Step Away From the Sippy Cup!

sippy

Sippy Cups became all the rage in the 1980s, along with oversized shoulder pads, MC Hammer parachute pants and bangs that stood up like a water spout on top of your head.   A mechanical engineer, tired of his toddler’s trail of juice throughout the house, set out to create a spill-proof cup that would “outsmart the child.”  Soon,  Playtex® offered a licensing deal, the rest is history and I suspect  that mechanical engineer is now comfortably retired and living in a sippy-cup mansion on a tropical island in the South Pacific.

Geez. Why didn’t I invent something like that?  I want to live in a mansion in the South Pacific. By the way,  I also missed the boat on sticky notes, Velcro® and Duct Tape®–all products I encounter on a daily basis, just like those darn sippy cups I see everywhere.  I truly shouldn’t be so bitter, though – in my professional opinion, over-use of sippy cups is keeping me employed as a feeding specialist and I should be thankful for job security.  Thank goodness for the American marketing machine – it has convinced today’s generation of parents that transitioning from breast or bottle to the sippy cup is part of the developmental process of eating.  Problem is, those sippy cups seem to linger through preschool.

As an SLP who treats babies with feeding challenges, I frequently hear from parents how excited they are to begin teaching their baby to use a sippy cup.  They often view it as a developmental milestone, when in fact it was invented simply to keep the floor clean and was never designed for developing oral motor skills.  Sippy cups were invented for parents, not for kids.  The next transition from breast and/or bottle is to learn to drink from an open cup held by an adult in order to limit spills or to learn to drink from a straw cup.  Once a child transitions to a cup with a straw, I suggest cutting down the straw so that the child can just get his lips around it, but can’t anchor his tongue underneath it.   That’s my issue with the sippy-cup: It continues to promote the anterior-posterior movement of the tongue,  characteristic of a suckle-like pattern that infants use for breast or bottle feeding.  Sippy cups limit the child’s ability to develop a more mature swallowing pattern, especially  with continued use after the first year.  The spout blocks the tongue tip from rising up to the alveolar ridge just above the front teeth and forces the child to continue to push his tongue forward and back as he sucks on the spout to extract the juice.

Here’s another important take-a-way on this topic:   A 2012 study by Dr. Sarah Keim of Nationwide Children’s Hospital in Columbus, Ohio reported that “a young child is rushed to a hospital every four hours in the U.S. due to an injury from a bottle, sippy cup or pacifier.”   Dr. Keim theorized that as children are just learning to walk, they are often walking with a pacifier, bottle  or sippy cup in their mouths.  One stumble and it can result in a serious injury.

Before I ever climbed onto the anti-sippy cup soap box, I let my own two kids drink from them for a short time.  I even saved their first sippy cup – I’m THAT mom who saved EVERYTHING.  If it’s too hard to let go of the idea of using a sippy cup, let the child use it for a very short time. Then, step away from the sippy cup if the child is over 10 months old or beginning to show signs of cruising the furniture.  In the near future, it will soon be time to conquer two genuine developmental milestones–mastering a mature swallow pattern and learning to walk.

Melanie Potock, MA, CCC-SLP, treats children birth to teens who have difficulty eating.  She is the author of Happy Mealtimes with Happy Kids and the producer of the award-winning kids’ CD Dancing in the Kitchen: Songs that Celebrate the Joy of Food!  Melanie’s two-day course on pediatric feeding is  offered for ASHA CEUs and includes both her book and CD for each attendee.  She can be reached at Melanie@mymunchbug.com.

Comments

  1. Not to mention, parents willingly put sugary drinks in them which in turn causes major tooth decay problems.ich

    • Hi Michelle, yes, good point. True with anything with prolonged use. I always feel badly for the parents, because they didn’t realize the damage was happening until the dentist broke the news to them why their child had tooth decay, need to have teeth capped (with metal) at the age of two, etc.

  2. What about the sippy cups that just have a stubby spout that the child has to bite to get the liquid to flow?

    • Hi Cindy, my professional preference is to not use those, because as a feeding therapist, I always ask myself “What motor patterns do I want this child to learn in order to eat and drink in an effective, efficient and enjoyable manner and that will do no relative harm?” Biting, then sucking, isn’t a motor pattern I want to teach. Now, for older kids, who have already progressed through the developmental process and learned all the motor patterns necessary for eating advanced foods, I’d be ok with it, if the spout was flexible, which it typically is.

  3. Some very good points, but what about using the sippy cup for what it was intended? Like when children are drinking a beverage away from the table (so maybe used sparingly it would not be as damaging) and use a regular cup with an adult guiding hand when they are at the table?

