Definition

• You want to stop bottle feeding, but your child does not.
• Your child protests with crying or other demanding behaviors.
• Your child is older than 12 months.
• The AAP recommends complete weaning from the bottle by 15 months at the latest.

Health Information

Potential Problems from Excessive or Prolonged Bottle Feeding

Excessive bottle feeding can cause problems. It should be considered an important problem if it causes any of the below:

• Sleep problems are the most common unintended consequence. The ability to sleep through the night is delayed. Night wakings for a refill continue far beyond 6 months. Reason: Milk feedings are used to put your baby to sleep. Result: Child does not learn how to self-initiate sleep. Harm to the mother: Sleep-deprivation.
• Refusal to eat any solid foods and over 6 months old. Result: Hard to start after 9 months old. Reason: It's easier to suck than to chew.
• Baby-bottle tooth decay from having milk coating the teeth too often
• Overweight from drinking too much milk (over 32 ounces)
• Speech delays because bottle in mouth
• Older children often strongly resist weaning. Bad habits become harder to break with each passing month. After 2 years of age, taking away the bottle may be a battle.

If your child has any of these problems, read the next section. Follow the tips on how to help your child become a healthier eater. Do this before trying to completely wean your child.

Causes of Bottlefed Weaning Resistance

• Excessive or prolonged bottle feedings
• Excessive bottle feeding means more than 4 times per day after 6 months
• Excessive bottle feeding also means giving the bottle for the wrong reasons
• Delayed bottle feeding means beyond 12 months

Care Advice

How to Stop Excessive Bottle Feedings and Prepare Your Child for Weaning

What You Should Know About Excessive Bottle Feedings:

• Bottle feeding too often can cause health and behavior problems. Those problems are listed above in Health Information.
• Decrease bottle feedings so they don't cause or worsen any of those problems.
• Here are some tips to help:

1. Reduce the Number of Bottle Feedings to 4 per Day:
   • For children over 1 year, get your child on a schedule of 3 main meals a day, including a bottle of milk.
   • Also, offer 2 nutritious snacks that do not include a bottle feeding.
   • Provide your fourth bottle feed at the start of the bedtime ritual.
2. Start Some Feedings from a Sippy Cup (if this was not done at 6 months):
   • Cup feedings are needed as substitutes for bottle feedings. This is needed regardless of the age at which weaning occurs.
   • The longer they don't use a cup, the less willing they'll be to try it.
   • Ideally, daily cup feedings are started by 6 months of age. This is a natural way to keep bottle feedings from becoming overly important.
3. Don't Allow Carrying Around a Bottle During the Day:
   • Stop this immediately.
   • The companion bottle encourages habit drinking (comfort drinking).
   • It can cause serious tooth decay that needs surgery. Called baby bottle tooth decay.
   • You can say, "It's not good for you to carry a bottle around". Say, "You're too old for that." Another option: "Your doctor said it was bad for your teeth".
4. Stop Using Bottle Feeding to Fall Asleep or Allowing a Bottle in the Crib for Sleep:
   • Stop this immediately.
   • All babies can handle a 7 to 8 hour fast by 6 months of age. That means they can easily sleep through the night.
   • But if they are fed until asleep, they will not learn to self-soothe to sleep. After normal night wakings, they will want a bottle to get back to sleep.
   • Also, don't allow your child to take a bottle to bed. This will cause sleep problems as above. Also, taking a bottle of milk to bed may cause severe tooth decay.
   • Offer the explanations suggested above in # 4.
5. Stop Any Night Time Feedings:
   • Ideally, this is done before 6 months.
   • If your baby is still waking at night for feeds and over 1 year, ask for help or information in stopping night time feedings.
6. Start Complete Weaning Now or Later:
   • Once you have made these healthy changes, complete weaning will be much easier.
   • Facts to consider: After 12 months of age, the bottle becomes more important to your child. It becomes more of a bad habit with each passing month. Weaning will become harder.
   • Caution: Do not start weaning if your family is under stress (such as moving). Also wait if your child is under stress. An example of this is entering a new child care.

How to Stop Bottle Feeding Completely (Weaning)

1. Delayed Weaning from the Bottle - How to Stop Bottle Feeding Completely:
   • Delayed weaning from the bottle means your child is over 1 year old.
   • You want to stop bottle feeding, but your child doesn't want to give up the bottle.
   • Also called weaning resistance.
   • This bad habit will become harder to break with each passing month.
   • Here are some tips that should help.
2. Offer Milk in a Cup Before Each Bottle Feeding:
   • Since your child is 1 year of age or older, you can use whole milk.
   • You can also use formula or mix some formula with whole milk.
3. Gradually Stop Bottle Feedings During the Day:
   • Weaning to the cup should always be done slowly and with love. The "cold turkey" or abrupt withdrawal approach will make your child very upset.
   • Get rid of one bottle feeding every 3 to 4 days. Use your child's reaction to figure out how fast this should be done. Replace each bottle feeding with a cup feeding and extra holding.
   • Stop bottle feedings in the following order: midday, late afternoon, morning, and finally bedtime.
   • For most children, the bedtime feeding is usually the most important one. In giving up this feeding, slowly decrease the amount of milk in the bottle. Do this each day for a week.
   • After 2 years, it may be easier to pick a day and stop all bottles abruptly.
4. Replace Bottle Feedings with Holding your Child:
   • Do not offer a bottle after you have completed the weaning process.
   • Respond to ongoing requests for a bottle by holding your child.
   • You can explain that bottles are for little babies. You might have your child help you carry the bottles to a neighbor's house.

Call Your Doctor If

• This approach to weaning has not been successful after you have tried it for 1 month
• Your child is over 2 years old
• Your child has tooth decay
• You think your child needs to be seen
• You have other questions or concerns

Author: Barton Schmitt MD, FAAP

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