We get a lot of questions. And this particular one has been coming up over and over again.
How do you successfully transition from breast or bottle to cup?
We asked our colleague and friend, Lisa Aquilino Haley, Occupational Therapist, to enlighten us.
Lisa Aquilino Haley has 15 years of pediatric occupational therapy experience. Her expertise shines through in feeding issues. She conducts videofluoroscopic swallowing studies and is a facilitator of an out-patient feeding program, supporting picky eaters and challenging feeders in an interdisciplinary setting. She has a special interest in transitioning children from tube feeds to oral feeds.
Can’t we just use a sippy cup?
Transitioning babies off of their bottle or sippy cup and onto an open cup can often feel like a daunting task! Spilling, spluttering and the mess that will ensue can make moms and dads really nervous about moving to this new stage. Isn’t it just better to keep them going on their nice, safe, spill-proof cup? While convenience plays a big part in choosing to move forward or not, from a skill-building and developmental perspective, sticking with that sippy cup may not be promoting adequate development of oral motor skills, and here’s why.
When babies drink from a bottle or spouted sippy cup, they are maintaining that same pattern of tongue movement – forward and backward pushing and pulling in and out of their tongue. While effective for bottle and spout drinking, sticking here does not develop more mature muscles and patterns of movement for eating and drinking. Other reasons to step away from the sippy cup include dental concerns, the ability for them to walk around while drinking (never a good idea), and the constant access to it throughout the day (hello not being hungry for dinner!).
So when should you start your patients on an open cup?
Practicing drinking from a small cup as early as 6 months old, (and sometimes even younger) as soon as their trunk and head control is appropriate, enables the baby to practice over time. Once they are transitioning off their bottle to obtain most of their liquid from a cup or straw, they will at least have had several months of exposure and skill development.
So how do we do it?
First step is to find an appropriately sized cup for baby’s mouth and hands. Imagine you tried drinking from a bucket – it would likely dump all over your head (gratuitous picture of my own daughter dumping water onto herself below). That’s what these kids feel with an adult glass – like a dumping of water into their mouths.
A small cup lets them seal their lips and the corners of their lips to the edge of the cup securely. It prevents giant over spilling and flooding into their mouths. It also allows parents to gauge how much to tilt into baby’s mouth. (Have you ever tried having someone help you drink? Seriously! Your anxiety over their ability to control the amount you get will hit the roof!).
What cup should I use?
I love a lot of these commercially available cups, but truly, a shot glass, dixie cup or medicine cup can do the trick! Heck, I’ve even used the plastic cap from an infant bottle in a pinch. If you are looking for commercially available cups, here are a few that I often recommend:
Lisa’s message is loud and clear – get them started on open cup drinking as early as six months or as soon as they’re developmentally ready. Whether you’re using a commercially available cup or a medicine cup, either will do the trick.
Stay tuned for Part 2 – next month, where Lisa will walk us through practical troubleshooting issues to be successful at cup drinking!
Charlene and Julie
P.S. Join our growing Facebook group: Pediatric Dietitians - Newbies to Masters | Facebook
P.P.S. Love what Lisa has to say?! Join our wait list for our next round of our flagship course Infant Nutrition Essentials where she delivers a full module on Feeding Readiness, Safety and Function – An Occupational Therapist’s Perspective.