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The Ultimate Guide to Cup Drinking

5/27/2020

 
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Top left (clockwise) via Instagram: @n_and_cs_mom, @livvy_k.a, @tpaigemcintosh, @jackie_bosco

Updated May 2020

Confused about cups?

You're not alone! One of the most common questions on our Facebook group and Instagram is "How do I introduce a cup?" We know you have questions about cups given your child's specific age and stage, so we want to break it down step-by-step so you know exactly how to introduce various cups and what cups are appropriate for your child's age.

Note: the images in this post were used with permission from parents in Feeding Littles Group. Thank you to everyone who contributed images - we wish we could use them all! 

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@jenniferedlin

The big questions.

Before we get to teaching specific cups and how to progress to more advanced skills, we wanted to answer some important questions.
Q: When should I introduce a cup?
A: Around 6 months, when your baby starts food (Baby-led Weaning or Traditional Weaning/spoon feeding).


Q: What type of cup should I use first? 
A: An open cup, then a straw cup (see schematic and videos below).

Q: How do I know when to move on from an open cup to a straw cup? 
A: When your baby can successfully swallow a small amount of water from an open cup that you assist in holding. (They don't need to be able to do it independently to learn a straw cup.)

Q: What are your favorite straw cups and water bottles?
A: In each section below after the video, look for the links to individual sections of our Amazon Store for specific cup buying recommendations.

Q: What should I put in the cup?
A: Water or breast milk/formula.

Q: What about juice?
A: We only recommend juice for constipation (prune, pear, peach juice diluted with water). Otherwise, juice isn't necessary for babies and young children - fruit is a better option! 

Q: How much water can a 6 month old have?
A: No more than 1-2 oz - we don't want it to displace baby's milk feeds.

Q: Why should I offer some water at 6 months? Aren't breast milk and formula perfectly hydrating?
A: Yes, they are! However, water in a cup has a few important functions:
  1. Offering water in a cup helps wash down food.
  2. Teaching cup drinking is an important skill to learn for when baby is eventually weaned from the breast or bottle.
  3. A small amount of water helps prevent constipation when food is introduced.
  4. We want babies to like water so that when they're older they have a drive to drink it! 

Q: How much water can my baby drink?
A: In general, we recommend no more than 1-2 oz around 6 months and 3-4 oz max around 9 months. Around 12+ months baby can have as much water as they want but will likely still be drinking breast milk, milk and/or formula along with it (see last question about milk needs, below). Many pediatricians consider a water maximum (after 6 months) as number of ounces equaling baby's age in months; thus, no more than 7 oz of water for 7 months. For most babies this would be far too much water for them to also drink enough of their milk, but it's a nice maximum guideline if baby is sick or for some reason isn't drinking their milk.

Q: When should I ditch the bottle?
A: Start working on transitioning off the bottle around 11-12 months. It may take many months for your toddler to stop using the bottle entirely and transition to cups, but the biggest issue with prolonged bottle use is the potential effects on your toddler's teeth. If using a bottle before nap or bedtime, try to brush your toddler's teeth before they go to sleep. We have a detailed Milk and Weaning eBook included in our Infant and Toddler online courses that addresses all of this. It can also be purchased separately here.

Q: How much fluid do toddlers and older kid need?
A: Toddlers and kids need more fluid than you think! Below are averages recommendations of total fluid per day. Read more specifics about your child's needs - and how to calculate them if you'd like - here.
  • 1-3 years: 4-6 cups 
  • 4-8 years: 7 cups
  • 9-13 years: 9 cups (girls), 10 cups (boys)
  • 14-18 years: 10 cups (girls), 14 cups (boys)

Q: How much breast milk or formula should my baby (under 12 months) drink?
A: Babies will vary wildly in how much their bodies need for adequate growth and development. Some babies drink 26 oz a day, while others need over 40 oz. Most babies need at least 24 ounces of breast milk or formula until they're closer to one. This equates to 6-12+ breast feeds depending on baby's milk transfer. Talk to your doctor, dietitian or lactation specialist if you're concerned about how much milk your baby is drinking.


