Is it really so terrible to let a two-year-old drink from a bottle?

June 11, 2015 4:43 PM

My almost two-year-old still has a bottle of milk before bed. It really helps her fall asleep and she is VERY attached. We brush her teeth afterwards, so tooth decay is not an issue (in bed while she is half asleep, since she is too young to spit anyway and doesn't need to be at the sink). She does not use a pacifier or suck her thumb, so the bottle is the only thing that gives her that magical sucking comfort. The doctor says we should stop with the bottles, but why?

I have been getting pressure from her pediatrician to stop the bottles since she turned one. The thing is, I don't really understand why. We are taking care of her teeth, and she is still at an age where she would have been breastfeeding before modern times, so getting comfort from sucking at this age seems natural to me.

The best argument the doctor could give me for completely cutting out bottles was that she might bite through the nipple and choke, but after having her bite through four sippy and straw cups and zero bottles that argument doesn't seem so great anymore. She currently drinks from cups with hard straws during the day, since biting through the soft rubber straws and spouts was such an issue. I think the cups were a problem because she loves to gnaw on them, but for some reason she doesn't gnaw on bottles.

Am I wrong about this? Is it really so uncommon or terrible to let children have bottles for comfort after age two?

(Also: no parenting advice category? Weird.)

posted by insoluble uncertainty to Health & Fitness (23 answers total)

Is it really so uncommon or terrible to let children have bottles for comfort after age two?

It wasn't weird for us and she wasn't brushing her teeth at two, either. I love our pediatrician, but he would occasionally come out with something that we'd just purely think 'that just doesn't seem right' and we'd chuck it out and never think about it again. Right up there is his suggestion that at six weeks we start letting her 'cry it out'. I'm cool with all parents doing different things, but that was not right for us so we filed that away under 'yeah. no.'

And then she slept in our bedroom for another two years.

So, uh, I guess...tolerances vary? I wouldn't steal a bit of comfort from a little kid without a good reason, though. The only thing that would give me pause in this case is the gnawing factor. If you don't think that's a factor in this case I'd do what you wanted to do.

Re the 'no parenting advice category': let's consider ourselves lucky.
posted by A Terrible Llama at 4:53 PM on June 11, 2015 [4 favorites]

Just wondering, in case it is a tooth decay issue / you don't want to do the brushing-while-asleep thing: have you considered putting water in the bottle instead (would your kid go for that?), and would that be OK by the pediatrician?
posted by spelunkingplato at 5:09 PM on June 11, 2015 [1 favorite]

I've heard the justification that prolonged bottle use can cause soft palate or jaw malformation. No idea how solid the scientific evidence is for this assertion, or how high or low the risk would be if it's true, but it's one of the common things that doctors say to discourage bottle use after age one.
posted by Mallenroh at 5:21 PM on June 11, 2015 [3 favorites]

I'm of the argument that you know your own kid best. Stop listening to the doctor unless it is really a health issue. Do what works best for you as a parent.

I have breast fed and bottle fed and I was bottle fed. I have babysat bottle fed kids and kids who had binkies and kids who did not (rarely). I have half breast fed and bottle fed. I have done it all. Listen, it is your kid, not the doctor's kid. You know them and you have to do what you think is right by your own kid. You sound like you know what you are doing but the doctor said something that conflicted with what you know and now you are waffling.

Is your child in ill health? No? Then keep on doing what you are doing. Follow your instincts. Not the doctor or the book or the website. Just what you feel is right for you and your kid. You will come out all right and so will your kid.
posted by Marie Mon Dieu at 5:22 PM on June 11, 2015 [8 favorites]

Yeah, I don't really understand this either. There seem to be a bunch of reasons (tooth decay, bad sleep habit, choking hazard) not to nurse/bottle to sleep if your child could go either way, but none really stands up on its own.

My kiddo nursed to sleep most of the time through age 3 and we never got hassled about it. To be fair, I also never sought any advice about this, because having such a nice bedtime all around seemed like a godsend rather than a terrible sleep habit. It seems like plenty of breastfeeding moms of toddlers agree there.

