February is Children's Dental Health Month. Here at Ready. Set. Food!, we want to help parents start baby’s dental health off strong.
Weaning baby off of the bottle at the right time, and helping them move to a cup, is vital for good dental health. This is because drinking from the bottle too long can increase your little one's risk for tooth decay.
Learn when you should wean your child off the bottle, and tips for convincing them to part with the bottle.
When to wean baby off the bottle?
Most pediatricians, experts and parents agree --- you should stop giving baby a bottle when they're between 12 and 18 months old.
Many dentists recommend bottle weaning at the early end of that range --- 12 months, or as close to 12 months as possible. That's consistent with what the American Dental Association (ADA) and American Academy of Pediatric Dentistry (AAPD) recommend.
For formula-fed babies, this 12-month timing means weaning off the bottle as --- or right after --- you move them from formula to cow's milk.
The earlier you wean off the bottle and move to a cup, the better. That's because the older they get, the less inclined baby usually is to give the bottle up.
Why is timely bottle weaning important?
Timely bottle weaning is one way to help keep baby's teeth healthy and strong.
Your little one's teeth are vulnerable to decay and cavities as soon as they come in.
And when your little one drinks formula or cow's milk from a bottle for a long period of time, the sugars that cause decay can settle on their teeth more easily and harm the teeth.
That's why cavities in very young children are often called "baby bottle tooth decay."
In baby's first year, you're fully in control of the bottle. It only comes out for feeds, and your baby can't move away with it.
But going into their second year, your little one is a lot more mobile. There's the risk that they'll start grabbing the bottle and drinking it throughout the day --- meaning more frequent exposure to the sugars.
Moving to a cup can help lessen the impact of these sugars on the teeth.
As the American Dental Association reports, "One of the risk factors for… baby bottle tooth decay is frequent and prolonged exposure of a baby’s teeth to liquids containing sugar --- including milk, formula and fruit juice. Because decay can destroy the teeth of an infant or young child, parents should encourage their children to drink from a cup by their first birthday."
Plus, there's another important reason to say goodbye to the bottle early in your child's second year. If your little one fills up on formula or milk from a bottle, they won't have an appetite for those important, healthy solids. Your little one needs to transition to eating all solids at some point in their second year. That's a lot harder when they are attached to a bottle!
How to introduce a cup?
You can actually introduce a cup earlier than you might think --- as early as 6 months of age. This early cup intro may make the bottle weaning process easier later on.
Before you start offering a cup, make sure:
- Baby is at least 6 months old, the age they can start having water
- Baby can sit upright on their own
- Baby is eating solids
- Baby can grasp the cup
Then, choose the right cup to introduce.
You may choose to start with a sippy cup. To protect the teeth, though, not just any sippy cup will do.
- As the American Dental Association warns, Avoid "no-spill cups" with valves. Baby can still suck drinks out of these, so they're no better than bottles.
- Instead, you want a training cup that requires baby to tilt and sip, just like an "adult" cup requires.
- Choose a cup that has a spout, attached to a snap-on or screw-on lid.
- Pick a sippy cup with two handles. A two-handled sippy cup helps baby get used to holding a cup with two hands. They'll need to use two hands to drink from an "adult" cup.
- A weighted bottom may help stop spills, eliminating the need for a valve.
- Make sure baby is sipping, not trying to suck. If baby tries to suck on a hard plastic spout meant for sipping, this could put them at risk for speech problems, an overbite, or an underbite.
Alternatively, you could choose to introduce a regular cup and skip the sippy cup altogether. This might take more time for your little one to get used to, but the results are well worth it.
Introducing the cup before age one doesn't mean giving up the bottle completely. (Baby still needs to drink mostly formula or breastmilk in their first year.)
Instead, this gets baby used to the cup first.
This way, when it's time to wave goodbye to the bottle for good, they'll already know how to use the cup.
- Let baby play with the cup first, before you fill it.
- Offer a little bit of water in the cup, so you don't waste formula or breastmilk.
- Offer the cup when giving solids, so baby gets used to the idea that the cup comes at meals.
- Always supervise your little one when they use a cup.
- Teach your little one how to hold the cup still and tilt without spilling.
- You could also try having baby drink from the cup while sitting in the bathtub, to reduce the mess of spilling.
