Transitioning from Bottle to Cup/Straw Feeding

I am an OT and a new mom to my 6-month-old daughter. We have just started introducing solid foods, but she drinks from only a bottle. I was wondering if you had any tips for transitioning from bottle to cup.  I have heard mixed reviews regarding sippy cups…
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I am not against using the right sippy cup as an intermediate step to teach cup drinking.  However, I find that many parents are not using them as a transition cup, but rather as a convenient, no-spill option.  Their convenience leads to prolonged use – usually to the exclusion of cup and straw use.  And without cups/straws, the lips, cheeks, tongue, and jaw may not learn to function correctly.  When drinking from a straw, the lips are extended and maintain a good seal, the tongue is retracted, and the cheeks assist.  Straws exercise the oral musculature, promoting proper development for feeding and articulation.
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Now, your daughter is a little too young for straw drinking, but you can teach her cup drinking first.  The Pink Flexi Cup is the easiest way to go.  It has a cut-out section for the nose so that you can more easily see what is going on as she drinks.  Make sure she is sitting upright with her head straight (not tilted back or forward) and her feet supported.  Pour some liquid inside the cup and squeeze so it flows toward the middle of the cup.  Show her the liquid and then place the edge of the cup up to her mouth.  Allow a couple drops to touch her lips.  This will teach her that liquid also comes from a cup, not just a bottle.  Once she understands this concept, she should easily learn to drink from a cup with practice.  When liquids are too thin for early learners, you can use baby food or applesauce instead.  Or a combination of juice and baby food for the right consistency.
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honey-bear-juice-bottle

At about 8 months of age, you can start working with her on straw drinking.  ARK’s Bear Bottle makes this transition very easy.  It comes with a special valve that keeps the straw full of fluid, thereby making drinking easier for beginners or individuals with poor oral motor skills.  Simply squeeze the bear’s belly until the straw is full of fluid.  Then give it an extra squeeze onto a napkin so she can see that liquid comes out of a straw.  Place the straw just inside her mouth and squeeze a small amount of liquid into her mouth.  Repeat until she gets the idea that she needs to suck to drink.  When she is ready, squeeze the fluid only partially up the straw, stopping a short distance below the top.  Because the liquid isn’t as high in the straw, it will require slightly more effort to drink.  Once she becomes comfortable drinking from this distance, lower the level of liquid again and repeat.
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Finger Feeding Tips for Toddlers

Finger feeding is a very important step towards 1. feeding independence and 2. setting the stage for healthy eating habits.  Finger feeding typically starts at about 8-10 months, but of course there are always exceptions.  A friend of mine didn’t start with her baby until 11 months of age for example.

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In order to be ready for finger feeding, your child needs to be able to sit up completely on her own, without support.  Another indication of readiness is when she begins to grab the spoon out of your hand as you feed her.  Or if she shows an interest in what you are eating and tries to grab food from your plate.
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Finger Feeding Tips for Toddlers

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To start, make sure that she’s not in motion, crawling around, etc.  She must be seated.  Allow her to place her hand over yours to assist in spoon feeding.  You can also give her a spoon of her own to use, but still feed her with yours to make sure she’s eating a full meal.  Take turns between feeding yourself and feeding her, which helps reinforce good social skills at the same time, such as turn-taking, eye contact, etc.
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Tips for Pleasing Picky Eaters

Offer a variety
Kids are naturally curious, so try offering them a variety of different foods to explore.  Put a different bite-sized snack in each compartment of an ice-cube tray or a muffin tin.  Include some of their preferred foods as well as soon non-preferred foods.  They will likely gravitate to their preferred foods and that’s ok – just having the other foods there will be progress.  If they won’t eat certain foods, see if they’ll touch them instead.  Talk about the food and have the child describe it.

 

Offer it again
Sometimes it can take up to 8-10 or more presentations before a child will feel comfortable enough with a new food to try it.  Oftentimes when a child refuses to eat something, parents put that food into the “no” category right away.  But sometimes the child just needs time “warming up” to the new food.  Give them lots of opportunities to do so.

