Hello everyone! Welcome to the second post in our Myths vs Facts series! Today, we will be tackling the tricky topic of when should we start to wean our child off the use of a milk bottle. Read on to find out more!

Myth #2: It is okay for children to use milk bottles at preschool age

Fact #2: Children should stop using the milk bottle from 12 months old

Just to be clear, we are referring to the use of milk bottles for any drinking purposes (e.g. for drinking water, milk, juice). The discussion is not about when we should stop giving milk to children. OK! Let’s move back to the topic!

The American Academy of Pediatrics recommends that children can start to stop the use of a milk bottle for drinking starting from 12 months old. By 18 months old, children should be weaned off the milk bottle. This includes the bedtime bottle that children may rely on to fall asleep.

But why do we need to wean them off the bottle? There are a few reasons.

1. It may limit the ability to develop a mature swallowing pattern

Young babies feed through suckling, which includes a forward-backward tongue movement along with a up-down jaw movement. As they grow, the sucking pattern changes to include vertical tongue movements. By 12 months, babies can suck using more mature up-down tongue movements with less jaw movements. In addition, there should be no (or minimal) tongue protrusion observed. Persistent use of a milk bottle allows continued use of the suckling pattern, instead of a mature swallowing pattern that is required with cup or straw drinking.

2. It may affect your child’s smile

The forward-backward tongue movement associated with suckling (when drinking from a milk bottle) may affect alignment of the front teeth due to the constant pressure exerted. If this occurs after the permanent teeth emerge, the child may require orthodontic treatment such as braces.

3. It may increase risk of tooth decay

Milk contains sugar which stays on the teeth, which could lead to cavities. This could be the case if your child has the habit falling asleep suckling on his bedtime milk bottle and therefore without brushing/cleaning the teeth. Further, our salivary glands produce less saliva at night, which is needed to clear food from the mouth. Therefore, it quite likely the milk may stay coated on the teeth overnight.

4. It may increase risk of ear infections

If left to fall asleep while drinking from a bottle and laying down, milk may flow through to the ear cavity and cause ear infections. And ear infections can be very uncomfortable for anyone. In children, chronic ear infections may also impact on their speech and language development as they pick up less information from their environment auditorily while their hearing is affected.

 

There will be many children who do not have any of these issues despite continuing to use a milk bottle in their preschool years. However, progression on to cup or straw drinking at about 1 year old follows the typical feeding development expected in children, allowing them to develop proper oral motor movement patterns as they grow up. So, why not start?

The longer a child uses a milk bottle, the harder it will be to stop its use. Parents who are transiting from a bottle to a cup or straw should expect that there may be some resistance at the start. After all, it is a change for your child. The transition can be introduced slowly, starting with small amounts of liquid in a cup with adult supervision to let your child learn to drink from the cup. Get fun, colourful cups to capture your child’s interest (perhaps a cup with your child’s favourite cartoon character?). Also, bottles can be replaced slowly, starting with the midday bottle. Let your child have time to get used to the changes.

Remember to praise your child as he/she achieves milestones! Be patient and persist!

Cheers! *clink*

References

https://www.aap.org/en-us/about-the-aap/aap-press-room/aap-press-room-media-center/Pages/Weaning-from-the-Bottle.aspx

http://www.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/feeding_guide_for_the_first_year_90,P02209/

http://www.webmd.com/parenting/baby/features/bottle-to-cup

McMillan, J. A., Feigin, R. D., DeAngelis, C., & Jones, M. D. (Eds.). (2006). Oski’s pediatrics: principles & practice. Lippincott Williams & Wilkins.

Winstock, A. (2005). Eating & Drinking difficulties in children: A guide for practitioners. Speechmark, 2005.