Monday, January 20, 2014

How to Wean Baby From Bottle



Many of you have asked for this post over the last year or so.  While I have worked on this as an OT with the families I service, I haven't had to as a Momma. My kids avoided the bottle at all costs (they were breast fed for a year), which is a whole separate issue. Needless to say, getting rid of bottles in my house was no biggie.  However, I know all to well that I'm in the minority.  Kicking the bottle habit can be a source of stress for toddlers and their parents.  I'm going to approach this two different ways.  First, for those of you that are being proactive and are reading this before your baby is one year. Next, for those of you that are at your wits end because you didn't realize it would be such a nightmare struggle with your 18 month, 2.5 year, or worse - year old. If you are in the latter situation, read it all because those foundational strategies will still prove useful.



When is it Time to Wean?

The answer is very clear: By one year of age. However, it is reasonable to be working on it until 15 months of age. The most important reason for weaning by age one is tooth decay, if you want to read more about that see the American Dental Association's explanation.  In addition, toddlers should be moving onto more advanced skills like drinking from an open cup and straw, which help to strengthen the muscles for speech development.  


Weaning for Tots Under 16 Months

First things first, you need to introduce some other vehicle to get liquid out of besides a bottle, the earlier you do this the better, from 6 months up. Ideally, to start transitioning from a bottle, begin to offer your child a sippy cup of water when they eat their baby food. The point isn't really to have them drink a lot, it's for practice.  I'm going to give you fair warning that your babe will spit it out, throw it on the floor, and do their best to try to make it leak on their tray.  Unfortunately, this comes with the territory, but don't fret about the mess, before you know it they will be drinking like a pro.  You won't be using a sippy cup long, but these are my favorite from a therapeutic standpoint because babies can easily hold on, they are short (long ones are hard for babies to manage), and they have a hard short spout.  






Also, if your child seems to have trouble getting anything out of the sippy cup, only add a little water and take the valve out (the little plastic thing on the inside of the nozzle that makes the cup "no spill"). After they get the hang of it, you can put the valve back in.

Once they reach 9 months, begin to introduce a straw. Babies are capable of this skill around this time, but if they don't pick it up right away, alternate sippy and straw cups at meals.  Want to know how to make straw drinking happen or what kind of straw cup to use, click here, I have a very detailed post that covers the whole topic.  When they have mastered drinking from a straw, leave the sippy cup behind for good.

9 months is also a good time to start a bedtime routine, if you haven't already. It is important that the routine is more than just bottle feeding. Include a stories or songs. This will be important when you want to take that bottle away.

By this 9 month mark, they will also be beginning to try some table foods.  Meals should start to account for more of their calories and you will see their schedule start to shift a bit as they eat more.  Follow you child's lead and move towards having them drink from a bottle after their meals except for the morning and night time bottles. By 10.5-11 months this should definitely be the case. Take your time and do this one bottle at a time.

In the 10th-11th month, begin to pull back from one bottle during the day and add a snack so that they are getting 4 meals total throughout the day.  Your child should be just about done with baby food, too. If you need more help on that check out my posts on Transitioning Your Baby to Table Foods, Part 1 and Part 2.

At 11.5-12.5 months, all bottles but night and morning should be gone.  Since they aren't allowed to have milk yet, place cold formula in their cups. If you feel they aren't drinking enough from the straw cup, then immediately following the meal give formula/breast milk in a bottle. 

As soon as they hit 12 months, begin to mix milk into their formula. Start with 25% milk to 75% formula/breast milk for 3-4 days, then move to 50/50 mix for another 3-4 days, lastly go to 75% milk and 25% formula/breast milk for 3-4 days.  Then, you can go to straight milk. This whole process will take 1.5-2 weeks.  During this time also begin to offer breakfast within 30 minutes of them waking and no bottle. Give them their milk mixture with breakfast. If they drink enough then skip the bottle after or finish them off with the bottle until they are drinking enough at meal time.