Q: How much milk should my toddler or child drink?
A: This is a tricky question and depends on your child's overall diet. If you have our Toddler Course, head to Step 16: Calcium, Milk and Beverages. If your child is drinking cow's milk or an alternative milk, general guidance recommends no more than 16-24 ounces per day to allow your toddler or child to also eat enough food and not fill up too much on milk. Drinking too much cow's milk can increase a child's risk for iron deficiency anemia as well. Many moms continue to breastfeed far into toddlerhood, and some families choose not to use any milk after infancy. Feeding Littles firmly believes that there's no one right solution for every child - some kids thrive on cow's milk while others breastfeed far into toddlerhood. Some kids eat high-calcium, high-fat foods and get all of their calories from solid foods and no milk. Every child is different and will vary. Please refer to our Milk and Weaning eBook in both courses or here for more details about choosing a milk for your child.

Q: What about smoothies?
A: Smoothies are OK as of 6 months in small amounts, as long as they don't contain artificial sweeteners or herbs (found in protein powders). Most straw cups made for thin liquids are too narrow for smoothies and the thicker smoothie consistency gets stuck. Check out our smoothie cup video and product recommendations at the end of this list! 

How do I introduce cups to my baby?

We recommend an order of cup introduction to help your baby progress through specific oral-motor skills. 

Your baby only needs to learn to drink from two types of cups:
  • First, an open cup.
  • Next, a straw cup.
​
Above all else, make sure to start with an open cup first. It really helps your baby learn how to take a small bolus of liquid in their mouth and swallow. We recommend avoiding hard spout sippy cups - the rationale is described in the final video.

What about Miracle 360 cups? Parents like the 360 cup, which is similar to an open cup with a silicone membrane lid, because it is less likely to spill. In the past we recommended it as the third cup type to teach your baby. However, recently many feeding specialists have expressed concern about how some kids use this type of cup. Please head to the 360 Cup section in this post for more details.

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Step 1: Open cup with adult assistance

First, let's talk about how to teach your baby to drink from an open cup:
Why does Judy recommend open cups first?
When can my baby drink from an open cup without my assistance?

As your baby gets older and more experienced with an open cup, they will begin to hold it independently and drink on their own. Many of Judy's private feeding therapy clients are able to independently drink from an open cup by 10 months of age, but every baby is different.

To help your baby drink from an open cup on their own after they've practiced with you holding the cup:
  • Give baby a small amount of water in the cup and hand it to them with your hands over their hands ("hand-over-hand" technique). 
  • Help them guide the cup to their mouth and drink a small amount of water. Say "AHH" for them to repeat (this promotes swallowing).
  • With your hands over their hands, help them place the cup back on their tray or table. Putting the cup down gives them a break between sips of water that keeps them from drinking too much, too fast. 
  • Ask them if they want more - this is where sign language can help! 
  • Repeat until baby is doing this on their own! Practice, practice, practice.
​ 
To see our list of favorite open cups, click HERE in our Amazon Store.

When can we move onto a straw cup?


As soon as your baby successfully swallows from an open cup using your assistance, try a straw cup! We want your baby to be able to use both types of cups.

Step 2: Straw cup

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@thefierycrash
While open cups are wonderful for drinking at home, reusable straw cups are preferred by parents for water drinking while on the go because they're oftentimes leak-proof (or at least leak-resistant). Some people are moving away from disposable straws for environmental reasons, but it's still important to teach straw usage because most kids' cups utilize a reusable straw, and as you'll learn later that we don't want to use hard spout sippy cups for oral development and speech reasons. Straws also strengthen muscles in the mouth that are important for eating and talking. 

Some babies learn how to use a straw simply by placing one to their lips or by capturing some liquid in a straw with your finger and placing the other end in baby's mouth. Many babies, however, need a little help figuring out the straw. Below Judy will go through how she teaches straw usage with her clients. If your baby figures out a straw cup without issue, you can skip the Mr. Juice Bear/Honey Bear step, but it's very helpful for babies who don't figure out straws right away.
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Miss Avery Mae
Straw cup video 1: Mr. Juice Bear / Honey Bear
Find Mr. Juice Bear and the Honey Bear in our Straw Cup HERE in our Amazon Store.
Straw cup video 2: Take N Toss and assisted straw skills
Check out the Take N Toss cup HERE in our Amazon Store! 
Straw cup video 3: Independent straw cup drinking
Handles can be easier for baby to use, but they're not required. Check out our favorite  straw cups in our Amazon Shop HERE! 

