Ideally, when to wean is a decision that you and your baby make together. Realistically, as many moms head back to work, this may be hard to do.
If you have been told to wean because of a medication you are taking or because of an illness, pregnancy, or surgery, make sure you check this out first. There's a bunch of bad information out there about medication and lots of unnecessary weaning taking place. And if you are weaning because you've been told that breastmilk has no benefits after a certain time, just keep nursing. No formula has come close to breastmilk, despite what they advertise, and there is no cow out there making better milk for your child than you are.
Weaning is almost always accompanied by some guilt and regret. I hope all of you know that I am really impressed with all the work that you put into nursing. I have helped some of you through very difficult starts to breastfeeding and I'm continually amazed at the motivation that you have to continue to breastfeed through very difficult circumstances.
Kids who are ready to wean are distractible, spend less time during feedings and may be more interested in solid foods. If we let the baby lead in weaning, we wait until they decide they want to nurse, without initiating or refusing to nurse. That way, the baby can cut back on the amount of feedings.
More likely, it's mom who wants, or needs, to wean. There are many ways to do this. The most common involves cutting back on one feeding every 3 days or so. The feeding should be replaced with lots of cuddling and close contact and if the baby reacts poorly (they may do things to get more attention) then we should slow down the process. And it's nice to try to replace the "work" feedings first, meaning, eliminate the feedings where you will be working or away from the baby first, and leave the nighttime and first morning feedings for last. In fact, you can keep those feedings for months after you eliminate the other ones. This doesn't have to be an all -or -nothing process.
If your breasts get uncomfortable, then pump just enough to relieve the pain. Staying full tells your body to make less milk. Staying too full however can lead to infection. Weaning too quickly can lead to mastitis and plugged ducts. You can use ice packs, tylenol, and ibuprofen just as we did during the early days of engorgement. Never do any breast binding-- that still shows up as as a way to stop milk production in some older references. It can lead to all sorts of bad things!
We should wean the baby to formula if they are under one year of age, and to cow's milk if they are over a year. I don't care which formula or which kind of milk. They can be weaned right to a cup or a container with a straw if they are over 6 months or so.
There are a few things for mom to be aware of. You may need to cut back on the calories you consume now in order to avoid gaining weight. You may have milk secretion for several months after you are finished weaning. Your period should start coming back, if it hasn't already, and it may be a bit irregular for awhile.
The guilt that comes with weaning is natural. Be kind to yourself. Your child didn't ask you to be perfect. Being the best you can be as a parent is enough. Whatever length of time you spent breastfeeding is a time for celebration. Do something nice for yourself. Seriously.