Q: My toddler is turning three soon and we are ready to move on from breastfeeding. How can I wean him off my breast?

Lactation expert Rita Rahayu Omar says,

You have breastfed your baby for up to three years, good for you! Research has shown that breastfeeding does not cause dependency. In fact, it helps your baby’s attachment to you as a caregiver, making her a more independent and secure individual as she grows.

Weaning does not mean a loss, but rather a transition from one relationship to another. Basically, it occurs by substituting other kind of loving care for nursing. Timely weaning occurs when the baby’s need to suck lessen, typically between nine months and three and a half years of age. The World Health Organisation (WHO) advises exclusive breastfeeding for the first six months, then breastfeeding with the introduction of solid foods for at least two years. If given the chance, many babies would breastfeed beyond their first year. Weaning is really a personal decision. In short, when one or both members of the mother-baby relationship are ready, it’s time to wean.

How to Wean

Weaning can either be baby-led or mother-led. Baby-led weaning occurs when babies wean themselves from the breast by becoming less interested in feeding over time. As for mother-led weaning, it is easier when you are not under a lot of stress.

There are two phases in weaning: withholding and substituting. As you gradually withhold your milk, you substitute solid foods, other types of milks, and other forms of emotional nourishment.Try to comfort your child by giving extra hugs and cuddles in place of breastfeeding. You may also get your spouse to take on a larger role in comforting baby. Try to avoid weaning baby by physically separating yourself from your baby (for example, by going for a vacation). Sudden separation from mother’s breast and mother all at once may cause extra stress for your baby.

The key to healthy weaning is, it must be done gradually:

• Replace one feed at a time.
• It is easiest to begin by dropping the feed your baby seems least interested in. For example, instead of breastfeeding mid-morning, take baby to the park, read a book, or have a snack or drink from a spoon or cup.
• Wait between a few days to two weeks before replacing another feed. This allows baby to adapt to the change and prevent yourself from having overfull breasts.
• The weaning method of “don’t offer, don’t refuse” often works best. It means that you do not offer baby your breast – one feed at a time. However, if your baby is interested in breastfeeding at the feed you are trying to drop, do not refuse him. Weaning does not mean refusing baby to nurse but rather gradually releasing your baby from breastfeeding.
• Try to limit situations that encourage breastfeeding such as sitting around your usual nursing area.
• Expect nap and night nursing sessions to be the last to end.
• When one of you is ready to end breastfeeding before bedtime, you should already have a sleep routine established. Lots of physical activities in the daytime helps your little one settle quickly too.
• It is helpful to have dad fulfil these evening routines so baby does not think of breastfeeding; this also allows important contact time between father and child.
• If your baby is upset, offer other sources of comfort such as stories, toys, games, songs, outings and projects. As you develop engaging interactions, your child will slowly learn to be content and prefer them to breastfeeding.
• Be prepared to breastfeed more often again if you see behaviours such as tantrums, anger or sadness in your baby. These behaviours may occur if you are weaning too quickly. Also, babies may have occasional spurts of breastfeeding again if they are ill, upset or experiencing new situations. At these times, your baby is most likely breastfeeding for comfort.

Q: I’ve been booked in for a Caesarean due to medical reasons. I’ve heard of a natural C-section – what is it?

Obstetrician Dr. Choong Kuo Hsiang says,

The idea of natural Caesarean section (C-sec) was conceived by Professor Nicholas Fisk, formerly a consultant obstetrician at Queen Charlotte’s Hospital in London, in response to the rising numbers of C-sec in the UK. It is a revolutionary technique that attempts to turn C-sec into an experience closer to vaginal birth.

The procedure involves parents; the drape that separates the mother from her abdomen is dropped to allow her to see baby’s head emerge. Mother’s view of the operation will be blocked by baby himself. The doctor makes an incision wide enough for the baby to squeeze through. So it is almost like giving birth naturally!

The baby is also allowed to emerge slowly through the wound. A combination of the naturally contracting uterus and the baby’s vigorous wriggles allows the lungs to expel fluid and aid baby to start breathing, just like a normal birth. Finally, the baby is also delivered straight onto mother’s chest for a skin-to-skin bonding. Breastfeeding in the operation theatre is encouraged.

Others requesting this should discuss this further with their doctor.

Q: My partner wants to support me in labour but is unsure what to do. Do you have some tips for him?

Midwife Ann Ibrahim says,

Remember it’s not about what you do and how much you know that makes a difference. It’s just being there and believing in her innate ability to give birth, by merely loving her:

• Be yourself, and give support in your own way. Acknowledge the things that you may not wish to be involved in, as well as the things you may like to do. Discuss them together before the birthing process begins.
• Protect her privacy and make the birthing place as conducive as possible.
• Offer realistic support. Don’t reassure her of things you don’t know of.
• Attend childbirth classes with her and be up-to-date with basic knowledge of pregnancy, the birthing process and baby.
• Trust her ability to give birth, love and provide her with confidence. Remind her that she can do it, and that you are here for her and your baby.

You can also:

• Rub her back.
• Massage her and hold her hands.
• Cool her forehead with a washcloth.
• Make sure she has enough to drink.
• Remind her to empty her bladder regularly.
• Making her comfortable (help keep her warm or cool).
• Suggest and aid her in changing positions.
• Provide her snacks.
• Breathe with her.
• Help her in times of panic by establishing eye contact, holding her firmly, breathing with her and reassuring her.
• During the transition stage and tense moments, do not take things personally. It’s just a phase she needs to get through.
• Don’t be the photographer, and put phone calls on silent or on hold.
• Look after yourself. Remember to eat and take breaks at appropriate times.
• Welcome your baby, and hold him/her close. You can even put your baby skin-to-skin on yourself.
• Look after the baby if the mum needs some alone time to clean up/shower.
• Assist with getting the baby on to the breast for feeding.
• Nurture the mother.