Step 3: Bigger kid cups - water bottles, heavier cups, etc.

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@iamjrhew
As your child progresses, they may be ready for a "real" water bottle or "big kid" cup! These larger cups and water bottles are great for daycare, preschool or the diaper bag because they're less likely to leak and hold more liquid. 

Some things to consider with heavier or larger water bottles:
  • Can your child lift it, or is it too heavy?
  • Can they open the top and drink from it independently?
  • Are their hands big enough to wrap around the water bottle?

If you've answered "yes" to these questions, it may be time for a "big kid" cup! 

Our Straw Cup Amazon list has lots of water bottles for kids 16-18+ months, including our favorite brands Contigo, Hydroflask and Yeti. If you're looking for even bigger water bottles for kids 4+ years, head here. 

Note: a hard or wider straw as found in the Contigo, Hydroflask and Yeti cups do not pose the same oral-motor concerns as a hard spout sippy cup. They are still straws and promote a normal suck pattern.

What about smoothie cups?

Parents in our Facebook Group always ask about smoothie cups. Check out what Judy recommends, below.
Check out our favorite smoothie cups HERE.

What about the Munchkin 360 cup?

As we explained above, we used to recommend the Miracle 360 cup for parents who wanted a more spill-proof option that mimicked an open cup. However, recently some feeding therapists have noticed that the 360 cup can contribute to problematic drinking patterns in some kids:
  • Some kids use excessive jaw movements to get the liquid out of the cup. (This is called jaw protrusion.)
  • This cup may cause your child's tongue to rest in the front of their mouth (anteriorly). With "normal" drinking patterns, the tongue is not meant to stick forward.
  • Some children tip their head back when they drink from the 360 cup. When they tip their head back, it forces their tongue to work in an abnormal pattern.
But we love the 360 cup! Should we stop using it?

  • Developmentally, it's important for your child to drink from an open cup and a straw cup.
  • If they're using a 360 cup, try to switch to an open or straw cup for the majority of their cup drinking.

If your child cannot or will not drink from anything but a 360 cup, here are some tips:

  • Pull off the silicone top lid of the 360 and offer it to your child with water or milk in the cup. This turns it into a modified open cup. Your child may need some time to learn to modify their drinking pattern and neck position.
  • Note: ensure that your child is sitting upright when drinking from a cup. If they were used to drinking it reclined or laying down, modifying the cup may cause the liquid to pour out onto them. 

Why do we avoid sippy cups?

Learn why Judy doesn't recommend hard spout sippy cups. With all the cup options available there's no need for traditional sippies! 

Bloopers....

As you can imagine, this post took us a bit of time to create, so we decided to have a little fun with it. Feeding Littles presents: "The Most Important Cups for Your Kitchen."
For the record, this was a joke...we do NOT recommend teaching your kiddo to drink from a flask. Or a wine glass. Joke. Seriously.

We hope this has helped you decide what cup to use for your kiddo! Cheers!

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Getting Back on Track after Vacation

11/2/2019

 
Feeding Littles | Coming home from vacation can be difficult for kids and adults. Here are some simple self-care tips for the whole family to get back on track after a fun trip.

Coming home from vacation can be, as one of our followers called it, very “disorienting.” Ain’t that the truth! Get back on track - no, not in a “diety” or restrictive way, but in a self-care way - with some of these simple tips.