    • Hi Millicent, yes, absolutely, as long as the child is progressing well. So, for many of my clients in feeding therapy, I wouldn’t do that, but for kids who are moving through the stages with ease, using it in this manner for a short time feels fine to me.

  4. I just came home from my first feeding & swallowing class, and I’m going to meet my client (tongue thrust) for the first time next week, so this is incredibly relevant to me. Thank you for this great read!

  5. Thank you for your article, it is something I’ve never even thought twice about. My 16 month daughter only uses the one with straws, but should I now just let her have a regular cup. What about the tervose tumbler with the lid to sip out of or will that still interfere? I’m happy to report that she has absolutely no eating or feeding problems…I am a RD that practices the division of responsibility though!

  6. What are the reasons for establishing a mature swallowing pattern? What could happen if one is not established at or around the age of one or later? Can this be developed later with age? What are repercussions and what is treatment?

    • Hi Laurie, Great questions! It can impact dentition, palate formation and facial structure. Naturally, it depends on the degree of tongue thrusting and other factors. Treatment involves teaching the mature swallow pattern or may include consultation/treatment with a certified oral facial myologist. Braces, etc. are sometimes part of the overall treatment plan. Secondary articulation issues, sometimes seen (but not necessarily caused by) with this motor pattern would be addressed as well.

  7. A sippy cup without a valve is different isn’t it? The child learns to drink rather than suck.

    • Hi Janecita, no, it’s the same. This issue is the spout in the way of the tongue tip elevating to the alveolar ridge. Even a straw cup, without cutting down the straw at a young age, can keep the tip from elevating. We don’t want to continue to encourage a motor pattern of significant anterior-posterior movement for swallowing. Thank you – that’s been a popular question on my facebook page too. Glad you commented here!

  8. What about children who are extended breast fed. Are they adversely effected?

    • Hi Becky, In my professional experience, I have only seen this when the child is breastfeeding a lot, day and night, and past the age of one, approximately. It’s tricky, because it’s a hard one to measure.

  9. I’m an adult with an immature swallowing pattern. I can’t say that mine was caused by sippy cups as I was weaned onto an open cup at 9 months due to breastfeeding challenges and a refusal to drink from a bottle or sippy cup. I had feeding therapy from an SLP at 15 and it helped a lot, but the things I list require actual thought to overcome. I can’t, for example, hold a conversation properly while eating.

    There were a lot of foods I simply couldn’t eat comfortably until well into adulthood. Meat, for example, was a challenge for me because I had to chew it into a fine paste before I could swallow it. One little bit of gristle or a spot I missed and I’d be gagging like a baby that shoved too much into their face. It’s a challenge to actually chew–I still mash most things with my tongue and have to consciously move food into my teeth.

    Speaking of my teeth, I can’t say 100% that this is the reason for it, but I had braces from the time I was 9 until I graduated high school to fix horrifically crooked teeth. My orthodontist tried to have barbs permanently installed on the backs of my teeth to keep my tongue away from them due to my severe tongue thrust. I refused.

    And last, but not least, the tongue thrust that I still have means that I have a lisp that simply will not go away. After my time with the SLP at 15, it improved, but it’s still there, especially if I’m tired or excited. I wanted to act, but that lisp made it impossible.

    • Thoenix, your comments are so helpful, thank you! You are so right, a tongue thrust, feeding/eating difficulties or with speech aren’t likely to be due to just one thing – like a sippy. I’m so impressed with your insight into your own situation and the SLP who supported your journey – thank you for sharing that here.

    • Hi Theonix, my apologies if this post appears twice – my computer had a hiccup while I was replying! I just wanted to be sure to thank you for these very insightful comments. You are right about so many things, and yes, a tongue thrust can be due to many factors, not just one thing, like a sippy cup. Thank you again for commenting!

  10. My kids nursed for a very long time and used an open cup starting around one years old if I remember correctly. We used water bottles for water and a cup at home. I never felt the need to use sippy cups. Plus, they are all plastic and I didn’t want them drinking out of plastic.

  11. How does this relate to the 360 degree cup that Sassy manufactures?

    • Thats what I want to know!

    • Hi JS, That’s a cup I’ve been wanting to try. From watching the videos on line, I think it will be terrific as long as the child learns to use it similar to an open cup. I sometimes get kids on my caseload who like to “hang out” on the rims of that type of cup, but other than that, I think it looks great! Have you tried it yet?

    • Hi JS, I was just in the midst of replying when I had a blip in my computer, so my apologies if this comment shows up twice! I have not had the opportunity to use the 360 degree cup yet, but I think it looks terrific! Some of my clients will occasionally hang out on rims of cups, biting them rather than using their lips, but that’s part of the teaching process. Have you tried this cup yet? How did you feel about it?

