Weaning as a Natural Process
Brylin Highton
Dunedin, New Zealand
From: LEAVEN, Vol. 36
No. 6, December 2000-January 2001, p. 112-114
The term weaning is
derived from the Anglo-Saxon word wenian, which means "to become
accustomed to something different." The Concise Oxford Dictionary
says to wean is "to teach the sucking child to feed otherwise than from
the breast." Weaning is often seen as the end of something; however,
it is more appropriately viewed as a beginning. We misuse the word wean
in the context of stopping other activities or habits; weaning is not
the cessation of breastfeeding but rather the addition of new foods.
History
The influence of increasing
scientific and medical knowledge and an ambivalence about breastfeeding
in Western society, combined with an ignorance of normal mammary function,
has led to a disregard of young children's sucking needs and an eagerness
to substitute artificial foods and feeding methods for breastfeeding.
However, long before the modern era some women chose not to accept their
biological role as nursing mothers and societies failed to provide adequate
support for nursing mothers.
In ancient times both Eastern
and Western women breastfed much longer than Western women do today.
The Romans believed complete weaning should not occur until a child
turned three (Galen) or had all his baby teeth(Soranus).
In medieval Europe, complete
weaning typically occurred between one and three years of age. Yet many
noble and wealthy women hired wet nurses, as they believed breastfeeding
would make them look old, prevent them from dressing fashionably, and
make their breasts sag. Nursing became the lot of the poor, as poor
women had no choice but to nurse their own children. Weaning was very
simple for most wealthy women and calamitous for their children, who
were simply taken from the wet nurse's home and returned to their family
of birth.
In the sixteenth century
supplemental foods were generally introduced between seven and nine
months. Though medical writers recommended breastfeeding for two years,
most German and Italian mothers had stopped by the thirteenth month
and most English mothers by the eighteenth month. By the eighteenth
century mixed feeding was promoted at two to four months and the median
age of complete weaning in the English educated classes was seven to
eight months. At this time in history various feeding devices and artificial
foods for babies were being developed. Artificial feeding became common
first in Scandinavia and northern Europe and then in the American colonies,
despite an awareness that artificially fed babies were more likely to
die.
Physiology of Weaning
The physiological process
of weaning is complex and involves microbiological, biochemical, nutritional,
immunological, and psychological adjustments for both mother and child.
During the weaning process
the composition of human milk adjusts to meet the needs of the growing
child so that, although the volume is decreasing, an appropriate level
of nutrients remains present and immunological protection is not compromised.
Studies on the composition
of human milk have shown that when milk consumption falls below 400
milliliters per day, the level of sodium and other inorganic salts increases
as the volume decreases. The fat, protein, and iron also increase while
the calcium levels stay the same and zinc levels decrease. Milk produced
during weaning also shows a decreasing concentration of lactose; fats
increasingly replace lactose as the main source of calories. The calories
provided by proteins remain stable. The concentration of immunological
components is maintained during gradual weaning with a slight rise in
the level of IgA, secretary IgA, lysozymes, and lactoferrin. Following
abrupt weaning, however, the concentration of these components rises
dramatically. Lipases (enzymes essential for the digestion of fats)
decrease in activity during weaning although bile salt stimulated lipase
does so only slowly.
The mother may experience
several physical changes after weaning. Most women find a need to adjust
their diets to eliminate the calories that were supporting milk production
to avoid gaining weight. Their breasts may sag at first and be soft
but generally return to pre-pregnancy size after several menstrual cycles.
If the mother was experiencing lactational amenorrhea, the reduction
in nursing frequency will stimulate the return of fertility. The hormonal
state of the mother will also change with the cessation of breastfeeding
as prolactin returns to pre-reproductive levels.
When weaning is rapid the
breasts may become uncomfortably full; a mother's body responds to signals
to reduce milk production only gradually. The mammary glands of other
mammals involute (return to pre-pregnancy size) rapidly. Humans, however,
generally continue to produce milk for about 45 days after complete
weaning with some women experiencing milk secretion for several months
or more. It is believed that a psychological nursing stimulus contributes
to this effect in humans since they continue to have contact with their
young long after weaning.
Abrupt weaning may leave
a baby feeling as though his mother has withdrawn her love as well as
her breast. The sudden shift in hormones may cause the mother to become
depressed, especially if the mother is ambivalent about weaning or if
she is prone to depression. The mother may also risk developing mastitis
or a breast abscess. If abrupt weaning is essential for any reason,
measures should be taken to relieve any breast engorgement and to keep
a careful watch for complications.
Although recent research
has shown that the protective effects of breastfeeding last well into
childhood, a weaned child is more susceptible to infections, not only
because of the introduction of other foods but also because of the loss
of the anti-infective and protective properties of human milk. In Third
World countries, morbidity and mortality in infancy rise sharply at
the time of weaning from human milk due to the rapid onset of infections
and diarrhea-related malnutrition.
When to Wean
Ruth Lawrence has said, "If
one were to determine the appropriate time for weaning to take place
it would be based on nutritional needs and developmental goals. Observations
among other mammals suggest that achievement of a degree of maturity
that allows the young animal to forage for food is a trigger for initiating
weaning by the mother."