  • Hydrate! Most people don't drink enough water while traveling - water helps us feel more energized!
  • Put your kids and yourself to bed early for 3-5 nights after you come home to make up for lost sleep.
  • Unpack quickly once you arrive home. Feeling organized will help you feel less anxious.
  • Include lots of high-fiber foods like veggies/fruits and probiotic foods like yogurt, kefir, and sauerkraut in your diet - traveler's constipation is a real thing!
  • Practice deep breaking or use a mindfulness app to reduce anxiety about getting back into your routine.
  • Plan something to look forward to a day or two after you come home (think family movie night, date night, etc.). 
  • Serve family meals and snacks as usual, focusing on your hunger and fullness cues - going on a diet or "cleanse" will only make you more food obsessed and less happy in the long run.​

So many of us feel anxious about the return to our normal life after we’ve been on vacation. We face mile-high piles of laundry (and emails) and don’t always feel well physically because of changes to our normal eating, drinking and sleep routines. Maybe we are sad that a much-anticipated vacation is over, or perhaps the change of environment caused our precious little angels to turn into sleep-deprived, hangry tyrants. Vacations with kids aren’t always relaxing, but they can be joyous nonetheless - we just have to figure out how to manage the depressing after-vacation effects so we can smoothly integrate back into our normal, crazy lives. We hope some of these ideas help you integrate back into normal life! 

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Quick Tips to Manage Illness

8/24/2019

 
Feeding Littles | Have a sick little one at home? Eating and hydration can be greatly affected by illness and can take a while for kids to get back on track. We listed some quick tips to manage illness including other hydrating options and when to call your pediatrician. It's ok if your toddler or baby has a change in appetite for a while, everything will get back to normal eating and drinking eventually.

Hydration is key.

Sick kiddo at home? One of the hardest parts of parenting is managing illness. You may have noticed that eating and hydration can be greatly affected by illness, and sometimes it takes days - or weeks - for kids to get back on track. Here are some quick tips when you have a sick kiddo:

  • Your child may not be interested in food, which is temporarily fine - we worry more about hydration above all else, especially during acute vomiting.

  • Continue to breast or bottle feed your infant as directed by your pediatrician. You may have to offer smaller amounts of your baby’s milk at a time during illness. Some pediatricians will recommend a bare minimum of 16 oz per day to prevent dehydration in usually healthy infants. If your baby is 6+ months, talk to your doctor about whether they want you to offer water on top of breast milk or formula during illness. Breast milk is often better tolerated than any fluid during vomiting.

  • Toddlers and older kids need hydration in whatever form they’ll take it. While electrolyte replacement drinks have traditionally been recommended, some kiddos refuse to drink them (mine included - plus, Megan's not a huge fan of Splenda, in Pedialyte). A recent study from JAMA (April 2016) suggests that children instructed to drink whichever beverage they preferred did better than those instructed to drink only electrolyte replacement drinks, likely because they could maintain hydration status better. In Megan's house, they do coconut water, diluted juice, water, unsweetened almond milk, and popsicles during illness.

  • Your tot may not want to eat for a few days, and their appetite may change. Offer preferred foods during the worst of the illness, but get back to a relatively normal diet within a few days. The BRAT diet is no longer deemed necessary because it’s nutritionally incomplete, although many kids prefer soft, bland foods when ill.

  • Above all else, consult with your pediatrician if you are worried about your child’s hydration status. Dehydration is the biggest risk with vomiting and diarrhea, and small bodies are more susceptible to it than older kids and adults. Watch for dry, cracked lips, drowsiness or lethargy, dark urine, and no tear output when crying. 

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Last Chance Labor Day Popsicles

8/30/2018

 
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Summer is coming to an end! For those of us in hot-weather climates, this is a welcome change...but we know many are trying to squeeze out every last drop of summer. This Labor Day Weekend we've partnered with some of our favorite dietitians and food bloggers to bring you some amazing popsicle recipes! Just combine ingredients (liquid on the bottom of the blender first is ideal), taste test to make sure it's to your liking, blend until smooth, and serve! 

Check out our amazing contributors! Thank you for helping us with these recipes (especially on such short notice...I {Megan} am kind of a spur-of-the-moment person when I have an idea)! Please check out their websites and instagram accounts, linked below.

