From the Guidelines
By age 2, children should no longer be using bottles, as recommended by the American Academy of Pediatrics, to prevent dental problems, excess calorie intake, and interference with speech development. According to the study published in Pediatrics 1, toddlers should not be given juice from bottles or easily transportable covered cups that allow them to consume juice easily throughout the day. This is because excessive juice consumption may be associated with malnutrition, diarrhea, flatulence, abdominal distention, and tooth decay.
The normal bottle requirements for a 2-year-old are essentially non-existent, as they should be transitioned to cups for all their drinking needs. The study also suggests that families should be educated that, to satisfy fluid requirements, human milk and/or infant formula is sufficient for infants and low-fat/nonfat milk and water are sufficient for older children 1.
Some key points to consider when transitioning a 2-year-old from bottles to cups include:
- Replacing one bottle feeding at a time with a cup, starting with daytime feedings
- Using sippy cups as a transitional tool if needed, but aiming to move toward regular open cups as the child's coordination improves
- Offering about 16-24 ounces of milk daily in cups with meals and snacks
- Being consistent in the transition process, which may take a few weeks to complete.
It's also important to note that the American Academy of Pediatrics recommends weaning children from bottles by 12-18 months of age, and at 2 years old, children should be primarily using cups for all their drinking needs, including water, milk, and other beverages 1.
From the Research
Normal Bottle Requirements for a 2-Year-Old
- The American Academy of Pediatric Dentistry recommends that children should be weaned off the bottle by the age of 12 to 18 months to prevent nursing caries 2.
- However, research indicates that more than 8% of children 2 to 5 years old still use the bottle 3.
- It is essential for parents to be aware of the risks associated with prolonged bottle use, including early childhood caries, and to adopt good oral health practices 4, 3.
- Healthcare professionals should educate parents on the importance of discontinuing bottle feeding around the age of 12 months and promoting good oral health habits, such as daily toothbrushing and flossing 2, 4.
- Parents should be advised to limit the frequency of carbohydrate exposures and to offer water instead of sugary drinks in bottles or cups 2, 5.
- A qualitative study found that parents' understanding of the prolonged effect of exposure to sugared drinks in feeding bottles and cups was poor, and that commercial influences on choices were strong 5.
- Another study found that nursing habits, such as frequent nocturnal bottle or breast feeding beyond a year of age, can establish the potential for gross dental decay in very young children 6.