Who should read this chapter? If your child is 15 months or older and is currently still using a bottle, you should read this chapter. If your child is less than 15 months, you should read this chapter.

Summary: The practice of using a bottle to put your child to sleep is incredibly convenient. When your infant's hands are strong enough to hold a bottle, you will find this practice frees you from the chore of feeding. Once your child's teeth emerge, this practice promotes dental erosion and decay. This practice should be stopped by 18 months of age or earlier.

At about 9 months or age, infants are able to hold a bottle on their own. You will find it incredibly convenient to prepare a bottle of formula to give to your baby. He/She can finish the bottle without any help from you so that you can do other things. Typically, once we put the bottle in their little hands, we can expect several hours of peace since their attention will be on the bottle and they will fall asleep after this.

There is some concern that feeding infants in this position (lying down on their back) promotes the development of ear infections. The importance of this concern is not clear, but many pediatricians believe this factor to be important.

There is definite dental harm done with this type of feeding practice once teeth have emerged (on average at 8 months of age). The front teeth are continuously bathed in milk or formula promoting erosion and decay. Even after the child has fallen asleep, he/she periodically sucks on the bottle to maintain the milk bath on his/her teeth. This is not very harmful when they are young because their teeth have only partially erupted and they are not strong enough to hold the bottle for long periods of time. However, prolonging this type of practice into later years (15 months, 2 years or 3 years, etc.), promotes dental erosion and decay.

I once saw a 3 year old child in the emergency room because he had cracked his front teeth. When I looked at these teeth, they looked like potato chips. No wonder they cracked. These teeth were the result of years of bottle feeding when falling asleep.

It is commonly recommended to wean from a bottle at 12 months of age, but this is too early for most families. Children should definitely be off the bottle by 15 or 18 months of age or earlier. Just discard all the bottles in the house. When your child is thirsty enough, he/she will drink from a sipper cup.

If you feel that weaning from a bottle is too difficult or inconvenient and you need a bottle to put your child to sleep at night, may I suggest that you use a sugar free solution in the bottle (plain water) when this is done. Diluted aspartame (Nutrasweet artificial sweetener) sweetened drinks such as Crystal Light may taste better and these are probably safe, but the long term safety of artificial sweeteners in young children is not as yet guaranteed.

Another strategy is to never put juice or dairy milk in a baby bottle. During infancy, the only thing that should go into a baby bottle is infant formula, expressed breast milk or water. When you introduce regular dairy milk at 12 months of age, it should only be given in a cup or training cup. When it is time to wean off of formula and/or breast milk, the only thing that should be given in a baby bottle, is water. This will encourage the growing infant to preferably drink from the cup (milk). He/she can give up the baby water bottle easily at any time and water does not promote tooth decay.