What Should I Do If My Toddler Refuses to Give Up Bottles?

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My 14-month-old daughter refuses to drink milk out of anything besides a bottle. We’ve tried several types of sippy cups, and she is not having it. We end up in a standoff with the milk-filled sippy cup until I eventually cave and give her a bottle with milk. She drinks water out of sippy cups just fine, just not milk. Our pediatrician’s recommendation was to wean babies off bottles at 1, so I am feeling a little anxious that she’s still glued to her bottles at 14 months. What is the data behind this? Is it imperative that I stop giving her bottles asap?
—Sippy Cup–Bottle Standoffs

Many health guidelines are given in absolutes, but biology does not have absolutes like this, for the most part. There is no magic thing that happens at the age of 12 months that means bottles before are fine and bottles after are some kind of disaster. A very large number of parents I talk to find this transition challenging, so you’re not alone.

There are basically three reasons why people are encouraged to wean their children off bottles as they reach a year old.

A primary worry is about teeth. Prolonged bottle use is associated with more cavities in kids. I say “associated with” because the causality here is not airtight. The strongest evidence is around bedtime, where either bottle or breastfeeding without toothbrushing afterwards seems to lead to an increased risk of cavities in babies over 12 months. This is logical: the milk stays around teeth and provides food for bacteria, which are what cause tooth decay. It’s not so much the bottle here but the milk — any delivery mechanism causes similar concerns.

A second concern is that children who rely on bottles may consume too much milk, at the expense of other foods, especially iron-rich ones. This is a theoretical concern, since milk doesn’t contain a lot of iron, but in practice, most studies find milk consumption is good or neutral. In general, as your child ages, they should get more calories from food and fewer from milk.

From a data-driven standpoint, if you are giving a bottle at bedtime, it’s a good idea to wean off that if you can, for cavity reasons. Other than that, it is not worth panicking. A reasonable approach may be to simply eliminate some of the bottles of milk, rather than trying to replace them with sippy cups. Or try an open-top cup of milk at meals. Over time, they will adjust.