  12. I am curious if this is referring to the sippy cups with the spout that protrudes from the lids, as well as those that are more of a built in spout in the rim of the lid (but raised up slightly)? I’m not sure if that made sense, I’m referring to a cup like the NUK/Gerber graduate cups like these (http://www.nuk-usa.com/gerber/all-products/cups-and-accessories/advance-developmental-cups-insulated-cup-like-rim.aspx).

    • Good question – thanks for asking me to clarify! It’s the raised up spout that is the concern, because it gets in the way of tongue tip elevation while the child is swallowing.

  13. I am not a speech therapist nor a dentist, but I am an extended breastfeeder (ie past one year). What I would say is that children that are breastfed past a year are still introduced to food and other drinks around 6-8 months, just like everyone else. So they are learning how to drink out of cups and eat with a spoon and fork, just like everyone else. I would add that the way an infant suckles when breastfeeding is necessarily different than when they suck on a bottle or sippy cup. Though there have been a lot of attempts to duplicate the breast, bottle nipples really cannot be sucked down the throat the way a breast can be. So there are different techniques used to accomplish both – which is why it is harder to go back and forth between a bottle and breast. Two different methods of consumption are required. I’ve used sippy cups (usually starting after a year, no inserts and pretty much the pour kind) but mostly with my first two or when some well meaning person thrusts it at my younger two… because I found that going between breast and an open cup is a LOT easier than using the sippy. Added to the fact that my dentist does not like sippy cups… I pretty much abandoned them. Anyway, my guess is there is a lot more similarity between a cup and the breast than a sippy or bottle and the breast. (My guess is also that the occasional use of a sippy cup is not a big deal. Why I don’t find the well-meaning sippy-providers. It is when you see a kid going everywhere with one. I do have to say that the first time someone gave my youngest a sippy, his reaction was pretty humorous – he thought it was a toy not for drinking. It was really FUN watching the fluid pour out…oops! Then, he would only use it with the spout on the upside, and then there was the demand to remove the lid…

  14. Thank you for this article. It always made me worry that I couldn’t get my now 11-month old son to transition to a sippy cup. Now I don’t feel terrible about it anymore. I’ll just switch him over to a straw and then down to a regular cup.

    Thanks again!

    • Thank you, your comment supports what I was hoping to convey in this article. It’s not a part of the developmental process, but I suspect because it’s been around since the 80′s, that over time, parents think that their child should drink from one, and worry if they don’t. Enjoy that little munch bug of yours! 11 months is such a wonderful age!

  15. GREAT article. I used sippy cups and this past summer moved to only thermos for school or car. My two oldest have out grown them but my three year old used one until about 2 years old. I did it to where if he was at the table he got a regular drinking cup and only got sippy cups when running around the house and only with water. Sippy cups went away at 3. If he wants milk or juice it goes into a cup and he stayed in the kitchen. Although at 3 1/2 he now can go anywhere with a cup. I was never dependent on them! I never gave into the wants of children. Simply moved them on. (Oddly enough, it’s my 8 yo that spills! Ha ha – flying hands while talking! My trait!)

  16. Ok, I AM a dentist and can’t sit still here. People, relax… Save your carpet and sippy cups. Get rid of the pacifier at 2. Let the kids drink from whatever safe container they choose. Kids will make the ‘normal’ progression from “little kid cups to big kid cups” in due time assuming a ‘normal’ environment. I have seen zero research and I have seen zero clinical experience to substantiate these claims. Sorry rant over. Let kids be kids.

  17. My kids are grown now but I don’t recall having the sippy cup like today’s version when mine were babies. I loved the Tommy Tippy cup we used though. It had a handle on each side and a lid with a slit in it. It was yellow with a picture of a bear on it drinking out of a Tommy Tippy cup which had a picture of a bear on it …. etc.!

    Of course, I didn’t let my kids wander around the house with the cup in their hands either! That was a recipe for disaster!

    • Hi Jackie! That’s one of the cups my kids had too! I know exactly which one you mean. Yes, the open slit is fine. (I also had a few spout cups. I suggest limiting the use of those.)

  18. I let my kids uses sippy cups till they were almost 2 and then I used mostly reg cups (lil ofcourse). And didn’t have a problem. Yes a few messes but nothing debilitating to their physical or mental well being. Read or child n go from there.

  19. Thank you for this post!

  20. Bravo on a great article.

  21. chris lemmon says:

    Interesting article but in all practicality, how would one get a child off a sippy cup? I had a heck of a time getting my son from a bottle to sippy before naps/bed (no troubles from breast to bottle). He will only drink from a straw at meals but still drinks a lot from a sippy before sleep and screams (literally for hours) until he has it. He is 14 months.

