Keywords
Infant
breastfeeding
Lactation
Postpartum Period
Categories
How to Cite
Abstract
Objective: to describe the weaning process, its classification, and associated factors.
Materials and methods: a search was conducted in the scientific databases PubMed, LILACS, Scopus, and SciELO, identifying 346 publications. After removing duplicates, 204 articles were obtained, of which 23 were selected for in-depth analysis.
Results: weaning time varies according to several sociocultural factors, with the appropriate age being around 2 years. Multiple factors are associated with weaning, such as perceived low milk production, breastfeeding difficulties related to the mother or infant, and return to work, among others. Weaning types can be classified as: natural weaning, infant-led weaning, mother-directed weaning, partial nighttime/daytime weaning, progressive complete weaning, emergency or imposed weaning, special needs weaning, and bereavement weaning. Multiple changes in the mammary gland and milk composition are described during the weaning process, which act as a protective factor associated with natural weaning lasting longer than one year. Practices for clinical management, including physical and pharmacological measures, are recommended.
Conclusion: there is no consensus among authors regarding the classification of weaning. The role of the midwife and the healthcare team is fundamental in maternal education and support to ensure a successful process.
References
1. Organización Mundial de la Salud; UNICEF. Estrategia mundial para la alimentación del lactante y del niño pequeño. Ginebra: Organización Mundial de la Salud; 2003. Disponible en: https://iris.who.int/handle/10665/42730
2. Comité de Lactancia Materna de la Asociación Española de Pediatría. Recomendaciones sobre lactancia materna [Internet]. Madrid: Asociación Española de Pediatría; 2012 [citado 15 nov 2021]. Disponible en: https://www.aeped.es/sites/default/files/201202-recomendaciones-lactancia-materna.pdf
3. Organización Mundial de la Salud. Lactancia materna exclusiva [Internet]. Ginebra: OMS; 2013 [citado 29 mar 2022]. Disponible en: https://apps.who.int/nutrition/topics/exclusive_breastfeeding/es/index.html
4. Greiner T. The concept of weaning: definitions and their implications. J Hum Lact. 1996;12[2]:123-8. doi: 10.1177/089033449601200216. Erratum in: J Hum Lact. 1996;12[3]:220.
5. Dettwyler KA. When to wean: biological versus cultural perspectives. Clin Obstet Gynecol. 2004;47[3]:712-23. doi: 10.1097/01.grf.0000137217.97573.01.
6. Grueger B; Canadian Paediatric Society, Community Paediatrics Committee. Weaning from the breast. Paediatr Child Health. 2013;18[4]:210-1. doi: 10.1093/pch/18.4.210.
7. Biblioteca del Congreso Nacional de Chile. Ley 21155: Establece medidas de protección a la lactancia materna y su ejercicio [Internet]. Valparaíso: BCN; 2019 [citado 29 mar 2022]. Disponible en: https://www.bcn.cl/leychile/navegar?idNorma=1138165
8. Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical professional. 7a ed. Filadelfia: Saunders; 2010. p. 319-320.
9. Padró A. Destete: Final de una etapa. Barcelona: Grijalbo; 2021. p. 44-105.
10. Brown CR, Dodds L, Legge A, Bryanton J, Semenic S. Factors influencing the reasons why mothers stop breastfeeding. Can J Public Health. 2014;105[3]:e179-85. doi: 10.17269/cjph.105.4244.
11. Mikami FCF, Francisco RPV, Rodrigues A, Hernandez WR, Zugaib M, de Lourdes Brizot M. Breastfeeding twins: factors related to weaning. J Hum Lact. 2018;34[4]:749-59. doi: 10.1177/0890334418767382.
12. Bica OC, Giugliani ER. Influence of counseling sessions on the prevalence of breastfeeding in the first year of life: a randomized clinical trial with adolescent mothers and grandmothers. Birth. 2014;41[1]:39-45. doi: 10.1111/birt.12097.
13. Hanley L. Medication use during lactation: either a potential contributor to premature weaning or evidence-based support of the mother/child couplet. Clin Ther. 2020;42[3]:393-400. doi: 10.1016/j.clinthera.2020.01.019.
14. Acosta DV, Lugo Rodriguez G, Domenech MG, Vera de Molinas Z, Maidana de Larrosa G, Samaniego Silva L. Interrupción de la lactancia materna relacionada con el consumo de medicamentos. Ars Pharm. 2020;61[2]:97-103. doi: 10.30827/ars.v61i2.13627.
15. Martins FA, Ramalho AA, Andrade AM de, Opitz SP, Koifman RJ, Silva IF da. Padrões de amamentação e fatores associados ao desmame precoce na Amazônia ocidental. Rev Saude Publica. 2021;55:21. doi: 10.11606/s1518-8787.2021055002705.
