toddler cup

Ask Amanda: Switching breastfed babies to a cup

Switching breastfed babies to a bottle or a sippy cup can be a challenge in the beginning. In this week’s kids’ nutrition Ask Amanda column, pediatric dietitian Amanda Gordon offers some ideas to make the transition easier

Dear Amanda, I have an 11-month-old infant who has nursed since birth and never accepted a bottle. She won’t drink well from a sippy cup either. My milk supply is running low and I’m not sure what to do.

First off, congratulations on making it breastfeeding for 11 months!  That is a big accomplishment.  According to CDC, only about 1/3 of all women who initiate breastfeeding in the United States make it that long.  

In terms of your good question, cow’s milk isn’t an option for babies until one year for many reasons. It contains high concentrations of protein and minerals, which the immature kidneys, stomach and intestines of young infants cannot handle well and it can make them sick. Cow’s milk also lacks iron, vitamin C and other nutrients that infants need, compared to breastmilk or infant formula. .We usually recommend trials of cow’s milk or a gradual transition after an infant turns one year old with a continuation of breastfeeding as possible. 

In terms of the bottle issue, many of the speech and feeding therapists we work closely with often recommend a transition straight to cup, instead of a bottle if an infant is that close to a year old and nursing.  When asked, my colleague, Ellie Trefz, MS, CCC-SLP, recommends, “I would say that starting a straw or open cup would be the next option. You could try water or expressed breastmilk if the infant is under one year old.”

If your supply allows, I recommend continuing to breastfeed up until one year, while also working on cup drinking with water.  Infant formula is an acceptable substitute as needed up until one year, and you can serve it in cup over the next month if necessary.  Whole cow’s milk, as long as it is well tolerated, is a good option after your baby is over a year.  

Ask Amanda is a weekly column from Feed to Succeed dietitian Amanda Gordon. Have a question? Email Amanda and let her know or submit an “Ask Amanda” question for a future column.