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A Pediatric Perspective

Sippy Cup Syndrome

Published February 8, 2008 10:15 AM by Wendy Hof

Several years ago a study published by the Journal of Dentistry for Children stated that out of 186 children presenting with baby bottle tooth decay like symptoms - 29% used sippy cups. This simple statement alone could, and did, cause many a parent to be worried about whether they should introduce sippy cups to their child as a transition from the bottle to the open mouthed cup. What is important to remember, and to share with the parents who are concerned, is that it is not necessarily the sippy cup itself that is the culprit but rather how it is being used.

Sippy cups were invented to help prevent messy spills when a child was transitioning from the bottle to the open mouthed cup. They grew in popularity because they not only prevented the frequent spills but also because they were a more acceptable option for children to have in their hands during car rides and trips around town. They were meant as a temporary solution to help the child learn how to use a cup. They were not meant to take the place of a cup.

The optimal way to use of a sippy cup is to utilize it in one of two ways. The first way is to offer them only at meal and snack times and to offer an open mouthed cup during the other times for practice. The second way is to do the opposite - offering a child an open mouthed cup at snack times and meals (with assistance until they know how to hold and take sips from it) and offering the sippy cup during the rest of the day to encourage fluid intake. It should not be used, however, all the time. It is important to introduce and practice several times a day with an open mouthed cup in order for the child to become proficient at it.

A sippy cup that has a straw instead of a spout would be more beneficial to the child. Drinking through a straw requires the child to use complex grading and coordination movements that would later benefit them when it comes to making sounds which require the same coordination/movement skills. Straw drinking will also promotes tongue retraction rather then tongue curling (around the straw in the same position as it would be in with a nipple when drinking from a bottle). Straw drinking is also the best choice if the child tends to drink more sugary beverage because the liquid will move further back in the mouth and not wash across the teeth.

It is not just the dentists who are concerned but several Speech Pathologists have also raised concern that sippy cups help to delay speech in children that use them all the time. They feel that the prolonged use of sippy cups causes a lazy tongue that produces sloppy "th" and "st" sounds. They have found that upon giving up the sippy cup and using a straw or open mouthed cup the child's speech improves.

If a sippy cup is used as it was intended to be used, as a transition object, then it would not be getting such bad press. It is important for us therapists to give parents a guideline on sippy cup use. Sharing with the family goals as to when to start and stop sippy cup use and how often and when during the day it should be used would not just benefit the child but also help the parents keep on track and transition smoothly to cup use.

Questions? Concerns? Comments? Suggestions?

posted by Wendy Hof


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