Must-Read Expert Advice: Pacifiers, Sippy Cups, and Speech
Understanding the impact of pacifiers, bottles, sippy cups, and other artificial nipples and spouts depends in part on understanding how reflexes and oral development change over time. Typically, all developing children progress through certain oral motor skills as they grow during their first few years of life. There are critical periods of development that occur for certain feeding skills.
Newborn to 4 months: Suckle reflex is present. A baby uses the buccal sucking pads to express milk from the breast or bottle, and the tongue moves the milk to the back of the mouth for swallowing. The lips are not active in feeding. Sucking is a reflex.
4 months to 6 months: The suckle and suck reflex is lost, and sucking becomes an intentional act. As the reflex diminishes, so does the forward tongue thrust motion. As the tongue thrust diminishes, a baby is able to accept pureed food via spoon feedings. The lips slowly become engaged in the feeding process.
6 months to 7 months: A baby uses a primitive bite and release pattern when given a soft cookie; however, the baby mostly sucks the cookie to break it down.
7 months to 8 months: As a baby begins to accept thicker pureed foods, the tongue movements are becoming more precise with up and down movements. By the end of eight months, the tongue begins to move from side to side. Cup drinking may be introduced at this time, although larger mouthfuls of liquid may cause choking or coughing due to poor coordination of sucking, swallowing, and breathing.
9 months to 12 months: As a baby begins to finger feed, the bite becomes more refined and chewing begins to transition to a circular (rotary) chew. The rotary chew is not fully established until 48 months. At 10 months, the lips move to remove food from the spoon. Straw drinking may be introduced.
12 months to 14 months: An infant can tolerate ground, mashed, and coarsely chopped foods, including small pieces of meat. The lips are active during chewing and are coordinated to drink from a straw. Some coughing may be present while drinking from a cup if the liquid is flowing too fast.
So what does that all really mean when it comes to teaching your child to wean from the bottle?
A baby begins to develop the oral motor skills necessary to learn how to drink from a straw at nine months. In the next three to four months, he or she develops a coordinated sucking and swallowing pattern to drink from a straw without difficulty. There is no reason to give your child a sippy cup other than for convenience.
Do sippy cups or prolonged use of pacifiers cause speech sound errors?
The field of Speech-Language Pathology continues to move toward evidence-based research to support our therapy techniques. A study done by Laura L. Shotts, D. Mike McDaniel, and Richard A. Neeley did not show any statistically significant relationship between prolonged pacifier use and articulation (speech) skills. However, we do know that the use of a straw and open cup promotes the appropriate tongue position for certain speech sounds and swallowing patterns.
A child's oral motor development begins to mature around the age of one. The tongue and jaw movements become more refined in order to precisely chew food for primary nutrition instead of suck liquid from a bottle. Using a straw over a sippy cup promotes appropriate oral muscle strength for the development of speech sounds.
I have treated many, many children with articulation errors such as lateral “s” (known as a lisp), who used a sippy cup and/or pacifier for prolonged periods. Often these children also have a reverse swallow tongue pattern that can impact dentition as well. Not all children who use a sippy cup (or a pacifier beyond a year) have articulation errors or a deviant swallow pattern. but I have found that many of the children I see have very poor oral muscle tone.
So when is the best time to wean my child from the pacifier and bottle?
The easiest time to wean a child from a bottle and pacifier is between 12 and 18 months. At this point, children are beginning to learn how to hold a cup and chew solid food. Weaning a child from either after two years can prove to be difficult, as they begin to manipulate their environment and communicate their demands.
When do you plan on weaning your child from the pacifier and bottle?