Bottle weaning

Baby bottles are great. They allow your baby to drink milk or formula in a manner that mimics natural feeding. They are easy to take on the go, and easy for your baby to use. However, as your baby approaches her first birthday, it’s no longer the best option for your soon-to-be toddler. By age 1, she usually has at least one or two teeth, and it’s a good idea to wean her off of the bottle.

There are many reasons why it’s important to transition your baby off of the bottle. First, continued use of the bottle once your baby starts getting her first teeth can lead to dental decay, depending on how and when she uses the bottle.

Secondly, prolonged use of the bottle can lead to malposition of the teeth, leading to an open bite. It can also lead to certain speech issues, such as a lisp.

Finally, as your baby grows, you want her to get more of her daily calories from solids versus milk. Prolonged use of the bottle can sometimes lead to a toddler being a picky eater or refusing solids in favor of milk.

So, let’s go over some healthy dental habits to begin as your baby turns 1, including some strategies to wean her off of the bottle.

Once your baby’s teeth start to erupt, start brushing them with a soft, infant toothbrush. You can find one at any local pharmacy or drugstore, and you can use a very minimal amount of fluoride toothpaste. Since your baby likely won’t be able to rinse and spit at this point, I suggest lying your baby down in your lap to brush her teeth. You can brush one or two teeth at a time, and then wipe the paste off with a wet gauze or washcloth as you go. This prevents her from swallowing the toothpaste.

If your baby drinks milk at bedtime, make sure to brush her teeth after she finishes her milk. When a baby goes to sleep drinking milk, it puts her at high risk for dental decay due to the posture she uses while drinking from the bottle — it causes a continuous pooling of milk over her front teeth. When your baby falls asleep without brushing her teeth, the milk residue left behind breaks down into carbohydrates that bacteria thrive on, leading to dental decay. This phenomenon is commonly known as “baby bottle tooth decay.” For many babies, it’s a comforting practice to go to sleep while drinking milk, so it can be difficult to break the habit. That’s why transitioning her away from the bottle before her teeth erupt — or soon after — is helpful. An ideal age to start is around 8 months.

Introduce a straw with her cup of water or milk a few times a day. Demonstrate to your baby how to drink from the straw and keep your baby practicing. She will keep watching you and trying on her own, and soon learn how to use the straw.

I usually don’t recommend trying a sippy cup spout, because it’s another thing that you have to wean your baby off of later. Sippy cups can have adverse effects on your baby’s teeth and speech very similar to the bottle, because of the way the tongue gets positioned while sucking on the tip. My suggestion is to go straight to the straw.

Some bottle companies also provide an adapter kit that allows you to keep using the same bottle but with a straw tip. This way, your baby still feels as though she has her bottle, but it has an age-appropriate tip. Using a straw keeps your baby upright as she drinks, making it harder to fall asleep drinking her milk. It’s easier to enact a routine of brushing after drinking milk. Once she becomes comfortable with the straw, you can even move onto a regular cup with a free-standing straw, or just a plain cup.

If your baby has teeth and has been falling asleep drinking milk from a bottle, it’s a good idea to have her seen by a pediatric dentist to rule out dental decay. (In general, for all babies, it’s recommended by the American Academy of Pediatric Dentistry that the first dental checkup is completed by age 1 or soon after the eruption of the first tooth.)

When you decide to wean your baby off of the bottle, remember to stay consistent. As soon as your baby gets the hang of using a straw, stop using bottles completely. Otherwise, some babies tend to continue using a bottle when they know it’s available to them, and it gets harder to give up as they get older.

And if you need another reason to wean baby off the bottle — transitioning to a straw means no more bottle washing and sterilizing for you, and more time playing with your beautiful little one!

Dr. Lavanya Venkateswaran is a board-certified pediatric dentist. She practices downtown at Tribeca Smiles as well as uptown at Park Ave Smile. She is an assistant professor of Clinical Dentistry at Columbia University Medical Center and is an attending dentist in the department of Pediatric Dentistry. She spends her time enjoying New York City with her husband and baby boy, and she is an avid runner and a student of Indian classical dance and music.