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 core 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 cups like 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.
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- 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.
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.