16. Moraes GGW de, Christoffel MM, Toso BRG de O, Viera CS. Association between duration of exclusive breastfeeding and nursing mothers’ self-efficacy for breastfeeding. Rev Esc Enferm USP. 2021;55:e03702. doi: 10.1590/1980-220X-REEUSP-2020-0382.
17. Santos VL, Holand BL, Drehmer M, Bosa VL. Sociodemographic and obstetric factors associated with the interruption of breastfeeding within 45 days postpartum - Maternar Cohort Study. Rev Bras Saude Mater Infant. 2021;21[2]:575-86. doi: 10.1590/1806-93042021000200014.
18. Warr DL. After the loss of an infant: suppression of breast milk supply. Neonatal Netw. 2019;38[4]:226-8. doi: 10.1891/0730-0832.38.4.226.
19. Hassiotou F, Geddes D. Anatomy of the human mammary gland: current status of knowledge. Clin Anat. 2013;26[1]:29-48. doi: 10.1002/ca.22165.
20. Silanikove N. Natural and abrupt involution of the mammary gland affects differently the metabolic and health consequences of weaning. Life Sci. 2014;102[1]:10-5. doi: 10.1016/j.lfs.2014.02.034.
21. Zhang A, Kim HK, Acero-Bedoya S, Trimboli A, Stover DG, Ludwig T, et al. Abrupt involution induces inflammation, estrogenic signaling, and hyperplasia linking lack of breastfeeding with increased risk of breast cancer. Breast Cancer Res. 2019;21[1]:80. doi: 10.1186/s13058-019-1163-7.
22. Jindal S, Narasimhan J, Borges VF, Schedin P. Characterization of weaning-induced breast involution in women: implications for young women's breast cancer. NPJ Breast Cancer. 2020;6:55. doi: 10.1038/s41523-020-00196-3.
23. Verd S, Ginovart G, Calvo J, Ponce-Taylor J, Gaya A. Variation in the Protein Composition of Human Milk during Extended Lactation: A Narrative Review. Nutrients. 2018;10[8]:1124. doi: 10.3390/nu10081124.
24. Czosnykowska-Łukacka M, Orczyk-Pawiłowicz M, Broers B, Królak-Olejnik B. Lactoferrin in Human Milk of Prolonged Lactation. Nutrients. 2019;11[10]:2350. doi: 10.3390/nu11102350.
25. Agostoni C, Marangoni F, Lammardo AM, Giovannini M, Riva E, Galli C. Breastfeeding duration, milk fat composition and developmental indices at 1 year of life among breastfed infants. Prostaglandins Leukot Essent Fatty Acids. 2001;64[2]:105-9. doi: 10.1054/plef.2001.0248.
26. Neighbors KA, Gillespie B, Schwartz K, Foxman B. Weaning practices among breastfeeding women who weaned prior to six months postpartum. J Hum Lact. 2003;19[4]:374-80. doi: 10.1177/0890334403257803.
27. Yang Y, Boucoiran I, Tulloch KJ, Poliquin V. Is Cabergoline Safe and Effective for Postpartum Lactation Inhibition? A Systematic Review. Int J Womens Health. 2020;12:159-170. doi: 10.2147/IJWH.S232693.
28. Tulloch KJ, Dodin P, Tremblay-Racine F, Elwood C, Money D, Boucoiran I. Cabergoline: a review of its use in the inhibition of lactation for women living with HIV. J Int AIDS Soc. 2019;22[6]:e25322. doi: 10.1002/jia2.25322.
29. Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. doi: 10.1016/S0140-6736[15]01024-7.
30. Jacobsen N. Antenatal Breastfeeding Education and Support: Summary and Analysis of 2 Cochrane Publications. J Perinat Neonatal Nurs. 2018;32[2]:144-152. doi: 10.1097/JPN.0000000000000323.
31. Health Canada. Breastfeeding duration of exclusive breastfeeding in Canada: key statistics and graphics (2009-2010) [Internet]. Ottawa: Health Canada; 2012 [citado 4 nov 2013]. Disponible en: http://www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/prenatal/exclusive-exclusif-eng.php
32. Hunegnaw MT, Gelaye KA, Ali MB. Factors associated with time to cessation of breastfeeding among mothers who have index children aged two to three years in Debre Markos, northwest Ethiopia: a retrospective follow-up study. BMC Pediatr. 2018;18[1]:77. doi: 10.1186/s12887-018-1060-6.
33. Huang P, Yao J, Liu X, Luo B. Individualized intervention to improve rates of exclusive breastfeeding: A randomised controlled trial. Medicine (Baltimore). 2019;98[47]:e17822. doi: 10.1097/MD.0000000000017822.