 

Reinvent it
Come up with fun names for the foods, such as cauliflower blasts, tomato balloons, pretzel light sabers, etc.  Have the child come up with names with you.  This can help make new foods more appealing / less threatening.

 

Dunk it
Almost everyone loves a good dip.  There’s a reason why dips are a staple at parties – they’re fun (and tasty) at any age.  Let kids take their foods “for a swim” in salsa, guacamole, hummus, cream cheese, ketchup, cheese whiz, yogurt, jelly, nutella, peanut butter, etc.  The child will likely be more open to trying a new food if it’s covered in one of their favorite dipping sauces.

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Get sneaky
Try hiding small bits of healthy foods inside foods they like.  Making brownies?  Add walnuts or applesauce.  Macaroni and cheese?  Add well-cooked puréed cauliflower.  Start with very small bits at first, working up to larger pieces over time.  This is a form of food chaining.  It’s also a way of getting them to eat more nutrient rich foods in the meantime.
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Continue reading Tips for Pleasing Picky Eaters

How to Teach Biting and Chewing Skills

For infants, learning how to bite and chew is a crucial stage of feeding development.  At approximately 5-6 months of age, babies begin using their fingers and teethers for oral exploration using a bite and release pattern.  The development of biting and chewing continues from this point on, with the baby refining the movements of the jaw, tongue, and lips.  When infants miss a part of this developmental process, intervention may be necessary to develop the ability to bite and chew.

 

Teach Biting & Chewing Skills

1.  One of the ways I like to begin is to provide the child with the opportunity to mouth ARK’s oral motor chew tools (the Grabber, Y-Chew, Probe, and/or Animal Tips).  These tools were specifically designed to increase oral awareness, to provide stimulation and tactile sensation, and to exercise the lips, cheeks, tongue, and jaw.  Through oral exploration, the child just might begin to bite on his/her own, and from there you can progress to chewing.

Continue reading How to Teach Biting and Chewing Skills

Strengthening Mouth Muscles

My daughter’s speech therapist suggested we have my daughter sip thick liquids (i.e. yogurt, chocolate pudding, etc.) through a straw to work on strengthening mouth muscles.  I have not been able to find straws thick enough to work.  Do you have a suggestion?


Straws are a great way to help individuals learn how to keep the lips closed, how to keep the tongue inside the mouth, how to improve cheek strength, etc. However, it may be difficult for your child to drink pudding or yogurt through a straw.  Perhaps your therapist may have meant for you to add pudding or yogurt to a drink in order to thicken it?
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Personally, I have found that straws from McDonald’s have a large circumference, and they may just do the trick for you.  You may also be able to find straws in Target or Wal-Mart with a wider circumference to accommodate thicker substances.
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Since it is a goal for your daughter to work on strengthening her mouth muscles, I would also like to suggest our Lip Bloks (pictured above).  Lip Bloks are essentially mouthpieces that can be inserted into the top of most standard drinking straws.  They come in three different sizes: ¾ inch, ½ inch, and ¼ inch.   You start with the longest (¾”) size, and then as soon as it becomes easy for your daughter to use that length, you progress to the next length level (½”).  When this becomes effortless, you progress to the final ¼” level.  The orange and purple Lip Bloks shown above are made out of a flexible material so that you can cut the stem to any custom length level.  The time frame between levels can vary for each individual, from one week or even longer.
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One of the children on my caseload is non-verbal, has sensory issues, autism, and can not close his lips due the position of his teeth.  I used a Lip Blok with him for 8 weeks, and the change was incredible.  His tongue is now closer to being inside his mouth, he no longer makes a suckle noise when he drinks through a straw, and he can now maintain closure with his lips.  Lip Bloks can achieve all of this by working the mouth muscles naturally.  Your therapist, however, should also be able to provide additional direction.
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For more oral motor exercise ideas, click here.
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