Weaning Off the Bottle
The short answer
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.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
This is the ideal window to introduce cups so that your baby starts becoming comfortable with them before the actual bottle weaning process begins. Offer small amounts of water or breast milk in an open cup or straw cup at mealtimes. There is no need to eliminate bottles yet, but early exposure to cups makes the transition much easier later.
Begin eliminating bottles one at a time, starting with the one your child is least attached to, usually a daytime bottle. Offer milk in a cup at meals and snacks instead. The bedtime bottle is typically the hardest to drop. Try moving it earlier in the bedtime routine so your child does not fall asleep with it, and offer comfort through a book or song instead.
If your child is still using a bottle at this age, it is important to work on transitioning. Some parents find that going cold turkey works well for toddlers who can understand a simple explanation. Others prefer a gradual approach, diluting milk in the bottle with water while offering full-strength milk in a cup. Talk to your pediatrician if you are struggling with the transition.
What Should You Do?
When to take action
- Your child protests for a few days when a bottle is dropped but adjusts within a week
- Your child drinks less milk from a cup initially compared to what they drank from a bottle
- Your child asks for the bottle at bedtime but accepts an alternative comfort after a brief adjustment period
- Your child prefers a straw cup or open cup over a sippy cup or vice versa
- Your child is over 18 months and completely refuses to drink from any type of cup
- Your child is drinking excessive amounts of milk from a bottle, more than 24 ounces per day, and eating very little solid food
- You are concerned about your child's dental health due to prolonged bottle use, especially with milk at bedtime
- Your child has become significantly distressed and is eating or drinking very little since you started the transition
- Your child is showing signs of dehydration because they refuse both bottle and cup
- Your child has visible tooth decay that you believe is related to bottle use and has not been seen by a dentist
Sources
Related Resources
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
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.
Baby Biting Nipple While Nursing
Biting during breastfeeding is a common challenge, especially when babies start teething. It can be startling and painful, but it is almost always a phase that can be managed. Babies cannot actively nurse and bite at the same time because their tongue covers the lower teeth during proper sucking. Biting typically happens at the beginning or end of a feed when the latch is not active. With some gentle strategies, most babies learn quickly that biting ends the feeding session.
My Baby Keeps Clamping Down on the Spoon
Clamping down on the spoon is very common, especially during teething or when babies are learning new oral motor skills. It is often a sensory exploration behavior rather than a feeding problem. Using a soft silicone spoon and placing food on the front of the spoon can help.
How Can My Baby Get Enough Calcium Without Dairy?
If your baby cannot have dairy due to allergy or intolerance, there are many other calcium sources. These include calcium-fortified foods, broccoli, kale, tofu made with calcium sulfate, beans, calcium-fortified plant milks (after 12 months), and sardines. Breast milk and formula provide adequate calcium before 12 months. If dairy-free after 12 months, planning is important.