Weaning off the bottle: when and how

The AAP describes the move from bottle to cup as starting around 6 months, when a cup is first offered, and finishing sometime between 12 and 18 months. It is a gradual swap rather than a single day: bottle feedings come out one at a time while cups take their place at meals. Most of the reasons for finishing in that window are about teeth and appetite, not about being old enough.

Around this age

The CDC’s timeline for cup skills runs alongside this. A sippy cup with a spouted lid or a cup with a straw can be offered from around 6 months, when solids start. Children can begin learning to use a cup without a lid at about 9 months, and at about 12 months most can drink from an open cup while you hold it.

At 12 months the contents change as well. The CDC says whole cow’s milk can be introduced at 12 months old, but not before, and that children aged 12 through 23 months need about 2 servings of dairy a day. The AAP’s drink recommendations for this age are water and whole milk, roughly 2 cups of milk a day for 12 to 24 month olds, with water alongside it. Juice is not recommended in the first year at all.

The reasons the AAP gives for finishing in the 12 to 18 month window are practical. Teeth bathed in milk, formula or juice for long stretches can develop early childhood caries, sometimes called baby bottle tooth decay. Children who sip from a bottle through the day often arrive at meals without an appetite, so they eat less of the food that carries the fiber and nutrients. And bottles used as snacks add calories that nobody counted.

What to try

Start with the feeding your child cares about least, usually a midday one, and offer the cup in its place. Put in whatever they already drink, breast milk or formula, so the only change is the container.

Keep one or two bottles at mealtimes if that is where you are, and drop the ones away from meals first. The AAP’s suggestion is to tell your child that bottles happen at mealtime, and to gradually eliminate the ones at other times, especially at naps and bedtime.

A bottle in bed is worth ending early, both for the teeth and because it is the hardest one to give up later. The AAP suggests replacing it with extra snuggles, songs or bedtime stories so your child feels reassured. The comfort was never really the bottle.

Expect spills. The CDC’s line on open cups is to give your child a chance to use one and be ready for some spills. A sippy cup without a valve makes a reasonable stepping stone toward an open cup, since the valve is what turns a cup back into a bottle.

Two weeks of protest is common, and progress often goes backward during teething, illness or a move. Families usually hold the daytime ground and let the bedtime bottle be the last to go.

When to call your pediatrician

Bring it up at a checkup if your child is not drinking much from a cup by 18 months, is losing weight or has stopped gaining, or is still taking most of their calories from a bottle at an age when meals are meant to be doing that work. A dentist or pediatrician can look at teeth if you see white or brown spots along the gum line.

Children with feeding difficulties, reflux, or a medical condition that affects weight are often given a different timeline on purpose. Your pediatrician can tell you which parts of the usual schedule apply to your child.

Sources

• From Bottle to Cup: Helping Your Child Make a Healthy Transition — HealthyChildren.org (AAP)
• Fingers, Spoons, Forks, and Cups — CDC
• Cow’s Milk and Milk Alternatives — CDC
• Recommended Drinks for Children Age 5 & Younger — HealthyChildren.org (AAP)

This is educational information from public sources, not a replacement for advice from your child’s healthcare professional.

In Withya, the bottles and cups anyone offers go into Care in the order they happened, so the week is visible to everyone doing the swapping.