There will be a lot of give and take during this time, and honestly it is where I see a lot of parents get caught up.  Parents worry they didn't eat or drink enough and grab for the bottle to ease their mind. This is understandable, but I would ask you to pause before you do that, if your child is a healthy weight.  They may make up those ounces in another meal or maybe they already had 12 ounces and a serving of cheese earlier that day.This may sound a little harsh but, babies and parents need to learn not to rely on the bottle so heavily.  Toddlers don't always eat great, it is part of toddler-dom. Of course, there is a caveat to this.  If your child has special needs or is of low weight you should absolutely talk to your doctor and possibly a dietitian/nutritionist first.

Babies caloric needs go down around 12 months, and they no longer need 20+ ounces of milk everyday, although it is okay if they drink that much for a time as long as they are eating well too.  By one year they only need 16 ounces of milk and less if they are getting dairy/calcium from other sources such as cheese and yogurt.  The year between one and two is a transition and by two most doctors don't want kids drinking more than 16 ounces a day. Click here for a specific nutritional guide. 

The last bottle you will get rid of is the night time bottle. If you are worried they will wake up hungry you can give a bedtime snack. This is where your bedtime routine comes in handy because you'll want to emphasize the story, song, and/or favorite blanket, not the bottle.  You can also try to change some part of the routine up. Maybe Dad does bedtime instead of mom and tries skipping the bottle. They may surprise you and let it go that easily.  If they don't start to put less and less milk into bottle every 5-7 days and keep an emphasis on the other parts of your routine.

Extra Tips:


  • Try Different Cups- sometimes the novelty of a new cup with a favorite character on it or one they picked out in the store can be enough to win them over. However, the goal isn't to replace the bottle feedings with a cup feeding. Meaning, if your kid takes a sippy cup before bed then that's defeating the purpose.
  • Milk is for Mealtime- Only allow milk to be drank at meals, otherwise it will fill them up and make for a poor appetite at the next meal.  You can give water in between. Early on, it is a good idea to use different cups for milk and water so your child isn't confused.
  • Use Different Liquids- If your child is really lacking motivation in drinking from a cup try putting juice, flavored water, milkshakes (these are harder to get through a straw) or strawberry milk in their cup (try blending fresh strawberries into milk). It may be the hook they need. This should be only temporary strategy. Then, slowly move to them being able to drink plain milk or plain water.
  • Never put any other liquid but formula or milk into a bottle. This sends the message that the bottle is here to stay.


Weaning for Tots Over 16 Months Old

Follow the above steps and tailor them as they make sense to your child's age. Also, pay close attention to the above "extra tips". They can really go a long way with older children. Here are a few strategies for the older tots:

1. Systematically remove all bottles until you are down to one. As, I mentioned before, begin with the middle of the day bottle first. Use distraction when they ask for their bottle during the day, give them a "special drink", and/or give them a favorite blanket/stuffed animal for comfort. If they don't have one, begin to encourage it, so they have something else besides the bottle for comfort. Try to keep them on a feeding schedule so you know that they have eaten enough.  See Basic Strategies to Improve Eating for more on this, the schedule is really important!

2. Go Cold Turkey.  Of course, I would still encourage you to remove all but one bottle before doing this, so it isn't too much of a shock. Also, start to talk about it a few days ahead of time, don't make it a surprise. This isn't for everyone, but it is a valid option.

3. Have a bottle fairy visit your house.  Believe it or not this has worked for quite a few of the families I work with.  Your child probably needs to be 2+ to grasp this concept, but you can collect all the bottles together and put them in a box or basket with your child. Have your child say goodbye to the bottle because they are a big boy/girl and they don't need them anymore. Remind them often in the days leading up to this event and especially the day of. When, they go to sleep that night they disappear. If they ask for the bottle, calmly and briefly remind them the fairy took them.


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If you have more questions or a strategy that worked please share! See the sidebar at the top to follow by email so you don't miss anything new. Your email won't be shared with any other parties.

I am available for consultations if you need more help with bottle weaning or another feeding/sensory processing concerns. Click here for my consultation page with testimonials from other parents. 

As always this is my opinion as an OT and mother, it is not meant to replace medical advice. This post contains amazon affiliate links for your convenience.






