Transitioning to Cups from Breast/Bottle

with Hallie Bulkin, MA, CCC-SLP, COM

Why do parents (Hi, I’m a parent!) like sippy and 360 cups? It’s simple! 

convenient
They keep the floors clean – no mess!!
Children can walk around with them without spilling.

Unfortunately, while they may not be harmful to all children, we are living in an epidemic of airway deficient children who have jaws and orofacial structures that are not optimal and we need to do everything in our power to optimize their development during critical periods.

So…out with the sippy and 360!

My only disclaimer here is that if your child has special needs and this is one of the only vessels they can safely or independently drink from, and your medical team has recommended continued use of a sippy cup for reasons specific to your child, then that is the exception to the rule. But this is not most children.

For those of you wondering how you part with the cup when it’s such an easy and integrated part of your child’s hydration and day. Here are some easy solutions to make a transition away from sippy’s and 360’s and begin using straw cups and open cups throughout the day.

Instead of allowing your child to walk around with a cup all day (hello spills!); create a central place for cups at a table in your kitchen or the room you are most frequently in during the day.
Take water breaks if you are worried about hydration.
At meal time: hand them the cup and then move it off the tray if you have concerns about cups being thrown to the floor and a mess being made.
When a cup spills, don’t react. The reaction leads to repetition. If they know you are going to react, they will continue throwing the cup. Keep that poker face on here!
Put WATER in the open cup so spills are just water and don’t create sticky floors and big clean ups!
Model how you use straw and open cups!

So why do professionals strongly recommend against the use of sippy cups or 360 cups?

Sippy cups were an invention of parental convenience. Gone are the days of suckling when it comes time to transition to an open cup or straw cup!

Sippy cups/360 cups create one of 3 atypical patterns. They perpetuate suckling which should only be present during breast and bottle feeding. 360 cups also force a bite and suck/suckle, which is also an atypical oral pattern for drinking. And they force the head/neck into extension, which is the opposite of what we want as it puts their airway at risk.

Think about it, how do we open the airway? We tilt the head/chin up/back. We do not want to purposely expose the airway by opening it while drinking (we want to protect that airway!)

SO if your child is struggling on a 360 it’s because they aren’t meant to drink this way.

If they take to it immediately or you are using it now, you can work on switching to a straw cup and/or open cup. This may take some time but don’t stress, just approach it the same you did as the bottle to cup transition initially.

How about those non-spill cups? Well, most have 2-way valves (yes, even straw cups that are “non-spill”). Valved cups are not ideal because they lead to….

jaw fixing
biting to stabilize
sucking harder than necessary
atypical use of the lips
thrusting the tongue forward 

Bottom line…these cups cause the child to overwork their muscles to pull the water out…all to keep our floors and their clothes clean.

As a mom I’d rather have a child with proper orofacial development and a maximized airway over clean floors and clothes (and my youngest is MESSY so this is no small feat in my house!)

NOTE: Munchkin released a straw top that fits the 360 cup. Switch them out for this new option!

Many factors come into play in regards to how our orofacial structures and swallow pattern develop. This is a BIG discussion as we need to consider epigenetics, changes in our diet over the last 50+ years, oral development in utero (did you know a fetus begins swallow around 12 weeks in utero?!), failure of apotosis and tight tissues (hello tethered oral tissues) along with general oral sensorimotor development that occurs through the first 3 years of life (to name a few!)

What we DO know when we look at all of the available data is:

breastfeeding most closely resembles open cup drinking
breastfed babies do better than bottle fed babies when learning open cup drinking
we are born with the suck we will use for life

So what happens when something GOES WRONG?

When we see certain symptoms as a result of using suboptimal patterns that are perpetuated by the very sippy cups our kids are drinking from we have an ethical obligation to speak up and recommend against them, which is why we have strong stances on using proper open and straw cups over sippy cups. 
We are not here to shame any single brand for their products or any parent for their choices (you can choose to use any cup you want!), but please know that companies are not researching the impact of their cups on oral motor development, and why should they? 
Read through the marketing and question any claims.

Research

  • No one has done research on various cup vessels and their impact on oral motor development. 
  • We need to remember that even the highest level of research, if it were available can be biased and is never the end all be all. Not many people know how to read the research or make sense of it; and those who do often weaponize it against parents to their benefit (this is a cruel practice but one you should be aware of!)

So what do we do when we lack research?

We turn to the experts in a given space and we discuss what we see CLINICALLY. And yes, this is part of the EBP Triangle (evidence-based practice triangle): CLINICAL EXPERTISE!
We look at our own CLINICAL DATA, patient feedback, years of studying oral motor development patterns and documented norms and THIS is what should guide our knowledge and clinical decision making (JUST AS MUCH if not MORE than a study) when it comes to oral sensorimotor skills needed for cup drinking.
Oftentimes specialists see patterns in their patients within their practice. We also use a variety of strategies, products, and more as deemed appropriate with our patients. Assessment and Treatment is always dynamic and arguably the quickest way to get up to date information on best practice recommendations. 
This does not downplay the importance of doing research. But at times, when we are concerned that harm is being done, we should not wait 3-10+ years until research pops up (if it even does!). We have an ethical obligation to remove a harmful object, treatment or practice immediately and make sound recommendations in the best interest of our patients.
Even further, we need to look BEYOND THE TOOL (e.g., the cup) itself to the SKILLS it is promoting. We need to assess if it is working towards the desired skills or against them. Wouldn’t you discontinue use of an object or treatment if it was causing harm or standing between you and your desired goals? This is exactly what we are recommending here with sippy cups and 360 cups. 

So I encourage you as a parent or practitioner to do just this. Look BEYOND the tool itself to the skills it’s promoting. If it’s working against the end goal or the skills we expect the child to develop, it’s time to ditch that product and replace it with a more optimal option. In this case, ditch the sippy and 360 cups and replace them with straw (non-valved!) cups and open cups! 

Discount codes: 

Ezpz code: HALLIE10

Sensominds 20% off: HALLIEB20

Share:

Archives