Definition

• Weaning means replacing bottle feedings with drinking from a cup. It means an end to nipple feedings.
• Weaning usually occurs easily and smoothly.
• Weaning is harder if the bottle has become overly important to the child.
• Weaning can be either child-led or mother-led.

Health Information

Goal: Child-Led Weaning at 9-12 Months

• Children normally show less interest in bottle feedings between 9 and 12 months of age. They lose interest in the bottle if they are also taking cup and spoon feedings.
• Many children start weaning themselves by 12 months.
• After the age of 12 months, the parent often has to start the weaning. The child will usually be receptive.
• After 18 months of age, the child usually resists weaning. This is because they have become overly attached to the bottle.
• For easy weaning have a goal of finishing by 12 months.
• The AAP recommends complete weaning from the bottle by 15 months at the latest.

Prevention of Sleep Problems and Feeding Problems

The following 2 recommendations are made to prevent potential feeding associated problems:

• Do not bottle feed your baby to sleep. It interferes with learning self-soothing behavior. It will cause persistent sleep problems. Exception: first 1 month of age.
• Avoid comfort feeds. Comfort feeds are using milk to calm a fussy child or one who seems unhappy, but not hungry. It will make later weaning more difficult.

Care Advice

Child-Led Weaning: How to Promote

1. Avoid Excessive Bottle Feedings:
   • After 6 months of age, keep bottle feedings to 4 times a day. Be sure 3 of them are given at mealtime with solids. Your baby can have the fourth feeding as the first step in the bedtime ritual.
   • Don't use bottle feeds for between meal snacks.
   • Don't bottle feed to sleep at bedtime or naptime.
   • Stop all night feedings by 6 months.
2. Hold Your Child for Crying:
   • Hold and comfort your child without feeding if she's upset and not hungry.
   • Assume hunger is not the cause if it's been less than 2 hours since the end of the last feeding.
   • Unexplained fussing and crying is common in the first 3-4 months. Many babies become fussy when they need to fall asleep.
   • Try swaddling, gentle rocking, different sounds and other techniques. Learn what works best to soothe your baby.
   • If you always feed your child in these instances, your child may learn to eat whenever she is upset.
3. Use a Pacifier when Your Baby Needs to Suck but is Not Hungry:
   • Some babies have a high suck drive. Learn to recognize when your baby just needs to suck.
   • The best way to tell is that it has been less than 2 hours since the end of the last good feeding.
   • At these times, offer a pacifier instead of food.
   • Feeding your baby every time he needs to suck can lead to excessive weight gain.
   • After teeth come in, a teether may be helpful for any fussiness.
4. Don't Bottle Feed or Hold Until Asleep:
   • To have a good sleeper, place your baby in the crib drowsy but still awake.
   • All sleep experts agree on this advice for preventing sleep problems. And sleep training is not harmful to your baby.
   • She needs to learn how to put herself to sleep. Self-soothing is a critical skill. If she doesn't, she will cry and want to be fed after normal night wakings. This sleep problem will require your presence during the night.
   • Your baby needs to be able to fall asleep without a bottle in her mouth.
5. Don't let a Bottle Become a Daytime Toy:
   • Don't let your child carry a bottle around as a companion during the day.
   • This habit may keep him from engaging in more stimulating activities.
6. Don't let Your Child Hold the Bottle or Take it to Bed:
   • Your child should think of the bottle as something that belongs to you.
   • She won't protest giving it up because it wasn't hers in the first place.
7. Introduce Formula in a Sippy Cup at 6 Months:
   • Exposure to cup feedings will make weaning easier.
   • At first, offer the cup after he has drunk some from the bottle. This might be the only way your child will accept the cup.
   • By 9 months of age, offer formula from a cup before bottle feedings.
   • Delaying cup feedings past 9 months makes your child less willing to try them.
8. Introduce Baby Foods (Solids) from a Spoon at 6 months:
   • Starting foods before 6 months is not recommended. It's not needed for growth and can cause gagging.
   • Delaying solids past 9 months runs the risk that your baby will refuse solids.
   • Finger foods can be introduced whenever your child develops a pincer grasp. This is usually between 9 and 10 months of age. Once your child can use finger foods, include her at the table during mealtime. She will probably become interested in the foods that she sees you eating. As a result, she will want to have other foods as well as formula.
9. Start Phasing Out Nipple Feedings After About 9 Months of Age:
   • Do this anytime your child shows a lack of interest in the bottle. You can offer formula in a cup instead.
   • Children normally show less interest in bottle feedings between 9 and 12 months of age. Don't miss this window of opportunity (9-12 months) for child-led weaning.
   • You can tell that your baby is ready to begin weaning when they:
   • Throw the bottle down
   • Take only a few ounces of milk and then stop
   • Chew on the nipple rather than sucking it
   • Suck only for a few minutes and then want to play
   • Become more interested in the world around them than bottle feeding

Call Your Doctor If

• After 2 months, needs feeding to fall asleep
• After 6 months, can't sleep 6 hours without a feeding
• After 7 months, won't accept baby foods
• After 9 months, won't accept a cup for some feedings
• You want help with weaning
• You think your child needs to be seen
• You have other questions or concerns

Pediatric Care Advice

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.