Free What to Expect the Toddler Years by Heidi Murkoff Page A

occurs when milk, juice, or another naturally sweet or sweetened liquid is allowed to pool in a child’s mouth routinely (as it does when he sucks on a bottle, but not when he sips from a cup), particularly during the time just before he falls asleep. The sugars in the fluids (lactose in milk and fructose in juice) are broken down by bacteria in the mouth. During the process an acid is formed, which feasts on protective tooth enamel, causing decay. Baby-bottle mouth can be severe and extensive enough to require extraction of the baby teeth and installation of a temporary replacement bridge. The cost is high both in money, and often, in self-esteem, since the toddler with missing teeth may develop speech and emotional problems. To prevent baby-bottle mouth, both the American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend weaning children from bottle to cup when they are a year old.
    Of course, convincing your toddler to give up the bottle will take more than scientific evidence, professionalpronouncements, or simple logic. As a first step, provide your child with a substitute container for his beverages: a cup. By this age, many children are already proficient at drinking from a cup. If yours is, that part of your job will be relatively easy. If not, see page 26.
    INTRODUCING COW’S MILK
    Most toddlers take to cow’s milk without a fuss, but an occasional child who’s been on formula rejects the taste of plain cow’s milk. One way to make the switch easier is to start by diluting the formula with a little cow’s milk. Gradually, over a period of a few weeks, increase the proportion of cow’s milk and reduce that of formula until your child is drinking pure cow’s milk.
    Once your toddler can drink several ounces of fluid from a cup at a sitting, you can begin saying “bye-bye bottle.” Choose one of the following approaches to weaning, keeping in mind how your child handles change—and how hooked he is on the bottle.
    Cold Turkey . If your toddler is easygoing, doesn’t panic in the face of change, makes transitions smoothly, isn’t particularly dependent on the bottle, and is proficient with a cup, a cold-turkey approach may work. Pick a time when you anticipate no other major changes in your toddler’s life—and when you will have plenty of time to devote to him. Select a day that begins well (if either of you wakes up on the wrong side of the bed, put the project off). Start the day with the announcement, proclaimed with great fanfare, that he’s a big boy now, and like all big boys (“just like cousin Josh” or “just like Daddy”), he can drink all his milk and juice from a cup (cheers and applause). Take him to the store and let him help you select several new cups in the style he likes best, with fun designs and bright colors. At home have him help you throw his bottles and nipples into the recycling bin. (Save one or two bottles to be used for play—as bathtub toys or when “feeding” baby dolls or stuffed animals.) During weaning, your toddler may be a little more cranky and sensitive than usual, and thumb-sucking may increase (or begin). Give him plenty of extra time and attention, and lots of hugs to make up for the comfort he’s no longer getting from the bottle. If your toddler remains unfazed at losing his bottle and makes no serious requests for it over the next few days, you can consider yourself lucky and the process complete.
    If, however, he starts to have second thoughts and begins begging for a bottle (he might do so at bedtime, or at whatever time of the day taking a bottle has meant a lot to him), borrow back the bottle you’ve saved for play, wash it, fill it with water, and offer it to him. Tell him that he can have a bottle of water whenever he wants (water won’t damage his teeth). Stand tough, though. If he asks for his accustomed milk or juice served up in the bottle, say firmly that those beverages will only be available in a cup from now