Thursday, January 24, 2008

Getting Off the Bottle

A friend of mine is having trouble convincing her husband that their almost two-year-old little boy needs to stop taking a bottle.

Here's some information she found on the issue from On Call:

Dr. Claire McCarthy said:

"You should get him off the bottle. Children don't need much milk at this age. Before a year, breast milk or formula provides the bulk of their nutrition, even as they start expanding their diet. But after a year, kids should be eating a variety of other foods, and milk becomes less important (in fact, filling up on milk can sometimes prevent them from eating other healthy foods).

Nutritionally, milk is important for its protein and calcium, but your child can get calcium from yogurt and cheese, and in vegetables such as broccoli, kale, collards, and mustard greens. Protein is available in other dairy products, meat, fish, beans, and grains. Milk is fortified with vitamin D, but 16 ounces a day is enough to meet a child's needs, and many other dairy products as well as cereals are supplemented with it.

My youngest child, Natasha, was breastfed exclusively and never made the transition to cow's milk — she simply doesn't like the taste. Now, at age 3, she'll take a sip here and there, but it adds up to a total of maybe eight ounces a month. So we push other dairy products instead, making sure she gets enough protein, along with calcium-fortified orange juice (which she loves), and daily multivitamins. She's a thoroughly healthy little girl.

Like most people who grew up being told to drink their milk, I certainly thought of it as something positive — and it is. But as a pediatrician I've seen how too much of a good thing isn't always a good thing. Being on the bottle too long, especially when a child is allowed to sleep with it, can lead to rotting teeth. Also, kids who drink large amounts of milk may end up with anemia or constipation due to the direct effects of excess milk, and also because it can replace iron-rich protein foods, vegetables, and other roughage."~Dr. Claire McCarthy

Here's some advice I found on a mommy blog:

"Have you tried giving him a drinking cup instead? If you don't have any then tell him that "he is a big boy now and bottles are for babies" then take him to the store and ask him to choose his drinking cup. You want to get him involved because when you come back home he is going to help you throw out the old bottles. "

"My daughter was very attached to her bottle at night too. I tried sippy cups but the flow was always too fast. Then I found this one at Wal-mart : Grip n Sip, the cost at Wal-mart where I am is 97 cent. It has a no drip stopper that prevents it from flowing out freely. So if she's laying down it's not going to choke her. The liquid has to be sucked out."

Here are tips on weaning off bottle feeding from Revolution Health:

  • Do not allow a toddler to carry the bottle around.
  • Help transfer the toddler's attachment from the bottle to another comfort object like a stuffed animal, blanket or doll. For example, tie an empty bottle securely around the neck of a favorite stuffed animal or other comfort object, then remove the bottle once your toddler thinks of the new object as the source of comfort.
  • Make changes in the toddler's routine, especially the rituals that are connected to bottle-feeding. For example, after a fall, comfort your toddler with hugs and attention rather than the bottle.
  • Keep the toddler busy with new activities.
  • Make a cup part of weaning.

-NewsAnchorMom Jen


Maria said...

Well, I hate to say this, but I can only assume your friend is trying to take the bottle of formula away from her son. Because of that, I am slightly disappointed in the doctor's answer. Also, I'd encourage your readers to click the link to read the doctor's response, as the full response on the webpage is presented slightly differently than your quotes. The Doctor encourages snuggles and other comfort in place of the bottle-- not just harshly taking it away.

My own search for information on the topic of tooth decay (because I still night nurse my son) lead to, where I found the following:
"Up until recently, the only studies that had been done were on the effects of lactose (milk sugar, which breastmilk does contain) on teeth, not the effects of *complete* breastmilk with all its components. Breastmilk also contains lactoferrin, a component in breastmilk that actually kills strep mutans (the bacteria that causes tooth decay). According to a recent article in the March/April 1999 issue of Pediatric Dentistry, "It is concluded that human breast milk is not cariogenic."" (

Furthermore, I hope the doctor was mostly referring to formula and cow's milk in her response, as I think her response would encourage women to wean their nursing child because "milk becomes less important" and the child can have his nutritional needs met by other dairy products. As a nursing mother who is delaying the introduction of cow's milk (and probably going to skip it all together), I found the advice to be somewhat misleading.