    • Hi Chris, Each child is different, and their are a lot of varying opinions on how to do this. My suggestion would be to consult your pediatrician, a he/she knows you and your child and may be able to offer specific advice that will work best for your family.

    • Hi Chris

      If you can maybe go cold turkey tonight, please consider ceasing the bedtime zippy tonight….a few restless nights for you and your child will be in his/her best health interest….ask me how I know! And hopefully there is only water in the pre-bedtime bottle, which is an entirely different issue.

  22. Self indulgent drivel…id rather have a clean house. I guess my kids are just exceptional because they never developed a problem. Come to think of it… everyone i know used sippy cups with their kids with no adverse effects. Perhaps you should look at a new study to explain the feeding issue…is this even really a problem? With childhood obesity on one side and malnutrition on the other, this seems like an incerdibly bourgeois issue.

    • HI Matt, Please keep in mind that my work involves helping children with serious medical issues, sensory challenges, developmental delays as well as the more typical “picky eater” in many families. So, my role is to address a wide spectrum of feeding issues. I also treat kids who are “exceptional” in so many ways – academically, artistically, etc. But, they are having trouble chewing, swallowing and/or eating a variety of foods. My role is to help them learn new motor patterns (and more) to enjoy mealtimes, pizza nights with their friends, etc. Recent articles in our association’s journals state feeding difficulties are present in 25% of typically developing children. So, you may not have encountered any stumbling blocks in your own family (that’s terrific news!) but for many, this is not a “bourgeois issue.”

    • Hi Matt

      Your point is well taken and certainly understandable. After 25 years of doing pediatric dentistry and orthodontics, it’s only been over the past 5-7 years that I have come to appreciate how important tongue posture is to the problems associated with healthy sleep, breathing and physical/neurological development. But the good news…a parent can have it all, a cavity-free, obese-free, apnea, and ADD-free child….plus a clean house! And while implementation of a Sippy cup alone will not necessarily render a child susceptible to the aforementioned health problems, many health risks associated with very early life environmental insults (e.g., inta-uterine stresses, negative oral pressure from pacifiers, bottle feeding…and yes, excessive use of Sippy cups) can indeed be minimized in many kids.

  23. What kind of straw cup do you like? The ones I’ve bought drive me nuts because they are hard to clean, and I never seem to put them back together right.

    • Hi Anna, I like a basic “take and toss” cup and then cut down the straw as soon as the child learns to suck from it with ease, but will sometimes add a softer straw if appropriate for that child. Soft, flexible straws can be ordered from therapy catalogs, such as “Talk Tools”. Pictures of 4 different cups are on my facebook page (My Munch Bug). Thank you for your question – it’s a good one!

    • Pipe cleaners! Yes the ones used for crafts work great for cleaning straws!

  24. what about special needs children? I have 3 children who use sippy cups, mostly for their pedisure. we’ve ben trying to find a sippy that the lids do not crack or leak. al l3 can drink from open cups, straws, cans. they drink the pedisure at night.

    • Hi Tawnya, yes, for some children with special needs, a sippy may be the only option at certain times. If possible, try to wean them off the pediasure at night, if their pediatrician is okay with that. Dental issues/decay are a concern. And, thank you for all you do for children. (-:

  25. But doctors are the ones who tell tell you to transition from bottle to sippy to open cup. Mine did.. with all three of my children. It seems as if the problems you describe would effect only a small small percentage. What are the statistics really for those who have complications like you described verses those who don’t?

    • Hi Laura, I would love for someone to do the research on that. Since we are considering this issue to be due to prolonged use and it’s very difficult to separate out all the factors (even the mildest “complications”) it’s a tricky one to study. I can offer this advice based on 15 years of experience focused on children with feeding challenges, from kids with significant medical issues to those who are considered “picky eaters”. I’m trying to spread the word about one factor – prolonged use, but oh, wish I could reach more doctors! I hear you – great comment, thank you!

      • Pediatricians are only with children for a few minutes per child. They are wonderful and helpful, but they are not the omniscient source of information on development. (Thankfully, my pediatrician makes certain his patients know this.) They usually follow whatever the AAP is recommending—and this changes. Sometimes dramatically. Usually AFTER OT’s, PT’s, SLP’s and others let them know their recommendations have some negative long-term effects. I usually prefer the opinion of the folks who deal with the fall-out.

        • Well said Donna, thank you!