If it reduces your stress and gets your kid a better night's sleep, I suspect this cancels out any risks associated with the bottle. But IANAEITBC (I am not an expert in toddler bottle chewing).
posted by cogitron at 5:25 PM on June 11, 2015 [1 favorite]

The doc might be thinking about the bottle forcing her teeth out of alignment, rather than tooth decay.
posted by easily confused at 5:25 PM on June 11, 2015 [6 favorites]

I've noticed that many doctors give advice based on "what's generally thought of as optimal" rather than a considered risk/benefit evaluation applied to an individual patient.

If you're brushing her teeth (I would NOT skip this), and she's spending, what, 15 minutes on the bottle? how much damage could that do to her palate? - and if you stay with her while she's on the bottle so she can't choke - then I'd just go ahead and do it.
posted by fingersandtoes at 5:32 PM on June 11, 2015 [3 favorites]

Response by poster: I understand the tooth alignment argument for avoiding too much time spent sucking on a thumb/pacifier/bottle, but this is only 15 minutes a day total, which seems low enough. Kids suck their thumbs four HOURS a day until much older than two.
posted by insoluble uncertainty at 5:40 PM on June 11, 2015 [2 favorites]

You are awesome for thinking about tooth decay and brushing her teeth after! That is the main risk for allowing a child to fall asleep with a bottle and you have taken care of it. Keep up the good work and remember that you know your baby better than your pediatrician. You don't have to tell the pediatrician everything.
posted by myselfasme at 5:40 PM on June 11, 2015 [1 favorite]

My 3.5 year old still has a bottle, and I know quite a few kids who use bottles as night/morning comfort drinks, and eh. My paediatrician is the very senior doctor at a major university hospital who treats a wide range of children (our kid had a difficult start) and when we brought up the bottle issue at the last visit, he laughed and said "She's happy and healthy? Brush her teeth and let her eat a wide range of food, she'll stop drinking from a bottle when she's ready."
posted by dorothyisunderwood at 5:48 PM on June 11, 2015 [3 favorites]

We gave my son a bottle of milk at bedtime until he was about two, because I was sure he needed it as part of his bedtime routine. At about two, we cut out the bottle cold turkey (I think in our case it was because he was brushing his teeth before bottle time), and I don't think he even noticed. YMMV.
posted by amro at 5:49 PM on June 11, 2015

Best answer: I think the general concern is sending kids to bed with a bottle, where they drink it by themselves and often fall asleep while sucking, with the potential damage to the palate and the teeth occurring after they're asleep and not simply from drinking milk from a bottle before bed. Your doctor seems stuck on the standard assumption and not able to understand that your situation (bottle doesn't stay in bed, teeth get brushed afterwards) is different. If I were in your shoes, I would ignore the doctor based on the differences there (but then, I think this mostly falls under a "parenting" concern and not a "medical" concern, and I give a lot less weight to parenting advice from my pediatrician than I do medical advice).

My only concern is that as you get closer to potty training, you're not going to want to give liquid that close to bedtime. So you'll have to figure out a way to wean her off of it by then, or probably night training will take longer. Not a huge concern in the grand scheme of things, but something to think about.
posted by peanut_mcgillicuty at 5:57 PM on June 11, 2015 [3 favorites]

We just switched from bottles to sippy cups at bed time for my 28 month old because he was chewing through the nipples. And then we brush his teeth after. It works, and that makes everyone happy.
posted by blue_beetle at 5:57 PM on June 11, 2015 [1 favorite]

Again, I will say to you: stop worrying. I sucked my thumb until I was 12. There is nothing you can do that will hurt your child, because you are a concerned parent, and babies throughout the ages have survived, including your concern. Keep on doing what you are doing, and know that you are a good parent, and your baby will grow up to be a good human being. You can't hurt the baby, just raise it.
posted by Marie Mon Dieu at 6:53 PM on June 11, 2015 [1 favorite]

I have memories of drinking from a bottle as an occasional thing, so I was probably 4 or 5. (I was old enough that I would climb on the counter and get a bottle from the cupboard and make chocolate milk/ovaltine in it). My teeth are in pretty good shape and I didn't have any cavities as a kid.
posted by any portmanteau in a storm at 7:16 PM on June 11, 2015

