For an infant, at what age should we replace the bottle with a cup, and how?

Question

The baby is 1.5 months old.

She is currently being bottle fed.
At what age should we replace the bottle with a cup, and how should we go ahead introducing the change?

Answer 1

The American Academy of Pediatricians recommends stopping bottle useage at age 1. Many pediatricians recommend making the switch away from the bottle by 15 months. Others set the limit at 18 months. A few say the switch is not necessary until 2. The concerns with extended bottle feeding are:

• Children who were still bottle feeding at age 2 were more likely to be obese later in life. See the source for more details.
• Bottle feeding often throughout the day and especially at night can cause an increased risk for tooth decay.
• Bottle feeding late in toddlerhood can cause speech issues or tooth deformation issues the same way that pacifier usage in late toddlerhood can.
• Studies show that drinking too much cow's milk, which is often what toddlers are drinking from a bottle, can interfe with iron absorption and cause children to eat too little from other food groups. Around 16 oz. is the pediatrician recommended amount of cow's milk for a toddler daily.

While a few parents go directly from a bottle to a sturdy, open tumbler, most parents use a sippy cup or a straw cup as a transitional cup. The straw cup is considered superior for oral motor development. The choice is entirely up to you. Our pediatric dentist did recommend not using a sippy cup for too long as the sippy cup is not helpful for oral motor skills or teeth.

Usually a cup of water is introduced at mealtimes when solid foods are introduced. This cup is more for practice than for hydration. There are usually three methods of making the final transition for toddlers over 12 months of age.

1. Eliminate one bottle at a time - for the morning bottle simply move breakfast earlier. For the bedtime bottle, if you still have one, replace it with extra snuggles or another comfort method. Drop one bottle a week to ease the transition, but do not go back once you have dropped a bottle.

2. Cold turkey - simply stop offering the bottle and replace it with a cup of milk at mealtimes. This may cause some frustration for your toddler for a few days, but many toddlers make the switch easily after this point. Transitioning to a sippy cup with a soft silicon spoud such as the Nuk Learner Cup or the Nuby Soft Spout cups can help ease the transition because they mimic the bottle nipple fairly well.

3. Wait it out - wait until your child allows you to replace the bottle feedings with meals and milk at meals. This method is often what leads to longer bottle feeding, but for families who are unwilling to endure the crankiness of a cold turkey transition it is basically the only other option. Again you can encourage use of an easy transitional cup here to try to speed the transition.

Sites like the very pro-breastfeeding kellymom.com also provide alternatives to the bottle for infants under 1 year of age. For example they recommend cup feeding using a cup such as the Foley cup. This resource also talks about teaching a special needs child how to use a straw cup and gives you all sorts of resources on straw cup useage. So should you desire to move away from the bottle in the 4 to 6 month range, it is possible though not necessary.

Answer 2

Rather than an age, I'd watch for when she can manipulate a toy well with one hand. By 'well' I mean she can control its orientation and position with enough accuracy that water/milk won't spill everywhere. Once she can do that, just give her a small cup about 1/4 filled to start with; she should get the hang of it within a few weeks.

I believe that we started my son around 12 months old, though we could have done it sooner.