According to anthropologist
Katherine Dettwyler, "Many primates wean their offspring when they are
erupting their first permanent molars. First permanent molar eruption
occurs around five-and-a-half to six years in modern humans. It is interesting
to note that achievement of adult immune competence in humans also occurs
at approximately six years of age suggesting that throughout our recent
evolutionary past the active immunities provided by breast milk were
normally available to the child until about this age."
It is theorized that the
six year nursing practice was probably modified by the use of fire in
cooking 0.5-1 million years ago followed by the domestication and processing
of grains about ten thousand years ago, providing alternatives to uncooked
vegetation and raw animal foods.
Around the middle of the
first year most babies show signs of wanting something other than human
milk. This begins the weaning process, but the length of time before
a baby is fully weaned varies from baby to baby. Some are enthusiastic
and others are not. Mothers can be reminded that human milk is the most
important food for their babies during the first year.
Developmentally the baby
is ready to chew solids at about six months even though not all of his
teeth have erupted. The sucking pads in the baby's cheeks begin to disappear
at the end of the first year. The rooting reflex has also been lost
by this time. The development of the chew-swallow reflex is necessary
for successful introduction of solids. Some think this reflex is a learned
behavior encouraged by oral stimulation after the baby reaches a certain
level of neurological development. If supplemental food is introduced
too early, the baby will push his tongue against a spoon to eliminate
solids from his mouth.
The introduction of new foods
is important both socially and nutritionally. Additional protein becomes
necessary toward the end of the first year and the infant also needs
bulk or roughage about this time. Eating solids and learning to drink
from a cup are important social achievements. This does not mean, however,
that breastfeeding should end, only that the baby's diet now includes
solid foods and other liquids.
For the human baby nursing
supplies comfort and emotional support. The need for comfort sucking
or non-nutritive suckling may last for several years as witnessed by
the use of bottles, dummies, and thumbs by many toddlers and preschoolers.
The optimal approach to weaning matches the needs and requirements of
a given child with the functions and capacities of his body.
Sometimes mothers are ready
to wean before their babies are ready. Vague fears and irrational biases
often promote early weaning from the breast. The family's needs may
conflict with the baby's needs. The intensity of the breastfeeding relationship
may cause others in the family to feel ignored. Western society teaches
that the only way a baby can gain independence is by being weaned and
the only way mothers can "get their lives back" is by weaning their
babies.
Early in the twentieth century
various books emphasized control over the baby. Rossiter (1908) said,
"Picking up or nursing a crying infant will cultivate self indulgence
and a lack of self control." Mothers were instructed not to give their
babies the breast or even pick them up when the babies cried at an "inappropriate"
time. Brown (1923) suggested meeting an infant's needs would make him
"a potential juvenile court case." This approach to child rearing still
has advocates today. Such management of breastfeeding often ensures
that the nursing period lasts for a very short time.
La Leche League encourages
mothers to continue to breastfeed ideally until the baby outgrows the
need. Breastfeeding is a relationship between two human beings and,
as in any relationship, there is give and take. THE WOMANLY ART OF BREASTFEEDING
does not set rules about how long to breastfeed, but it does suggest
that weaning is best done "gradually, with love" for both the mother's
and baby's sake. Weaning is a personal decision made by the mother with
the baby's and her own needs in mind.
While mothers who are still
nursing children at two, three, four, or more years are considered exceptional
in many cultures, they are perhaps greater in number than most people
realize because most remain purposefully invisible. Many women plan
before their baby's birth to nurse their babies for three months, six
months, or a year only to find their feelings, knowledge, or circumstances
change after the baby arrives.
Various researchers have
suggested that there are windows of opportunity for weaning. Babies
sometimes exhibit lagging interest in breastfeeding as a direct or indirect
result of developmental events at four to five months, seven months,
and at nine to twelve months. Between 13 and 18 months, researchers
have found that children experience more negative emotional reactions
to weaning than any other time. As they develop mobility and communication
skills they also develop intense separation anxiety. The nursing attachment
to their mother is very reassuring. Sudden refusal to nurse, especially
when the baby is under one year, is not an indication that the infant
is ready to wean but rather that he is communicating that something
is wrong. Many mothers misinterpret this message and do wean completely
at this time.
Conclusion
Throughout history, culture
and society have influenced the natural process of weaning. Breastfeeding
is more than just a choice of milk, and weaning is more than just ending
access to human milk. Today early weaning and failure to breastfeed
are mainly products of social pressure and lack of knowledge and support.
The last few decades of the twentieth century are probably the only
time in human history when a large number of babies have been completely
weaned from the breast in the first three to six months of life. Mothering
through breastfeeding encourages a mother to understand and satisfy
her baby's needs. Ideally, as the breastfeeding relationship develops
she becomes sensitive to her baby's cues and is guided by them, considering
both of their feelings and preferences before initiating weaning.
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Last updated Friday, September 15, 2006 by njb.
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