Wednesday, May 7, 2014

To Wean or Not to Wean, That is the Question

Remember that time when nobody judged anyone else and we each had magic ponies that granted wishes? Yeah, me neither.

I've been trying to decide how long I plan on breastfeeding Mr. Man. My original goal was 1 year, and (I cannot even believe that I'm saying this) that's rapidly approaching. I didn't think much about it beyond that because 1 year was SO FAR AWAY *sobs into keyboard*.

Some women have very strong feelings about breastfeeding. They super love it or super hate it. I don't feel strongly about it. I don't like having to schedule pumping when I'm away from Mr. Man. Sometimes I wish I could have a beer with dinner on the occasion that dinner is ready before I nurse the baby *sob* to sleep. But those things are becoming less of an issue as he nurses less and is staying awake late enough to eat with us. There are times where breastfeeding is sweet and touching and special, and sometimes it's annoying because he has to pop off fifty bajillion times to point out that the dog is in the room or he keeps trying to snap my bra strap.

As I started researching extended breastfeeding*, the fact that many women have strong feelings about breastfeeding was rapidly apparent with the judging and the agendas and the I HAVE STRONG FEELINGS ABOUT THIS that were not so much hidden between the lines as waving a middle finger over the lines. And, because I am human, I started feeling defensive that I was even considering weaning.

*Extended breastfeeding = breastfeeding beyond a year. I don't know who decided to call it that either, but I'm guessing it was a man who wished his wife would stop breastfeeding so he had access to boobies again.

My brain started in with the rationalizations: I exclusively breastfed my baby who happened to eat every freaking hour he was awake for months and months. Do you know how much pumping that requires? I have suffered, people. My baby started getting teeth very early. He went through a nipple twisting phase - and sometimes I didn't trim his nails often enough! Serious suffering!

Of course, it doesn't help that most of my friends have breastfed their baby for two years or more. Though, my defensive brain points out, only one of them exclusively breastfed.

AND attachment parenting is the current thing. Whether you like it or not, there is always a current trend that does influence your behavior, even if you don't realize it. Sometimes you react against it, sometimes it just "coincidentally" coincides with what makes sense/feels best/works for your family, etc. I don't go out of my way to ensure my parenting approach is attachment oriented BUT (I admit grudgingly) the majority of the things we do fall in line with the crunchy attachment parenting zeitgeist: cloth diapering, breastfeeding, making our own baby food, baby wearing, room sharing yada yada yada.

Extended breastfeeding definitely falls into the attachment parenting camp, where it is viciously guarded by Le Leche League badge wearing warriors.

Speaking of Le Leche League, I went to one of their meetings recently. The topic was weaning. I was there to get some perspectives. Qualitative research, if you will. There were two women who dominated the discussion. One was talking about weaning her five year old. The other was talking about how to wean her oldest, as she was tandem nursing her three and one year olds. There's some perspective for you.**

**When I said I don't feel strongly about breastfeeding, I should note that I feel very strongly that I don't want to be either of those two women. Do NOT. Nope. No thank you.

The research on extended breastfeeding isn't very robust. Breastfeeding is great for babies, especially cognitive functions, IQ (which is often measured separately because research babble), and greater disease immunity. The research shows us that these benefits are strongest for babies who have been exclusively breastfed to six months and who have been breastfed for a year. No one is arguing that. Skirting around the statistical jargon and research methodology, basically the benefits after one year are about immunity. The toddler who is breastfeeding gets more antibodies and gets less sick and sick for less time. The other benefits may be there to some degree after a year, but there's not much evidence that supports it. There is some, but the research tends to have some pretty big flaws and it hasn't been reproduced.***

Personally, based on my research and personal experience, weaning is more about the relationship with my son. Much to my husband's chagrin and my mixed feelings of pleasure and guilt, I am my son's most favoritest person in the whole wide world. It's a big responsibility. But I don't think it has much to do with boobs anymore. He mainly likes to nurse to sleep, mostly to go to bed at night. Even then, he's just as happy with a bottle. We nurse several times during the day, but that's almost always me offering it based on our schedule. He doesn't nurse to help self-soothe. A cuddle from mama is all he needs.

Total disclosure: If there is an exposed nipple within his reach, he will latch on because nipple, obviously.

I think I could drop all but the three sleep/night related feedings (going to bed, middle of the night, first thing in the morning) without him even noticing. In fact, he doesn't always ask to nurse first thing in the morning, I just usually want him to because of throbby boobies.

So, here are my lists of the pros and cons to weaning him over this summer. 

Pros related to weaning:

  • Mr. Man wakes up once in the middle of the night to eat and I could totally do without that. 
  • I could finally stop taking that cruddy-tasting prenatal vitamin. 
  • I would have my body back for however short of a time that is before we start trying to reproduce once more. 
  • Will not accidentally get bit on the nipple! 
  • No more pumping!!
  • Getting to skip people judging me for breastfeeding my toddler, who, at 10 1/2 months, is already huge compared to me.

Cons related to weaning:

  • When he's sick, it makes him feel better. 
  • If he wakes up early in the morning, we can bring him to bed with us, I nurse him, and we all get another hour or two of sleep! 
  • I currently eat whatever I want and continue to lose weight. 
  • People judging me for not breastfeeding my toddler.

Basically, I need that magic pony so I can skip the judgment and guilt of either decision.

***For those of you who are interested and/or who want to fight about it, strap on your nerd goggles: The effect size (eta squared or r squared, depending on research design) representing the benefits of extended breastfeeding decline below statistical significance after one year in almost all studies. This is because most of those studies were not designed to measure effects after one year and the initial study grouped babies breastfed for one year or longer together; some studies were reanalyzed later to focus on extended breastfeeding - a big research no no. Studies specifically looking at the benefits of extended breastfeeding are often conducted in third world countries because there are not enough women in industrial countries that breastfeed beyond one year - in both of these populations (babies in third world counties and those in industrialized counties that have extended breastfeeding experience) there are other confounding variables that make comparisons to babies who have breastfed for less time very difficult (meaning there is something different about their mothers' education/health/resources/etc. that may be responsible for any differences found in the babies). Also also, many babies who are breastfed for an extended period of time are actually sick or weak in some way that leads their mothers to breastfeed for longer, which is referred to as reverse causality and is a prime confounding factor in much of this research. Then you toss in family size and birth order and the whole research design becomes so messy that odds ratios have to be interpreted with all these addendums and qualifiers and no one wants to bet their career on these findings but they HAVE VERY STRONG FEELINGS!

No comments: