Weaning is such an adventure for both you and your baby. And it isn’t just about food – so in my latest mini-series with Charlotte we will take a look at HOW and WHAT your little one should be drinking, starting with WHAT cups they should be drinking from! This advice is sourced from evidence-based guidelines with a splash of practicality.
Infant feeding is quite a complex process involving coordination of sucking, swallowing, and breathing. When babies are born they have a natural suckling reflex, then as a baby grows they acquire new skills. It is recommended that open (or free flow) cups are introduced from around 6 months of age. This guidance is issued by the NHS alongside advice from the British Society for Paediatric Dentistry and the British Dietetic Association.
The use of an open cup can be beneficial for several reasons including;
- It encourages a sipping action (rather than sucking). This is important in the development of the oro-facial muscles used for talking. It is also good for promoting jaw development and better for tooth positioning.
- It prevents liquids from pooling around the upper front teeth: reducing the contact time between the drink and the tooth surface.
- Using a small cup helps babies to develop their fine motor skills involved in gripping the cup and their hand-eye coordination in moving it up towards their mouth.
So that all sounds pretty good right? But a common concern about introducing an open cup is the potential mess. However little ones will gradually develop the sipping skills, grip hold and dexterity involved with drinking from a cup. Some of our practical tips for mess management include;
- Using only a small amount of liquid means the cup won’t be overloaded or too heavy to lift. (But not so little that they have to tip it upside down to reach!)
- Initially you can hold the base to guide it up to their lips and allow baby to hold the sides of the cup.
- A baby-sized shatterproof plastic cup is most appropriate as they are specifically designed with mini mouths and hands in mind.
- Start using a cup at home and when a change of clothes is due: for instance at breakfast time if they’re still in their pyjamas and with the evening meal as bathtime will probably be next up.
- At mealtimes offer some finger foods first to help baby make the connection between their hands and mouth.
- Let them observe you and others drinking as a form of ‘role modelling’.
- Babies often drop the cup *after* taking a sip so hover closely and be ready to grab it, initially.
- Invest in a good cover up/apron bib and a floor mat.
- Give praise and gentle encouragement when they achieve a sip. And try not to yelp if they do spill or drop the cup as this may scare them or actually make them do it again to get a reaction.
- You can also let them practice handling an empty cup at playtime. Or mini cups make a useful little bath toy when they are already wet!
- Baby should always be sitting upright and never be left alone when drinking.
Weaning is always going to be a fairly messy time. Babies are learning how to move their mouth to sip, chew and then swallow solid foods using their jaw, tongue and cheeks – all of which is great for their oral-sensory awareness. As with using a spoon to self-feed some babies will learn a new drinking technique quicker than others. Independent self-feeding is an important part of child development: so let them experiment a little and embrace the mess!
Lidded Cups & Beakers
Devices that can be turned upside down without leaking usually contain a non-drip (spill) valve. These still rely on a sucking motion so are not teaching new skills, but often you can remove the spill valve from this type of cup. Cups that are ‘free-flow’ are generally preferred as the drinking action moves liquids to the back of the mouth quicker so it doesn’t pool around the teeth. A ‘free-flow’ cup also uses the facial muscles in different ways which can be helpful for speech development.
Lidded cups are definitely less messy so you can consider using a ‘free-flow’ (no valve) cup when you’re out and about. You could even take a lidded cup with you and then whenever possible remove the lid to make it into an open cup. Potentially only using spouted cups could affect tooth position and impede tongue movements. But those with a ‘free-flow’ flip-down spout or separate cap are useful when you’re on-the-go.
Often lidded cups are a convenient option for young children to carry around themselves but this can then lead to more frequent small amounts being consumed over longer periods. This isn’t great for teeth as the mouth needs time to recover a neutral state in between eating/drinking. Whilst it’s clearly important to keep little ones hydrated this repeated sipping might also mean they’re not as hungry when it comes to mealtimes. Plus we don’t really want toddlers running around with a cup in their hands (or mouth) in case they trip over!
From a hygiene perspective open cups are easier and quicker to clean out. Also liquids in an open cup are often freshly poured as opposed to a closed cup when it might be left sitting in the vessel for longer.
NHS guidance says “as soon as your child is ready, encourage them to move from a lidded beaker to drinking from an open cup”. It seems with any lidded cup there’s always some form of compromise but really it’s about balance and being adaptable to each situation. We understand that lidded beakers can be practical, so it’s fine to use them as long as open cups are the main drinking vessel for young children. We also appreciate that some children may have difficulties swallowing and there may be a medical indication to use a valved cup. Health care teams would be able to offer appropriate support with this issue.
Be super cautious if you’re letting baby drink from a glass. They are often too heavy for little ones to lift independently and are liable to shatter if dropped. Even if you’re holding onto the glass it could potentially cause trauma to babe’s little front teeth if knocked on the rim too.
When eating out or if you’ve forgotten a cup, sometimes this is necessary and that’s OK, just be extra careful when using!
The liquid from an artificial teat can drip into a baby’s mouth even when they are not sucking on it. This is not a problem when they are little but once they have teeth through this can lead to drinks being in contact with the tooth surface for longer. Research has found that bottle feeding involves statistically less ‘sucks per minute’ than breast feeding so the liquid isn’t always as efficiently swallowed. Comfort sucking on a bottle can easily become a habit and the prolonged use of a bottle can also affect tooth alignment and bite.
The current advice is to discourage bottle-feeding from the age of 1, as this is normally around the age when the upper front teeth have erupted. Introducing another method of drinking early on helps to reduce the number of bottle feeds and as the amount of food a baby eats increases, the amount of milk they require decreases. Some babies find this transition easier than others. Your little one may prefer a specific style of cup, others are more adaptable. Realistically you might need to experiment to find one that suits your child best. Trying out a variety of cups is good as this supports optimal development of drinking skills.
If at 6 months old your baby has been exclusively breast-fed then they can move straight to using an open or free-flow cup without a bottle phase at all. The breastfeeding mechanism differs from a bottle and the human nipple is drawn deeper into the mouth. Amazingly open cups may also be used in the early weeks of life to safely feed a small baby expressed milk until they are able to feed normally. This should be done with the guidance of a health professional.
When using a cup remember that under 12 months babies should only be offered plain water or their usual milk (more on types of drinks coming up soon…) Water is a good option to introduce an open cup as it wipes up easily, so you can start to offer small amounts of plain water with meals during weaning. Having a little bit of water after eating also helps to cleanse food particles from the mouth. Another school of thought is that babies may prefer a familiar taste to begin with, so you can offer expressed milk or formula from an open cup too.
Many health professionals including paediatricians, dentists, nutritionists, speech therapists and occupational therapists support open cup drinking. Also it was recently reiterated in the Public Health England “Foods and drinks aimed at infants and young children” document (June 2019).
So, as you can see, open cups and beakers are another essential tool for the weaning journey!
We really hope you find this helpful. More on this topic to come from us this week and we will also be doing a Q and A Live on Instagram too.
This post was written by Jemma Hook BDS (Hons), MFDS RSC (Ed), PGCert with support from SR Nutrition.
Jemma is a NHS family dentist and clinical teacher in Paediatric Dentistry. She started the instagram @themummydentist whilst on maternity leave last year to promote oral health for mums & babies. And also to find support in the breastfeeding/weaning/sleep deprivation chat!