When Should Babies Stop Using Bottles?
Babies should stop using bottles by 12 months of age, with bottle weaning ideally occurring around the first birthday, as recommended by the American Academy of Pediatrics and American Academy of Pediatric Dentistry. 1
Why This Timing Matters
Dental Health Risks
- Prolonged bottle use is a major contributing factor to dental caries due to extended exposure of teeth to sugars, particularly when children carry bottles throughout the day or go to bed with bottles 1
- The practice of bedtime bottles creates excessive carbohydrate exposure that directly promotes tooth decay 1
- Never allow children to go to bed with a bottle 1
Nutritional Consequences
- Excessive bottle use reduces intake of essential nutrients including protein, fat, vitamins, and critical minerals such as iron, calcium, and zinc 1
- Toddlers should not be given juice from bottles or easily transportable covered cups that allow continuous consumption throughout the day 2
- After 12 months, juice intake should be limited to at most 4 ounces per day, and juice offers no nutritional benefits over whole fruit 2
Impact on Weight and Growth
- Each additional month of bottle use beyond 12 months is associated with a 0.47 increase in BMI-for-age percentile at 36 months 3
- Prolonged bottle use (beyond 12-18 months) is significantly associated with increased risk of childhood overweight and obesity 3
- About 34% of children use bottles longer than 12 months, and 13% continue beyond 18 months, indicating this is a common problem requiring intervention 3
Practical Implementation Strategy
Transition Timeline
- Begin transitioning from bottle to cup around the first birthday 1
- If needed, bottle weaning can extend to 12-15 months maximum, but should not continue beyond this window 1
- After 1 year of age, all liquids (juice, milk, water) should be offered in a cup, not a bottle 1, 2
High-Risk Populations Requiring Extra Support
- Multiparous mothers, low-income households, Hispanic families, mothers with lower education levels, and those who did not initiate breastfeeding require additional support for successful bottle weaning 3
- These populations show higher rates of prolonged bottle use and need targeted intervention 3
Feeding Recommendations After Bottle Weaning
- Continue breastfeeding beyond 12 months if possible, as it remains nutritionally superior to cow's milk 4
- Limit cow's milk intake to no more than 16-17 ounces (500 mL) per day for children aged 12-24 months to ensure adequate intake of other nutrient-dense foods 4
- Establish a dietary pattern with 3-4 meals and 1-2 snacks per day, offered every 90-120 minutes 4
Common Pitfalls to Avoid
- Do not allow bottles at bedtime or for self-soothing 2, 1
- Do not use bottles as a means to calm an upset child after 12 months 2
- Avoid introducing juice before 12 months of age, as it offers no nutritional benefits and can displace needed calories from breast milk or formula 2, 5
- Do not allow children to carry bottles throughout the day for continuous sipping 2, 1