Breast to Bottle to Cup

19 months old tomorrow and Matthew still drinks his milk-based formula (for toddlers 9-24 months old) from a bottle. I have discussed most (if not all) the possibilities to switch him over to a cup completely with his Occupational Therapist (OT), Developmental Therapist (DT) and Speech Therapist (ST). We don't have any strong concerns about his oral motor tone. I think it boils down to his emotional attachment to the bottle. Perhaps he gets some kind of comfort or satisfaction from bottle drinking? I initially tried offering milk in a cup at snack time, you know, cut back one meal at a time. My efforts to wean him off the bottle have always been met with little hands pounding the food tray and waving away the cup. How does one be persistent enough with this without turning snack time or any mealtime into a milk battle? Why couldn't this be as easy as the transition from breast to bottle?

Yes, I was able to successfully nurse for 9 months and supplemented with pumped milk in a bottle. We used standard Dr. Brown's bottles, recommended to us by one of the specialists at the hospital when Matthew was born. Sure, there were concerns about the bottle promoting tongue protusion, a common issue for kids with Down syndrome. I had considered switching him to other bottles but I didn't. Why mess with something that was working well? The Dr. Brown's bottle seemed to prevent colic, spit-up, burping and gas (as it advertised). More importantly, Matthew was gaining weight so we knew he was getting enough. Matthew suckled and latched on well but there were many times when he would tire easily or fall asleep. This was expected though. Because of his low muscle tone, it took more effort for him to nurse. So I always pumped after nursing to make sure he also got the hindmilk he needed. Weaning him seemed to happen naturally as I began to pump more than nurse. Eventually I supplemented with formula when I wasn't producing enough. I think the fact that Matthew was already introduced to the bottle early on (starting when he was in the Special Nursery at the hospital) and that it was easier to drink out of the bottle helped him transition as easily as he did.

As every mom with a special needs child knows, the age ranges in lists of developmental milestones for typically developing kids do not apply. 'Stage Not Age' at Down Syndrome New Mama also points this out. The developmental chart in 'An Overview of the Development of Infants with Down Syndrome (0-5years)' available at Down Syndrome Online estimates 20 months as the average age that a child with Down syndrome would drink from a cup, with the age range being 12 to 30 months.

I introduced him to water in a Munchkin brand sippy cup and water in a clear open cup when he was around 8 or 9 months old with the goal of weaning him off the bottle by the time he turned 1. The new goal is "when he's ready". It's not that he won't drink from a cup at all. He can drink juice and water from his sippy cup and an open cup, with fairly good lip closure at the rim. But he flat out refuses milk in a cup. I've even tried other special cups without the spout, since the spouted sippy cup may encourage tongue protusion just like the bottle. He hasn't warmed up to any of these cups yet. The clear and pink ones are called Little Spill cups that Matthew's OT got for him to try. The only place I have found them is at Beyond Play online. They also have flexi cups (not pictured here) but Matthew only tossed around the one he had. The Playtex cup is available at Target.



In the back of my mind, I know he will agree to drink milk from a cup. Just 'when he's ready'.