          • Melanie, I am a Neurodevelopmental Specialist and find that sippy cups disrupt the integration of the Babkin Palmomental Reflex—responsible for sucking, swallowing and chewing. Almost every child I see whose BPR is non-integrated drank out of a sippy cup past their toddler years. On a large scale, almost every “convenience device” designed for infants/toddlers (exersaucers, walkers, sippy cups, baby bumbo seats, etc) interrupts the integration of reflexes and provides MAJOR hurdles for development. Folks who say, “I used those and my kids are fine”, either a)should fall down on their knees and thank God they are one of the few lucky ones or b)their child is not quite as “fine” as they would like to think. And it will show up as they get older. And by that time much water has gone under the bridge—there is emotional wear and tear and the problem becomes more complex to ameliorate. It seems it would be wiser to skip the “conveniences” now and help development proceed the way it was designed.

          • Donna, that is fascinating! You’ve got me thinking! Thank you for this comment.

          • This is very interesting to me. As I have not yet come across this, will you please send me reference(s) describing Babkin Palmomental Reflex?

            Thanks

            Kevin Boyd,DDS

          • If you google “Masgutova Babkin Palmomental Reflex” it’s a good beginning. If you go to http://www.masgutovamethod.com, you can buy the Infant Postural & Dynamic Reflexes Manual. Excellent Information. Hope this helps. I can’t really do it justice in this venue.

  26. Give me a break!! Have you nothing better to do? Mature swallowing pattern?? WOW The silly things I hear these days! Mothers have enough real problems to deal with!!

    • For mothers that have a child with poor swallowing patterns, it is a real problem. A mature swallowing pattern has always been around and is not just something made up “these days”. If a child doesn’t have it, it can cause long-term issues (please read the comment left by “Thoenix” above). I’m happy that you don’t have a child with a swallowing problem but please be sensitive to those mothers that do and the therapists that do their best to help.

      • Thank you Vanessa. Yes, for Jennifer and others who may not be familiar with the importance of developing this motor pattern, I highly recommend Diane Bahr’s book, “Nobody Ever Told Me or My Mother That! Everything from Bottles to Breathing to Healthy Speech Development”. The developmental process of feeding (including swallow patterns) is well researched in multiple journals too.

  27. What’s the evidence behind this? I didn’t see any studies or research cited …

    • Hi Joanna, Oh, I wish we had some studies specific to sippy cups, but for now we just have studies on the developmental process of feeding, prolonged use of pacifiers/finger sucking, tongue thrusting patterns, etc. Still, According to the American Speech, Language, and Hearing Association (ASHA, 2005) “the term evidence-based practice refers to an approach in which current, high-quality research evidence is integrated with practitioner expertise and client preferences and values into the process of making clinical decisions.” I based this blog post on my professional experience as an SLP with 15 years focused on feeding, my continuing education via ASHA and my clients’ progress. I would love to see this researched as well, but for those of directly involved in feeding for years, it feels like common sense simply because we observe the children so often. My role as a feeding therapist is to ask myself “What motor patterns do I want this child to learn in order to eat and drink in an effective, efficient and enjoyable manner and that will do no relative harm?” It depends on the child; it depends on a multitude of factors. But, oh, I would love the research to be there too.

  28. Can drinking from a sippy lead to speech issues? My almost 4 year-old drinks from a sippy during non meal times and from a regular cup during meal times. She has trouble saying her L’s and R’s. Could this be from her sippy? And if so how do we correct it without a speech therapist??

    • Hi Callie, while I am not aware of research that links sippy cups to speech, I can see where for some children having difficulty with articulation, it could be a contributing factor, depending on the bigger picture. But, that requires a professional assessment with an SLP. Children who are 4 years old often have distorted L’s and R’s, but having a speech evaluation would answer your question about your kiddo. Check with your pediatrician about referring him/her for an evaluation – possibly even through your local school district or other resources.

    • And I would add to Melanie’s excellent recommendation to seek and SLP per your questions about possible speech implications with zippy cups. I’d only add that you consider consulting with and SLP that is additionally certified in OMT (Oral and Myofunctional Training). Many dental hygienists are also certified in OMT but do not necessarily have the SLP background

  29. I’m not sure if I used sippy cups a lot, but I did have an immature swallowing pattern that my dentist caught. I see some comments asking what the big deal is about having a mature swallowing pattern. I know my parents sure appreciated my dentist saying something because it prevented them from spending thousands of dollars on braces. I would push on my teeth to swallow and not my upper palate, which was changing the shape of my mouth and the placement of my teeth. Thousands of dollars of money saved by something seemingly so small.

    • Very helpful comment Marilyn, thank you!