12 comments:

  1. Thanks so much for your post! As a mom and fellow OT (not pediatric), I appreciate and enjoy your blog! My 12 month old son seemed to have mastered the straw cup, but recently he started letting a ton of breastmilk and/or cow's milk dribble out of his mouth and onto his chin and shirt. He does great with table food. Our pediatrician explained that his need for milk has decreased, but I admit it is tempting to turn back to the bottle when he doesn't seem to be drinking much.

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    1. You're welcome! Glad you are here, it is awesome to hear from other OT's, even if they aren't in peds. It sounds like you guys are right on track, there is a reason they call it a transition!

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  2. We never used the valves in sippy cups with our son and he learned quickly to be careful, even with open cups. Also, we used tiny glasses (think shot glass size) for him to learn how to drink out of an open cup. Very little liquid to start and then moved up to more liquid and bigger glasses. From the very beginning, we put his cups (sippy or otherwise) on a coaster on any table, even at meals, to model the behavior, so he learned that habit from the start. They are never too young to learn!

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    1. Yes, little cups are the key! Thanks for sharing that. I love your coaster idea, so smart!

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  3. We have a 10mo old and a 2yr 4mo old (both boys) and both are still on bottles when going to sleep. The older one throws an absolute fit and will not go to sleep without one, unless he didn't take a nap that day or he's just dead tired. Should I go ahead and take both off the bottle now? I know we've let the older one go way too long and we're seeing what might be the "side effects" of it.. delayed speech. He's super smart and understands everything you say, but says very little. Anyways, I know it'll be easier to take them both off at the same time, so should I do it now? Or wait a few months for the baby?

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    1. I would definitely keep your baby on the bottle for another month or so, unless he seems really ready to let it go. I would try prepping your older child for the transition, but I think it is fine to wait and do it together.

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  4. Thank you for this post! I'm new to your blog. I have boy/girl twins- 13mo old. Our daughter has struggled with eating since day one. It's a very long story- I'll spare you :) We're just struggling on how to get them both off of bottles- esp our daughter. She still strongly dislikes her bottle, but I just can't see her drinking much at all when we finally drop it. We give her a straw cup with water and she blows air into it and spits out any water she might get. With cups- she just dumps it out. With solids- she holds food in her mouth and won't swallow for a very long time. Our son though- he eats like a champ and is always begging for more. They couldn't be more different! Here's to hoping we will be successful in getting rid of bottles :)

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  5. Hi,
    My daughter is 11 months old and I'm a little late to the game but I just introduced the sippy cup. She still gets her bottles during the day (we're down to 3-4), but I'm trying water in the cup. All she does is throw it. I can't even get her to bring it near her mouth. Any tricks for getting her to actually drink from the cup, or do I just let her play with it until she decides to actually try and drink from it?

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  6. Our 19-month old son is weaned off of bottles and is drinking from a non-sippy (normal) cup for a while, water and milk. However we put a bottle filled with water in his crib at night. Usually by the morning, it is empty. I do this to encourage his water intake, and it is a way for him to soothe himself back to sleep when he wakes up at night. Do you think this is OK?

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    1. I have to say that as his parent you probably have to make the judgement call. There aren't any major side effects to this, except the ones I list at the beginning of the post. I can tell that most pediatricians would strongly discourage this as they want him to be able to learn to soothe himself without a bottle. I would have water available to him constantly throughout the day and also see my post on drinking from a straw- that would be really good for him. See the article index or the popular posts lists in the sidebar.

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  7. My 11 month old is a formula loving bottle junky (he still has 7 bottles a day). I'll work on some of your transitions, but we've FINALLY just got in a good sleeping pattern and I'm scared by cutting back on the formula that will wreck the sleep I'm finally getting. Do you find it does? Any advice or recommendations for that? Also on a kind of random question with cutting down on the bottles, is this the time you might start adding in an afternoon and/or morning snack as well then? Wasn't sure when you started giving babies/toddlers snacks? Thanks for all your helpful posts!

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    1. Yes, I would definitely add a snack or two and take away the bottle or give it at the end of the meal. Make a slow transition, I don't recommend doing anything cold turkey. When you cut back on the bottle he should eat more food to make up for it and won't wake at night. Start to shift towards him eating every 2.5 - 3 hours.

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