Bottles, Pacifiers, & Sippy Cups – Oh My!

Major news stations including CBS, Fox, and CNN responded in full force to the article “Injuries Associated with Bottles, Pacifiers, and Sippy Cups in the United States” published last week in the medical journal “Pediatrics”. The authors’ stated goals were to increase parental awareness and potentially develop products that could minimize likelihood of trauma.

News coverage of article by Keim et. al

The study was a well constructed retrospective analysis using data from the National Electronic Injury Surveillance System. Ultimately, the authors identified that over the 20 year study period (1991-2010), an average of 2,270 children were taken to the ER for injuries related to the items each year. The results of the project were that over 70% of injuries were to the mouth and most children were around the age of 1, when kids are most unstable as they learn to walk and run. Bottles accounted for 66% of injuries, pacifiers 20%, and sippy cups 14%.

As dental students, we also know the dangers bottles, sippy cups, and pacifiers can pose to a child’s oral health. When used between meals, and especially when left with a child at bedtime, bottles and sippy cups can lead to childhood caries. If not discontinued at an early age, pacifiers can lead to occlusal anomalies like restricted palatal width and anterior open bite.

There remains, however, some ambiguity regarding appropriate use of pacifiers and bottles. The American Academy of Pediatrics recommends that pacifiers be used in infancy (which is associated with decreased risk for SIDS) and discontinued by 6 months to prevent otitis media. Our own American Academy of Pediatric Dentistry has a slightly different standard, recommending discontinuation of pacifiers before the age of 3 to prevent changes in dental occlusion. The AAPD also advocates transitioning from a bottle directly to a lidless cup by 12 months in order to prevent dental caries, while the AAP is more lenient with advice to wean by 15 months.

Unfortunately, many parents do not adhere to recommendations from either organization. An Arizona study showed that almost half of children aged 1-2 are still using bottles and an Infant Feeding Practices study demonstrated that ~40% of one year olds are still using pacifiers. If parents would follow the guidelines and implement changes, the vast majority of these traumas could be avoided.

So parents, start listening to your pediatricians and your dentists! Encourage your children to only drink when seated. Don’t allow kids to constantly sip on liquids (especially sugary ones!) throughout the day. And follow the recommendations set forth by the AAP and AADP. Your reward will be healthier, safer environment for your child.

What do you think about the usage of bottles, sippy cups, and pacifiers in children? Have you seen any interesting cases on your pediatric rotations? Share your thoughts!

~Ashley N. Phares, UConn ’13, contributing editor

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Comments (10)

  1. dentiste holistique

    Thanks for sharing this info. As a first time mom, I’m still on the verge of finding out the things that needs to be done in taking care my 9 month old baby. Although her teeth does not show just yet, we are starting to train her to drink in sip cups as early as 8 months. I also would like to recommend a holistic approach in dental hygiene, you can find some holistic approach at dentiste holistique.

  2. Tim Hamich

    Thanks for this. I remember my cousin who loves drinking milk in a bottle up until he’s 1 years old. We found out that he’s two front teeth is becoming too small that it hurts him sometimes. We tried to train him in a cup now, and we already consulted a dentist veneers lexington.

  3. Anna Hayes

    Great seeing such informative article. My baby needs bottle training. She’s turning 2 this month and we can’t remove her bottle addiction. So what we did was we planned to visit our dentist and tried their invisalign atlanta procedure for her.

  4. Connor Hudson

    You really have to be reminded with these important facts about having a healthy life. Of course, like what my rockford dental dentists said to me. It is important that we consider dental health part of our healthy lifestyle.proper brushing, flossing and a regular dental check up. Be reminded of these things.

  5. Billy Stanford

    Always watch what your kids put on their mouths. Especially the materials they use in drinking and eating. We went to our dentists sydney just last week and advised me to not use sippy cups for my kid anymore.

  6. Lea Michelle

    Yes, I make it a point to always watch what my kids eat. Now that he’s 2 years old, he’s becoming more curious of everything the he sees and almost all of it go straight to his mouth. Good thing, my cosmetic dentist houston helped me with his regular dental check up.

  7. Vince Fury

    It is an alarming statistic, which should be a cue for dental practitioners to be more vocal and aggressive in their efforts to educate parents. I couldn’t agree with this line more – “If parents would follow the guidelines and implement changes, the vast majority of these traumas could be avoided.” It sounded like those words are coming from a dentist in longview texas.


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