My Toddler Still Wants a Bottle at Night
The short answer
Night bottles after 12 months increase the risk of tooth decay and can contribute to excess calorie intake and overnight waking. The AAP recommends weaning from bottles by 12-15 months. Gradually reducing the amount in the bottle, switching to water, or replacing the bottle with a comfort object can help break this habit.
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By Age
What to expect by age
Night feeds are essential at this age. Babies need to eat frequently and should not have feeds restricted overnight.
Night feeds are still normal and expected for most babies at this age.
Many babies still need one or two overnight feeds. Talk to your pediatrician about when night weaning may be appropriate based on your baby's weight and growth.
Many babies can drop night feeds by this age if growing well. If baby takes a bottle at bedtime, try offering it 30 minutes before laying them down rather than in the crib to avoid a feed-to-sleep association.
Night bottles should ideally be discontinued by 12-15 months. Milk pooling around teeth overnight causes baby bottle tooth decay. To wean: gradually reduce the amount in the night bottle by half an ounce every few nights, switch to water in the bottle, or replace the bottle with a cup of water and a comfort object. Expect some pushback for 3-5 nights.
What Should You Do?
When to take action
- Toddler asks for a bottle at bedtime during the transition period
- Toddler takes a few nights to adjust to no night bottle
- Toddler accepts water in a cup as a replacement
- Toddler is over 18 months and you cannot get them to give up the night bottle
- Toddler has visible tooth decay or discoloration from night bottles
- Toddler drinks large amounts of milk overnight and is not hungry for meals during the day
- Toddler has significant tooth decay or dental pain
- Toddler is choking or gagging on the bottle while lying down at night
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Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Feeding Concerns
Toddler Still Using a Bottle
The AAP recommends weaning from the bottle by 12 to 18 months of age. Prolonged bottle use, especially with milk or juice at bedtime, can contribute to tooth decay, ear infections, and excessive calorie intake. But if your toddler is still attached to their bottle, you are not alone. Many families find this transition challenging, and there are gentle strategies that can help make the switch to cups.
Weaning Off the Bottle
The AAP recommends beginning the transition from bottles to cups around 12 months and completing it by 18 months. Prolonged bottle use is associated with tooth decay, excess calorie intake, and iron deficiency anemia from drinking too much milk. A gradual approach that replaces one bottle at a time with a cup usually works best and causes less distress for everyone.
When Should I Stop Night Feeds?
Most healthy, full-term babies who are growing well can sleep through the night without feeds by 6-9 months, though some may need feeds longer. Readiness signs include good weight gain, eating well during the day, and waking at consistent times rather than from hunger. Night weaning should be discussed with your pediatrician, as premature or underweight babies may need night feeds longer.
When to Introduce Allergens to Baby
Current guidelines recommend introducing common allergens (peanut, egg, cow's milk products, tree nuts, wheat, soy, fish, shellfish, sesame) starting around 4-6 months when your baby is developmentally ready for solids. The landmark LEAP study showed that early introduction of peanuts (by 4-6 months) reduced peanut allergy risk by 80% in high-risk infants. Do not delay allergens - the old advice to wait until 1-3 years has been reversed because early exposure actually prevents allergies.
I'm Worried My Baby Is Aspirating During Feeds
Aspiration means liquid or food enters the airway instead of the stomach. Occasional coughing during feeds is common and does not usually indicate aspiration. True aspiration is less common and may present as recurrent respiratory infections, a wet or gurgly voice after feeds, or chronic cough. If you are concerned, a swallow study can provide a definitive answer.
Could My Baby Be Aspirating During Feeding?
Aspiration occurs when food or liquid enters the airway instead of the esophagus. Signs include coughing or choking during every feed, a wet or gurgly voice after eating, recurrent chest infections, and breathing changes during meals. Silent aspiration can occur without obvious coughing. If you suspect aspiration, contact your pediatrician as a swallowing study can diagnose it.