I'd put water in there and if it's the comfort of sucking that'd doing the job great and no worries about tooth decay.
posted by wwax at 7:28 PM on June 11, 2015

my 7 year old drinks his bottle morning and evening and has lost only 2 baby teeth so far, the rest are not decaying or crooked fwiw. He has regular checkups with the dentists, who says all is well.
posted by waving at 7:58 PM on June 11, 2015

If it helps, I am 100% confident there is a book somewhere that says not only that it is fine, but that it is optimal. If the pediatrician (or anyone else) criticizes you, I suggest you pretend to have read the book - "Oh, we're just following what our parenting book says". Then you can do whatever you want and hopefully they'll leave you alone.
posted by contrarian at 5:45 AM on June 12, 2015

Are you in the US? It seems like in every on-line parenting discussion circles I've been in, US parents get enormous gobs of unsolicited parenting advice from their pediatricians. And best I can tell the rest of the world is taking their tots to a GP and not hearing a word of anything not strictly medical.

Which is a long-winded way of saying I would just ignore the "advice." Why is he pressuring you? That seems crazy from here and would send me to a new doctor. It isn't his kid, it isn't a medical issue.

I'm not even sure how this sort of thing comes up. I have never had a discussion about non-medical things with any physician my kid has ever seen. I nursed for years* and that, for example, never came up. They check weight and height and vital signs, peer at ears and eyes; I ask about a spot on the skin or whatever, and we're done.

* so having done that and observed the need, I am very much in favour of young kids having a teat. I would not yank a bottle from a 2yo.
posted by kmennie at 6:56 AM on June 12, 2015

Best answer: Dentist here, but of course NYD. It sounds like you are managing the tooth decay issue just fine by brushing after the bottle (but i agree that an attempt to switch to water would be good too).
It is very unlikely that a short duration bottle habit at age 2 will cause any lasting deformity in palate/jaw/bite.
Pediatricians, IME, don't really know jack about tooth development or best practices for kids' teeth, they are just giving you canned advice.
it's never too early to see a dentist, in my practice we wouldn't charge to see a 2 yr old member of an existing family for advice on issues such as this.
posted by OHenryPacey at 10:14 AM on June 12, 2015 [1 favorite]

One of my kids had bottles until he was maybe 7? I don't remember and hasn't thought of it in a long time. When I worried about it to a pediatrician friend, she raised an eyebrow and said, "It's just another way of having a drink."
posted by not that girl at 5:14 PM on June 12, 2015

Best answer: Here are my theories about why doctors want to stop the bottle at this age (I have a 2 year old, too, that stopped using her bottle around 20 months old):
- Worried about tooth decay, which you seem to be managing
- Falling asleep with the bottle, which you are not letting your child do.
- Worry about children growing dependent nutritionally on milk from the bottle because the delivery is so quick and they "chug" it down so quickly, but again, since it's a nighttime bottle only and not all day, seems fine
- Potty training. We're not there yet (toddler echo is still in diapers), but I understand that you will want to limit the fluids you give your child at night so that they can start managing their bladder. If potty training is in the near future for you, then this may be something you want to consider, but it's really more about liquids than the delivery of said liquids.

If you do want to switch - try just giving a sippy cup in lieu of the night time bottle at the same time and in the same situation, she may just surprise you (ours had no problem with this switch at all for her last bottle - we snuggled up in the glider, read her a book and gave her a sippy instead of a bottle and she did not protest at all).

Btw, consider getting her used to brushing her teeth while awake - she's at the age where she might find this fun and a good way to "help" you and it will get her used to it for the future.
posted by echo0720 at 6:20 PM on June 12, 2015

As a child, I grew up with a ridiculously strong preference for milk over water when thirsty, and I can't help but wonder whether this contributed somewhat to my lifelong difficulty in keeping my weight under control.

If you value the comfort that your child derives from her nighttime bottle, but you'd rather not lock in milk specifically or flavoured drinks in general as being strongly associated with snuggly comfort, you could try diluting the milk over time. Even one part full cream milk to two parts water still tastes more like milk than low-fat milk does; if you were to prepare her milk with 1% more water replacing milk every day, I doubt she'd even notice the transition until she was drinking pretty much straight water.
posted by flabdablet at 5:16 AM on June 13, 2015 [1 favorite]