34. Oflu A. Weaning Practices of Turkish Mothers: A Mixed-Model Research. Breastfeed Med. 2020;15[2]:109-113. doi: 10.1089/bfm.2019.0262.
35. Miller MP, Commons ML. The Benefits of Attachment Parenting for Infants and Children: A Behavioral Developmental View. Behav Dev Bull. 2010;16[1]:1–14.
36. Gürarslan Baş N, Karatay G, Arikan D. Weaning practices of mothers in eastern Turkey. J Pediatr (Rio J). 2018;94[5]:498-503. doi: 10.1016/j.jped.2017.06.019.
37. Piwoz EG, Huffman SL, Lusk D, et al. Issues, risks and challenges of early breastfeeding cessation to reduce postnatal transmission of HIV in Africa. Washington, DC: Academy for Educational Development; 2001.
38. Dinc A, Dombaz CI, Dinc D. Traditional practices related to breast milk and breastfeeding of mothers with infants aged 6-18 months. Balikesir Health Sciences Journal. 2015;4[3]:125–130.
39. Kearns AN, Castro MC, Lourenço BH, Augusto RA. Factors Associated with Age at Breastfeeding Cessation in Amazonian Infants: Applying a Proximal-Distal Framework. Matern Child Health J. 2016;20[7]:1539-48. doi: 10.1007/s10995-016-1954-x.
40. Carroll K, Noble-Carr D, Sweeney L, Waldby C. The "Lactation After Infant Death (AID) Framework": A Guide for Online Health Information Provision About Lactation After Stillbirth and Infant Death. J Hum Lact. 2020;36[3]:480-491. doi: 10.1177/0890334420926946.
41. Welborn JM. The experience of expressing and donating breast milk following a perinatal loss. J Hum Lact. 2012;28[4]:506-10. doi: 10.1177/0890334412455459.
42. Revista Matronas. La lactancia materna como factor protector del cáncer de mama: una revisión bibliográfica [Internet]. Enfermería21; 2018 [citado 13 mar 2022]. Disponible en: https://www.enfermeria21.com/revistas/matronas/article/110/la-lactancia-materna-como-factor-protector-del-cancer-de-mama-una-revision-bibliografica/
43. Anstey EH, Shoemaker ML, Barrera CM, O'Neil ME, Verma AB, Holman DM. Breastfeeding and Breast Cancer Risk Reduction: Implications for Black Mothers. Am J Prev Med. 2017;53(3S1):S40-S46. doi: 10.1016/j.amepre.2017.04.024.
44. Schedin P. Pregnancy-associated breast cancer and metastasis. Nat Rev Cancer. 2006;6[4]:281-91. doi: 10.1038/nrc1839.
45. Borges VF, Lyons TR, Germain D, Schedin P. Postpartum Involution and Cancer: An Opportunity for Targeted Breast Cancer Prevention and Treatments? Cancer Res. 2020;80[9]:1790-1798. doi: 10.1158/0008-5472.CAN-19-3448.
46. Borges VF, Schedin PJ. Pregnancy-associated breast cancer: an entity needing refinement of the definition. Cancer. 2012;118[13]:3226-8. doi: 10.1002/cncr.26643.
47. Williamson I, Leeming D, Lyttle S, Johnson S. 'It should be the most natural thing in the world': exploring first-time mothers' breastfeeding difficulties in the UK using audio-diaries and interviews. Matern Child Nutr. 2012;8[4]:434-47. doi: 10.1111/j.1740-8709.2011.00328.x.
48. Lucchini Raies C, Márquez Doren F, Rivera Martínez MS. Yo quiero amamantar a mi hijo: Develando la experiencia de mujeres que enfrentaron dificultades en su proceso de lactancia. Rev Chil Pediatr. 2017;88[5]:622-628. doi: 10.4067/S0370-41062017000500008.
49. Cortés-Rúa L, Díaz-Grávalos GJ. Interrupción temprana de la lactancia materna. Un estudio cualitativo. Enferm Clin. 2019;29[4]:207-215. doi: 10.1016/j.enfcli.2018.11.003.
50. Prieto-Gómez R, Saavedra-Sepúlveda A, Alvear-Aguirre G, Lazo-Millar L, Soto-Acuña A. Lactancia materna no exitosa, percepción de los profesionales de la salud: estudio de casos, IX Región, Chile. Rev Colomb Obstet Ginecol [Internet]. 2019 [citado 15 mar 2022];70[4]:219-227. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S00347434201900040021&lng=en
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2026 Mariela Marisela Sáez Yefilaf, Araceli Saavedra-Sepúlveda, Claudia Fernández-Rivera, Gloria Marín-Cortés, Daniela Sepúlveda-Romero, Ruth Prieto-Gómez