If you are going to cut back on the milk the child drinks, why push other dairy products? Why, if milk is less important, not push other foods besides dairy products?

Sorry, my comment is all over, but I was trying to cover a lot in as little space as possible! said...

I, too, am a nursing mom. I have been thinking about how and when to wean my baby. I am hoping he will just slow down and stop on his own. That is what many of my friends' children did. I haven't heard anything that shows tooth decay from breastmilk either. I will ask my mom, who is a lactation consultant in St. Louis.

Great comment and great issue!

Maria said...

I am hoping for child lead weaning too, and since The Boy has turned one (he's 13 months now), I have noticed that he nurses less, but if he asks, I don't deny (he signs some), and I am careful how much I offer, because I do want him to eat a variety of foods. That being said, I don't see us stopping any time soon.

Back on the dairy issue-- I just don't see a reason to push any cow's milk in the diet. All the nutrients and vitamins can be found in other foods, but that is what works for us. We nurse and offer a variety of foods. Everyone needs to do what works for them (of course).

Knight in Dragonland said...

I'm sorry, call me heartless and cruel, but I just don't think any child is going to be permanently scarred if you take their bottle / pacifier away at age two. Just throw them away! Will there be wailing and gnashing of teeth? Of course! Deal with it. It's part of being a parent ... you can't be the good guy all the time.

The bottle and/or pacifier should have been tossed out at 12 months. The "crisis" would have been a lot easier to deal with then.

Maria said...

Why "should" it have been? Most of the research I have found indicates that at 12 months approximately 25% of a child's calories/nutrition should come from solids-- the rest from milk (I only looked in to breast milk, because it is what is relevent to me).

A child that hits 12 months doesn't "magically" become ready to eat 100% solids, and who is to say that a child shouldn't continue to gradually get rid of that bottle instead of just one day not having it.

My son bucked his own bottle recently and takes his milk "from the tap" or in a sippy. He did it on his own, because he is ready, but not all children develop at the same rate. Therefore, a blanket statement about what a parent "should" have done at 12 months really is uninformed and inapplicable to the situation.

I wouldn't say you're heartless or cruel. You did/do what works (or worked) for you, but I don't think that makes it something that "should" be done.

Shannon Sandoval said...

I think there are two separate issues here...

Is it the bottle or what's in the bottle that we're talking about weaning off of?

I think the doctor in the article does a pretty good job of explaining why cow's milk isn't as "necessary" as conventional wisdom leads us to believe. I was kind of surprised to see it, actually. I didn't learn much about milk until after I started having children and noticing problems they had that were directly related to cow's milk. (From me drinking it since they never had formula).

If the issue is the bottle itself, I personally think there are gentler ways than cold turkey to accomplish that. But I do advocate for parents doing what feels best for them and their children and maybe cold turkey (or the bottle fairy making a visit to the house?) would work best. Honestly it's not something I've faced with any of my children - they all had minimal bottles anyway (actually my youngest never had even one bottle of anything) and happily transitioned to sippy cups before they were 1.

Knight in Dragonland said...

Cow's milk can be a great source of protein and calcium as part of a healthy diet. Too much of any one food is not healthy. I've seen dozens of kids who had iron deficiency anemia because they drank milk all day and wouldn't consume any other sources of protein. 2-3 cups per day is plenty. If you find other sources of calcium and protein for your child, fine.

I'm not stating that milk needs to go away at 12 months ... just the bottle. Continued use of a bottle or pacifier into the 2nd and 3rd year can lead to deformation of the teeth, tooth decay and increased ear infections. No, you don't need to snatch them away at 12:01 on the kid's first birthday, but transitioning to a cup should be done at around 12 months. The longer you wait, the more resistance you're going to meet.

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