      • Dear Melanie

        As the importance of transitioning from an infantile suck-swallowing pattern, to a mature chew-swallowing pattern…usually by age 3 or 4, is NOT something that is usually taught at most dental schools, I would say that you are very fortunate to have your child under the care of this particular dentist. I would appreciate knowing where he/she practices if you wouldn’t mind posting info.

        Congratulations!

        Kevin Boyd, DDS

    • I meant to post this to Marilyn…not Melanie…sorry

      Dear Melanie

      As the importance of transitioning from an infantile suck-swallowing pattern, to a mature chew-swallowing pattern…usually by age 3 or 4, is NOT something that is usually taught at most dental schools, I would say that you are very fortunate to have your child under the care of this particular dentist. I would appreciate knowing where he/she practices if you wouldn’t mind posting info.

      Congratulations!

      Kevin Boyd, DDS

      • Mark A. Penshorn DDS, PA in Schertz, TX.

        It was actually me that he treated but he’s still in practice. I still remember having to relearn to swallow. I’m sure there are better techniques that y’all use now than 25 years ago. Lol.

  30. I am a Biobloc-Orthotropically focused (www.orthotropics.co.uk) pediatric dentist/nutritionist who works very closely with Oral Myofunctional Therapists (OMT’s) in the Chicago area. To my knowledge, ALL forms of infant/early childhood artificial drinking devices, save Babycup (www.babycup.co.uk), OXO tot (www.oxo.com) and Foley Cup (www.foleycup.com)….I have no vested interest in promoting these companies’ products beyond their being medically advantageous, will likely eventually render a child susceptible to later problems associated with improper tongue posture, poorly aligned teeth and jaws (malocclusion) and/or mouth-breathing (apnea)….and possibly even attention issues like ADD/ADHD. And this is not merely conjecture on my part; there is ample evidence to support this in the scientific literature if one cares to explore.

    Sincerely

    Kevin Boyd, DDS, MSc

  31. Can you provide some tips on how to transition from bottle to cup? Our 13 month old nurses in the morning and before bed and is still using bottles during the dayat daycare. We’re stuck on how to make the switch – and to what. Can you provide some links to cups you’d recommend? We are also trying to avoid plastic so this feels like a real challenge.

  32. Can I also add pouches to this!?!? Between pouches, sippeys, and pacifiers I feel like there is no wonder so many of our kiddos have low muscle strength and sensory issues. No one is asking them to use anything beyond a suckle and minimal munch pattern! I’m walking away from my soap box now, but I completely agree with your blog!

    • Thank you Lisa! Being a feeding therapist, there are times I thank goodness for pouches, for sippys with my kids who won’t have another alternative, for a paci when I have a child who just desperately needs one. But, for most kids, if I can just make that general statement, I agree – limit the use if possible. If we do research on this topic, we need to ask “how much is too much” and what other factor’s come into play, such as a hypermobile jaw, which is something I see quite a bit, but who knows – maybe that’s because those kids get referred to me. I think you and I are on the same page – we are both wondering…hmmm…

  33. What a great discussion! I am a practicing SLP treating dysphasia in infants through geriatrics since the mid 1980′s! Boy have we grown in our knowledge and practice….very lovely. When I was in high school in the 1950′s my best friend who had had her braces removed, passed me a note in study hall stating that her front teeth were beginning to protrude again. It was in 1980something that I took the 8 week NDT (Neurodevelopmental Treatment/Bobath) Course where I learned about severe tongue thrust and restructuring of the upper incisors and palate! My dear friend had passed away and I was not able to share this with her. I can imagine that parents who have no need for feeding or speech therapy for their kids can look at this discussion as generating from Mars—but for those of us who assess and treat these issues know how complicated and far reaching this issue is. I trade my families with babies straw cups I either buy or make from a variety of non-poisonous plastic squeeze bottles( from plastics companies that deal with food grade items ) with a straw-they are usually acceptable to the concept of the need for appropriate oral development for feeding and speech. I have identified children who used pacifiers too long when I call a parent and ask why their typical child has a mouth that appears as if he had cerebral palsy–retracted lips, tongue during eating, drinking, speaking–and the response and discussion to solve the issue always leads to pacifiers, baby bottle or sippy cups while talking! Now that I am getting to be an old lady with less myelanization of cranial nerve nerves, I will actually ask people in public places if they are willing to remove the pacifier while their child is telling them something to increase the child’s speech intelligibility. No one has hit me yet! It is so great that you are all discussing this and reducing the chances of rotten 2 yr old teeth like I had to deal with with my youngest of 3 sons due to his allergy to lactose even tho I always diluted his juice. It’s the nighttime bottles that does it as the contributing, aware Dr. Boyd, is sharing here. !Our young woman who had so many years of speech and feeding therapy with resultant tongue thrust can still work on increasing her tongue base strength with specific tongue in and out exercises with a weight on top of mid plane of tongue–raisins–small weights, etc,,,,it is a muscle training thing…is the gagging sensory based? A life long challenge. I know “normal” eaters who gag when they see pudding or yogurt but eat everything else. Aren’t we amazing we, humans, with out strengths and weaknesses and preferences? Thank you so much for your discussion! Amazing what technology has allowed in our field over the years.
    Happy New Year everyone!

