You Decided to Take Away the Bottle.... Now What?

Straw drinking is usually what I recommend transitioning to. For one thing, they are used to the action of sucking from the nipple of the bottle, so transitioning to straw drinking will be more familiar than cup drinking, but also they are going to improve lip rounding, developing appropriate placement of the tongue and strengthening their cheek muscles. Why does this matter? As I mentioned in a previous blog post "Bye Bye Bottle:Why You Need to Ditch it Sooner Rather Than Later!", lip rounding, cheek strength, tongue position, impact feeding AND speech. So if they are just beginning to accept table foods, using a straw will only benefit them, because through developing those cheek muscles, chewing skills, including tongue movement, will be positively impacted. Whereas, continued use of a bottle will not provide any benefit because it sits further back in the mouth, keeping the tongue flat in the mouth and the blade of the tongue and hard palate are doing most of the work.

You can always use a simple straw and open mouth cup if you begin while directly working with them on taking sips, but of course you have to be ready for spills. If you prefer a closed cup with a built in straw, just be careful because some of these cups can offer "no spill" due to an extra component known as a "valve". What is a valve? It is defined as a device that controls the flow of air or liquid. In the case of straw cups, the way that this works is it requires more force to pull the liquid out. So, if your kiddo isn't able to develop sufficient pressure to overpower the valve, they are going to have a difficult time taking a sip. That would be discouraging and so it's less likely that you'll be able to easily transition them to straw drinking over the bottle. If you've already bought the cup and are noticing that your child is having difficulty, see if you can remove the valve. You can always put it back when they have improved. If you're worried about spills, you have a few options. Fill it with water while they are walking, watching tv, or playing, this way you don't have to worry about stains. Create a structured snack time where you only have juice while sitting at the table. Make it seem like a special treat, so if you're working on having your child to sit at the table, you're killing two birds with one stone so to speak. A second option would be to only use the straw cup without the valve attached, during structured snack or mealtime activities regardless of what it is filled with. It does require frequent breaks to ensure they have plenty of opportunities to practice and to properly hydrate. The third option, would be to take your chances and just brace yourself for spills. Let them use the cup without the valve throughout the day so they get plenty of practice.

If your kiddo is having difficulty, opt for a softer straw that you can pinch. This is because for those kids who need a little extra assistance because they can't maintain the seal around the straw with their lips in between swallows, you can help them by pinching the straw about an inch away from their lips to keep the liquid higher up in the straw. It mimics the assistance the honey bear cup provides by preventing them from having to start from scratch with every sip. If with each sip the liquid drops back down to the bottom of the straw, sipping then becomes tiring and they are also taking in more air with every sip which can make them gassy and uncomfortable. Grab a juice box and try it yourself. You'll notice that you don't start from scratch with every sip. You'll see that you maintain a seal with your lips around the straw, and so with every swallow, liquid remains high up in the straw. Now, release the seal and test out how tiring starting from scratch with every sip can be.

With practice, you can decrease the physical assistance you provide your child (pinching the straw), and shift to only providing verbal cues. If they need visuals drink from a straw with them in front of the mirror so they can imitate you. BUT! If they are having difficulty please get an evaluation with an ASHA certified SLP before trying out any new strategies. It's better to ask a professional if the strategies you are considering would be worth implementing, than potentially either wasting your time or implementing something that could create set backs. Use this information to ask questions and to educate yourself on the topic of straw drinking.

Back to straws. The width of a straw makes a difference as well. For a thin straw, your child has to be able to purse or pucker their lips enough to create an appropriate seal. While the wider straw (like boba drink straws or some water bottles) doesn't require as much pursing, it does require more force to pull a larger amount of liquid up the straw. I would recommend getting one of each for yourself so that you can take a sip from a thin straw and a wide straw to get a better idea of what I'm describing. In this case, the middle ground is best, which is why most toddler cups use them.

Next is the weighted straw. A weighted straw differs from a valved straw, so be sure to double check what your cup has. The purpose of the weight is to use gravity to your child's benefit by keeping the straw in the liquid, regardless of the direction the cup is tilted. I do like a weighted straw for new straw drinkers because it keeps them from tilting the cup up along with their chin, which is an unsafe drinking posture. Why? For beginners or those who have swallowing disorders or difficulties, in the raised chin position, gravity is working against your safety. If you miss time breathing and swallowing, the liquid is going straight into your lungs. For the most part, our reflex kicks in and we cough out any liquid that has entered the lungs. If anything remains though, for example if you have an insufficient cough to completely clear your lungs, you could develop something called aspiration pneumonia. I'm not taking any chances, whether in therapy or in this blog, so I'm going to clearly state that you should avoid letting your child drink while lifting their chin up into the air.

Keep this in mind for the next section. Cup drinking. I don't usually push one product on parents. I prefer to give the appropriate characteristics to look for, and I will do that here too.

• Wide mouth

• Tapered

• Short

  

That's really it. As long as your child doesn't require any special adaptations.

A wide mouth keeps them from tilting the cup and their chin up, again, an unsafe drinking posture. A tapered body is easier to grip. A short height means less liquid, so sure less liquid to spill, but more importantly less liquid they can swallow at one time. Large overwhelming gulps won't be an issue, and the added weight of a larger amount of liquid also won't be an issue.

Of course, I have to state that if you have any concerns with your child's ability to drink from a straw, a cup or concerns with their feeding or swallowing in general, PLEASE schedule an evaluation with an SLP in your area as soon as possible.