From the Guidelines
Breastfeeding should be continued for at least 2 years or beyond, as recommended by the World Health Organization, with the decision to wean depending on the mutual readiness of both the mother and child. The American Academy of Pediatrics also supports continued breastfeeding until 2 years or beyond, as mutually desired by mother and child 1. According to a recent study published in Advances in Nutrition in 2024, breastfeeding recommendations are supported by strong evidence regarding health and development, including reduced risk of overweight and obesity, infections, and positive effects on cognition 1.
Key Considerations
- The weaning process should ideally be gradual, dropping one feeding at a time over weeks or months to allow both the child's digestive system and the mother's body to adjust.
- When beginning to wean, introduce age-appropriate solid foods and alternative milk sources as recommended by your pediatrician.
- Breast milk continues to provide nutritional and immunological benefits even into the toddler years, including antibodies that help protect against illness and infection.
- Some children self-wean naturally between 1-4 years of age, while others may continue breastfeeding longer.
Supporting Evidence
- A study published in Pediatrics in 2005 recommends exclusive breastfeeding for about 6 months, with complementary food introduction at about 6 months, and continued breastfeeding until 2 years or beyond 1.
- The 2024 study in Advances in Nutrition highlights the importance of breastfeeding for planetary health, including its environmental sustainability and contribution to addressing the global syndemic of obesity, undernutrition, and climate change 1.
Clinical Implications
- Pediatricians should provide information to support informed feeding decisions and avoid disrupting breastfeeding unnecessarily.
- Policies that protect breastfeeding, including universal paid maternity leave and the right to breastfeed in public, are essential to supporting families in sustaining breastfeeding.
- National breastfeeding rates should be tracked, and data should be stratified by known breastfeeding disparities to inform areas that need improvement.
From the Research
Weaning Off Breastmilk
- The American Academy of Pediatrics and the World Health Organization recommend that infants receive human milk exclusively for the first 6 months of life and that breastfeeding continue beyond the first or second year of life for as long as a family deems appropriate 2.
- Exclusive breastfeeding provides optimal nutrition for infants until they are six months of age, after which infants require complementary foods to meet their nutritional needs, marking the beginning of the weaning process 3.
- There is no universally accepted or scientifically proven time when all breastfeeding must stop, and the timing and process of weaning need to be individualized by mother and child 3.
- Weaning might be abrupt or gradual, take weeks or several months, and be child-led or mother-led, with physicians guiding and supporting mothers through the weaning process 3.
Factors Influencing Weaning
- The decision to wean off breastmilk depends on various factors, including the child's age, nutritional needs, and the mother's lifestyle and preferences 2.
- As more infants breastfeed beyond the first year of life, best practices for weaning toddlers come into question, highlighting the need for guidance and support for mothers 2.
- Current evidence on weaning from an evolutionary, social, and practical perspective is presented in various studies, providing insights into the complexities of weaning 2.
Additional Considerations
- Other factors, such as the use of galactagogues to increase breast milk production, may influence the weaning process, although evidence to support their efficacy and safety remains limited 4.
- The use of antidepressant medication during lactation may also impact the weaning process, with some medications considered relatively safe to use during breastfeeding, while others should be avoided 5.