education: Benefits of breast milk for premature babies (The Basics)
Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.
Patient education: Breastfeeding guide (Beyond the Basics)
Patient education: Pumping breast milk (Beyond the Basics)
Patient education: Common breastfeeding problems (Beyond the Basics)
Patient education: Starting solid foods with babies (Beyond the Basics)
Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.
Common problems of breastfeeding and weaning
Dietary history and recommended dietary intake in children
Poor weight gain in children younger than two years in resource-abundant settings: Etiology and evaluation
Introducing formula to infants at risk for allergic disease
Introducing solid foods and vitamin and mineral supplementation during infancy
Poor weight gain in children younger than two years in resource-abundant settings: Management
Websites — The following organizations also provide reliable health information.
●Academy of Breastfeeding Medicine
(www.bfmed.org/protocols, including The Mastitis Spectrum)
●National Library of Medicine
(www.medlineplus.gov/healthtopics.html)
●Centers for Disease Control and Prevention
(www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/weaning.html)
●United States Department of Health and Human Services
(www.womenshealth.gov/breastfeeding/breastfeeding-home-work-and-public/weaning-your-baby)
●United Stated Department of Agriculture
(wicbreastfeeding.fns.usda.gov/weaning-your-baby)
●American Academy of Pediatrics
(www.healthychildren.org/english/ages-stages/baby/breastfeeding/Pages/default.aspx)
●Massachusetts Breastfeeding Coalition
●Breastfeeding On Line
●Working and Pumping
●Working without Weaning: A working mother's guide to breastfeeding, by Kirsten Berggren
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ACKNOWLEDGMENT —
The UpToDate editorial staff acknowledges Lisa Enger, RN, BSN, IBCLC, who contributed to earlier versions of this topic review.