  34. Interesting article.My 3 are 6, 4 and 2 and yes they did all use sippy cups (all different kinds). But as others have stated always regular cups at the table. I got rid of them pretty early with my youngest because I was so tired of cleaning them! I use stainless steel water bottles that have an open spout at the top when she is on the go. So yes it can spill but it has a little thing on top that she can close, she can drink freely and it spills less then an open cup. Oh and my favorite part is that is’s easy to clean with only 2 pieces.

  35. What about the cups that don’t have a “spout”? They are like drinking from a regular cup, but have a valve that prevents spilling. Would these create the same issues? http://www.amazon.com/Playtex-Insulated-Spill-Proof-Coolster-Tumbler/dp/B000BN63KM/ref=sr_1_6?s=baby-products&ie=UTF8&qid=1389798850&sr=1-6&keywords=spill+proof+cup

  36. Hi. First time mom here. My little one is 7 months, and still nurses and also drinks from a bottle. If I were to introduce a sippy cup, which one do you recommend, and for how long before teaching how to drink from a straw or regular cup?

    • Hi Jennifer, thank you for your question. There are a few options in the comments throughout this discussion and pictures on my Facebook page of ones I recommend. They include: Take and Toss Cups and straws (although I often use the soft straws from Talk Tools catalogue for younger kids or kids with sensory challenges), Playtex Coolster or a pop up straw thermos that doesn’t require biting the straw. But, when you have time (lots of comments here!) scroll through for more ideas!

  37. My daughter has been drinking from a sippy cup for a few months now. How do I switch her to a cup with a straw? She will be a year in a few weeks.

    • HI! I outline this in my book, Happy Mealtimes with Happy Kids, but let me try to give you the brief version of how to do it. Use the Take and Toss straw or the soft straw from Talk Tools like a spoon, with a puree that she likes, such as smooth applesauce. “spoon feed” the puree using the straw, so she gets the idea to close her lips around the spoon/straw, which has puree on the outside of the straw. Then, once she is accepting the straw well, put it in a small glass (like the size of a shot glass) that is filled to the top with puree. You can even cut the straw shorter, which makes this easier at first. When you set it in the glass, you automatically fill the interior with puree. Put your finger on the top of the straw to stop the puree from dripping out, and offer it to her lips, but his time, wait for once second as she begins to suck. She’ll suck an inch or two of puree! Once she can do that a few times, keep the straw in the shot glass, but put a swipe of puree on the outside of the top of the straw. Offer the straw (now in the glass) to her lips and the puree on the outside will get her to close and start to suck. Now, she is straw drinking! You can now shift to a regular straw cup, filling it as full as possible with a puree (a smoothie or smooth yogurt is perfect) so that there is less for her to prime, and she’ll get the hang of it. If she is unsure, you just need to swipe the top of the straw with puree to remind her. If they have the oral motor capability to do so, I’ve never had this not be successful. Takes one day to one week (daily practice) in my opinion and your can start at 7 months if the gross motor stability and oral motor skills are in place.

    • Oh, and one last point: Once she can control the puree, gradually thin with water and she is drinking thin liquids via a straw!

  38. 4ringcircus says:

    Couldn’t we just make out kids sit at the table with the cups to avoid injury?! I dont approve of the roaming sippy cup….you find them months later under the couch….and they do spill a little when turned over. As for oral concerns, the interior plug can be removed so the child isn’t sucking as hard. I am not so sure this is a topic to be concerned about…

    • Hi 4ringcircus (sounds just like my house!) – thanks for commenting. Scroll through the comments here for more info on why so many professionals are concerned. I know what you mean about the suction, but the issue is also the hard spout, the facilitation of anterior tongue tip positioning, palate and dental issues, including tooth decay. Still, it’s about prolonged use – that’s my biggest concern, so I just say step away.

  39. As Melanie points out, speech-language pathology practice is informed by high quality research, professional experience, and client preference. Quality research is not available to support a connection between the use of sippy cups and swallowing or speech development. Therefore, I think parent preference–and convenience–is what matters most here.

  40. Thanks for this interesting article. Let’s say that a 1 year old is not ready for an adult cup yet. Would it be better for them to drink water from a baby bottle or a sippy cup? or the same?