By a year old, most babies will have the coordination to hold and sip from a cup.
Stopping the bottle feeds
After baby's first birthday, it's time to think about weaning baby off of the bottle completely.
Your little one needs to learn that drinks now come with meals --- drinks aren't going to be full meals anymore, as meals are now mostly solids.
You could immediately eliminate all bottles and only offer drinks in a cup. But going "cold turkey" is often harder.
Many parents find it easier to wean their little one off the bottle more gradually:
- Get rid of the bottle feeds one at a time. Replace each feed with a cup of cow's milk at the table or in the high chair (preferably, right before or right after solids).
- Often, the mid-day bottle is easiest to get rid of first.
- Get rid of one bottle feed every 2-3 days to every week, and replace it with a cup.
- The night bottle should be the last bottle you get rid of. This bottle is the most difficult to get rid of, as it is often very soothing before bed.
- When getting rid of the night bottle, offer a cup of milk at dinner, then move to the rest of the night routine.
- Never offer milk after brushing baby's teeth at night.
- Use other kinds of comfort instead of the bottle, like stories, songs, or snuggling.
You can also do a gradual weaning where you dilute cow's milk in a bottle with water.
- Replace more milk with water every few days.
- Meanwhile, offer undiluted milk in a cup at another point in the day. This may lead your child to ask for the "better" milk in the cup, and drop the bottle.
Ready to wean baby off of formula? Doing this at the same time as you're bottle weaning is a great strategy. Replacing bottles of formula with the cups of cow's milk shows your little one that the cow's milk always comes from a cup, not the bottle.
And if you’re not quite ready to transition off formula yet, it’s perfectly fine to offer formula in a cup – and better to do so after age one vs. sticking to the bottle.
Tips for the cup transition
How to encourage a successful transition from the bottle to a cup? Use these tips:
- Explain to your little one that they are a big boy or big girl who doesn't need bottles anymore. You might also tell them it's time to give the bottles to a baby who needs them.
- Praise your little one when they drink from the cup: "You're a big boy/girl, drinking from the cup!" Or "You're drinking from the cup, just like mommy/daddy!"
- Out of sight, out of mind --- hide or throw away the bottles, and put fun-looking cups out where your child can see.
- You can even help your little one collect the bottles in a bag or box (to pack away, throw away, or donate.) In exchange, give them a new toy or a special trip to a place they enjoy.
- Let your child choose their new cups at the store.
- Throw a little "party" with your child at home --- complete with party hats, balloons, streamers, and fun music --- to celebrate growing out of the bottle.
- Offer plenty of healthy meals and snacks. A big part of the bottle transition is moving to a point where most of your little one's calories come from solids.
- If your child forgets about the bottle at some point during weaning, awesome! Time to cut off the bottle for good --- they've shown you they don't need it.
- If your little one still asks for the bottle, figure out what they actually want or need. They might want comfort or playtime, not food. And if they really are hungry, offer the cup and/or solids.
- Be patient and persistent. Once you've started weaning, never offer the bottle when baby cries for it.
And to keep baby healthy and safe:
- Never offer juice. Stick to water and milk, as these are the healthiest drinks. Juice is very sugary.
- The only time you should offer milk is at meals and snacks. (This cuts down on the time the milk can sit on your little one's teeth. As the ADA explains, that's because "saliva production increases during a meal," which helps "rinse" out the mouth.)
- If your little one wants a drink at another time, only offer a cup of water.
- Never let your little one go to sleep with a bottle or sippy cup. After they have their teeth brushed at night, the only drink they should have is water, to prevent sugars sitting on the teeth at night.
- Make sure baby is sitting down to drink from the cup.
- Don't let baby carry the cup around --- if they fall while they drink, this could injure their mouth.
- When they're in the car or stroller, don't let them sip milk from the cup at will. Only let them have a cup if it contains water.
Moving from sippy cup to regular cup
If you started with a sippy cup, remember that the sippy cup is a transitional tool. It's meant to teach skills needed for drinking from a regular, "adult" cup.
Your little one should move on to drinking from a regular cup, and stop using sippy cups, by two years of age.
When your little one has mastered sipping, wean off the sippy cup immediately or gradually, just like you did with the bottle.
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