When Should a Baby Stop Using a Bottle? How to Switch to a Cup

When should a baby stop using a bottle?

Between 12 and 18 months, in the American Academy of Pediatrics' advice, with an open cup by about age 2. The AAP recommends offering a cup when your child starts solid foods, usually around 6 months, then reducing bottle feeds slowly and completing the move sometime between 12 and 18 months. The NHS is shorter: once your baby is 1 year old, feeding from a bottle should be discouraged. The Canadian Paediatric Society (CPS) says to switch to a regular cup for all drinks between 12 and 15 months.

Question	What the guidance says
When to start a cup?	Around 6 months, when solids start (AAP, NHS)
When to stop bottles?	From 1 year (NHS); 12 to 15 months (CPS); by 12 to 18 months (AAP)
Open cup by	About 2 years (AAP)
Bottle at bedtime?	No bottle in bed; if one is needed at nap time, water (CPS)
Milk after 12 months	About 16 oz (2 cups) of whole milk a day (AAP); at least 350 ml or 2 servings of dairy foods (NHS); no more than 750 ml (25 oz) (CPS)
Formula after 12 months	Not needed (NHS)

If your child is 13 or 15 months and bottles are still part of the day, nothing has gone wrong. Switching sooner is easier than waiting, though: the AAP's observation is that toddlers cling to their bottles even more fiercely as time goes by.

Why does it matter when a baby stops the bottle?

Three reasons: teeth, how the mouth learns to drink, and appetite for food.

The AAP says early childhood caries happen when a child's teeth are constantly bathed in milk, formula, juice or other drinks.

A cup teaches sipping. The NHS recommends an open cup or a free-flow cup without a valve, because it helps a child learn to sip and is better for their teeth, and rates it above a bottle or a beaker with a teat. The AAP adds that children who drink from bottles well into their second year may have tooth alignment problems and even speech delays. The same reasoning applies to the first cup of water at 6 months.

On meals, the AAP says that for many children bottles become high-calorie meal supplements and snacks, which can lead to toddler obesity and mean less of the fibre and nutrients in solid food. The CPS sets a ceiling of 25 ounces (750 ml) of milk a day after 12 months: "Otherwise, they will fill up and won't want to eat solid foods." Too much milk, it adds, can also lead to iron deficiency anaemia. A feeding log with bottle volumes shows how much of a normal day still comes through a teat.

Is a bottle at bedtime bad for teeth?

It can be, which is why most guidance starts here. The CPS says tooth decay is caused by bacteria and happens more easily when teeth are often in contact with sweet liquids, such as formula, milk, juice "and even breast milk (which contains sugar)", and are not cleaned regularly. The NHS adds that drinks flow slowly through a teat, so a sugary drink stays on the teeth for longer.

What the CPS advises:

• Do not leave your child in bed with a bottle.
• If a bottle is needed at nap time, offer water rather than milk or juice.
• Clean your child's teeth before they go to sleep, including after a breastfeed at nap or bedtime.
• Take your child for a first dental visit by 12 months.

Moving the milk earlier in the bedtime routine, before teeth are brushed, means it is not the last thing before sleep.

How do you wean a baby off the bottle?

One bottle at a time, keeping the mealtime ones longest. The AAP suggests telling your child they can drink from a bottle at mealtimes while you gradually drop bottle feeds at other times, especially naps and bedtime, and offering cups mainly at mealtimes. Plain water in bottles between meals, then in cups, can help the transition too.

Falling asleep on a bottle is the habit to stop first; the bedtime milk itself can stay a little longer if it moves to a cup and comes before teeth are brushed.

For many toddlers the bottle is comfort as much as food, and that part needs replacing as well. The AAP suggests a new routine in which your child snuggles with you, listens to a story or soft music and drifts off, extra snuggles, songs or stories while the change settles, and notes a pacifier may help. Notice the progress and praise it. Tell other caregivers, so everyone follows the same routine.

Expect a few unsettled nights. The AAP's warning is that temporary sleep problems can turn into serious struggles if you give in to protests and offer a bottle at bedtime.

What should a toddler drink from the cup?

Whatever they already drink, to begin with. The AAP suggests putting formula or breast milk in the cup first, then plain water at mealtimes, and calls plain water the healthiest drink for a child. From 12 months the NHS says cow's milk can be the main drink, and that formula, including follow-on, growing-up and toddler milks, is not needed after 12 months. What changes at 12 months covers that switch.

How much milk varies by guidance body. The AAP puts 12 to 24 months at about 16 ounces (2 cups) of whole milk a day. The NHS says to try to give at least 350 ml (12 oz) of milk a day, or 2 servings of foods made from milk such as cheese or yoghurt. The CPS sets the ceiling at 25 ounces (750 ml).

Water and plain milk are the choices to aim for, in the AAP's words. It says added sugars should be avoided under 2, that toddler milks are unnecessary, and that sweetened drinks are best avoided even when calorie-free.

Breastfeeding is a separate matter. The AAP supports breastfeeding for as long as you and your baby want, to 2 years or beyond.

When should you ask a doctor about weaning from the bottle?

• Resistance has turned into a full-blown power struggle. The AAP names this as the point to talk to your pediatrician.
• Your child has a chronic illness, a physical difference or a developmental delay that affects their ability to give up the bottle. The AAP suggests planning the schedule with your pediatrician.
• Your child refuses cups entirely and is drinking noticeably less, or has fewer wet nappies.
• You are worried about weight or growth.