    • Hi Bucky, time to transition to open cups and straw cups. (-: One year old – such a fun age! If you are on facebook, visit My Munch Bug, where I posted pictures of cup alternatives.

  41. I read your line about how most parents believe the transition to a sippy cup is a developmental milestone and I thought, “It’s not?!” I agree that sippy cups are definitely marketed as such.

    I introduced a spill-proof straw cup to my 9 month old daughter. Now that she seems to have the hang of it, I plan to get some take-and-toss straw cups. I love your advice about cutting down the straw!

    I totally understand what you’re saying about the prolonged use of a sucking/swallowing pattern. I sucked my thumb for a long time (well past toddlerhood) and to this day, I rest and swallow with my tongue against my front teeth. I had to have braces to correct an overbite and huge gap and I have permanent retainers as well as a night retainer. My teeth hurt all the time. I know thumb sucking is not the same as using a sippy cup but I see how they train the tongue into the same pattern. Thank God my daughter is not much of a thumb sucker. I will absolutely be teaching her how to use a regular cup asap. Thanks so much for writing this post!

  42. I agree the Sippy Cup is a scourge for developing mature oral motor skills. I’ve seen babies use anterior/posterior jaw movement as well as the tongue to create the suction for fluid. However, typically developing infants seem to have the ability to adapt to the abnormal pattern, so parents (and pediatricians?) count that as a milestone. Happily, I’ve seen those same babies leave the adaptation behind as they continue on their developmental course. But for children with developmental motor problems, it is a very poor choice and seems to build in the abnormal movements. I think it’s important to consider that the children we see with developmental/oral motor difficulties likely had the issues prior to the use of devices that are being discussed here as associated with (no proof they cause) the problems. We tend to have a skewed perception because our case loads don’t include normal/typical children and we therefore make assumptions based on our experience (which is self selective).

    So, while this is an important issue, no one should generalize these concerns to typically developing children without more empirical evidence. Even if there was evidence that a percentage of typical children end up with abnormal motor patterns, etc, from use of a device, that would not mean the device will CAUSE problems for ALL children.

    Melanie’s advice about prolonged use of a sippy cup is important and applies to all areas of development, i.e. infant seats, bouncy seats, seating devices in general, supine positioning during sleep and play, etc. Rapid change is a hallmark of infancy and childhood and all children should have exposure to a variety of experiences. They will usually gravitate to experiences that meet their needs and move on when they acquire new needs. There is a tendency to “blame” devices, like pacifiers, and leads parents and others to refuse to allow infants their use when the infant may need it for a time to assist with state regulation.

  43. I find this article very interesting and informative, however as a mother of a 1 year old who has spent the last 2 months trying to wean my son from a bottle to a sippy cup I am left confused as to what type of cut I should be using. I appreciate the importance of teaching the use of an open cup and do so whenever possible, however as a busy mother and with a child in day care this is not possible 100% of the time. Can you provide further guidance on what types of no spill cups are appropriate?

    • Hi Lauren, Thank you for your question. Peruse through the comments on this blog – there are lots of good options mentioned along with links. If you are facebook, I posted a photo on my page of options too, as well as mentioning them in response to several comments here. Thanks again!

  44. No wonder mothers are so anxious about every decision they make for their babies! It is articles like this that make them second guess their choices. I understand your points in the article and the following thread of comments, I really do. But come on! The sippy cup has a time and place and if used appropriately is going to ensure your child is adequately hydrated and can learn to hold a cup and master the action of bringing cup to mouth and tipping head back for liquid (especially if your child has never used a bottle in their life and only breastfed for milk up until the sippy cup is introduced). What about mothers who go from breast to formula around the 10+ months mark and don’t want to introduce a bottle… are you suggesting that the mother painstakingly sit there with made up formula or cows milk in a cup, slowly offering it to their child while most of it ends up down the front of them? I can just imagine all the mums fretting after reading this article that they have somehow delayed their child’s development all because they let their baby have a sippy cup.

  45. Boob to regular cup (along with continued boob) here. You start with a small amount of water in a cup so they figure it out, and if they spill a little, who cares. The culture as it stands today is too into “convenience for the sake of the parent” and we should be focusing on child-centered care. We don’t have sippies in the van because 99% of the trips we make in it are 7-10 minute trips. They drink what they need at home and are fine and don’t need to tote a sippy into the stores anyway. I don’t know how they ever did it before sippy cups (kidding). ;)

  46. I’m a big fan of Just the Right Byte – thanks for including these thoughts here.

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  1. […] Read the Rest of this Article on ASHAsphere […]

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