Yummy Toddler Food - @yummytoddlerfood
Born to Eat Book - @borntoeatbook
Veggies and Virtue - @veggiesandvirtue
Kids Eat In Color - @kids.eat.in.color
Baby Bloom Nutrition - @babybloomnutr
Heather (Veggie Buds Club Blog) - @heather_kidskitchen
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Keeping Kids Hydrated in the Heat (and All Year Long)

5/24/2017

 
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Some parts of the U.S. are just now starting to thaw from a pretty rough winter, but in Arizona we are rapidly approaching 100 degree F heat. Young children don't seem to mind operating at full-speed in hot temperatures but can dehydrate faster than adults, so it's especially important to make sure that they are drinking enough fluids, especially in hot weather. We want to share some favorite mom hacks that keep kids - and adults - hydrated all summer (and all year) long.

How much is enough?

For babies under 6 months of age, breast milk or formula will fulfill all of their hydration needs, and additional water is not recommended (and can even be dangerous in large quantities). Breastfed babies should have at least 5-6 wet diapers and at least 6-12 feeds per day, depending on baby's age. Formula fed babies will usually drink at minimum 20-24 ounces per day after the newborn period. Hydrated babies have moist mucous membranes of the mouth and eyes, pale yellow urine, plenty of tears when crying, and no sunken soft spot.  

Babies 6 months and older can have a few ounces of water per day, gradually increasing water intake toward their first birthday. Click here to learn how to introduce cups to your 6+ month old. It is important to not displace breast milk or formula with water until baby is closer to 1, as baby's milk will remain their main source of nutrition and ​hydration in infancy as their solid intake slowly increases. 

Fluid need estimates for toddlers vary depending on the source. The National Academies of Science, Engineering and Medicine recommends about 44 oz of fluid (5.5 cups) per day for 1 - 3 year olds, while other various sources recommend about 4-6 cups of fluid per day. If you'd like to calculate your child's estimated fluid needs by weight, check out this calculator. 

Yes...this is a lot of fluid. It's a lot more than what many toddlers drink. Instead of focusing on a number, watch your toddler. His urine should be pale yellow (unless taking B vitamins, perhaps as part of a multivitamin supplement), and he should not have a dry mouth. Watch for crankiness, headache, lethargy, dizziness and dry skin - all signs that your child is dehydrated. Call your pediatrician immediately if you're worried about your child's safety when it comes to their hydration status.

Other hydration estimates from the Academy of Nutrition and Dietetics are below:
​
  • 4-8 years: 7 cups
  • 9-13 years: 9 cups (girls), 10 cups (boys)
  • 14-18 years: 10 cups (girls), 14 cups (boys)

Your child will need extra fluid while playing outside in the heat, performing strenuous activity or while sick. 

What counts as fluid?


​Water, milk, juice, and fluid from soup, veggies, fruit, and other high-fluid foods like popsicles all count toward your child's water intake. We don't recommend juice regularly unless indicated by your doctor for constipation, hydration issues or medical issues. We recommend sticking to water as much as possible.

If your toddler drinks milk, it is recommended to limit their intake to no more than 16-24 ounces (2-3 cups) per day - that leaves a need for at least 1-2 cups for water for a child that drinks milk. 

Try to offer water as the sole beverage besides milk and encourage free access to water throughout the day for all children 12 months and older.  Offering at least 3 types of veggies and at least 2 fruits daily also helps to increase your child's water consumption, although we are fully aware that your toddler or kid might not eat the food that is served.

What can I do to keep my child hydrated?


  • Set a timer or other digital notification that reminds everyone in the family to drink more water. Have a visual kiddo? Check out the app Plant Nanny (on iTunes or Google Play Store) and watch your plant grow and thrive - or not - depending on how much water you drink. 
  • Offer water in a designated water bottle or cup, and make sure you have water with you at all times to offer to your tot. We have so many favorite straw bottles - check them out here in our Amazon shop!
  • Put a mark on your child's cup or water bottle as a visual cue to drink down to the mark. A rubber band or hair tie can also serve as a visual cue. ("Let's drink down to this line!")
  • High water volume veggies and fruits like watermelon, tomatoes, cantaloupe, broccoli and cucumber are great summer staples that have high water content.
  • Figure out how your child likes water best - with a straw? Iced? Room temperature. Try to serve it in their preferred form when possible to promote more hydration.
  • Make homemade popsicles! Try combining coconut water or coconut milk with fruit and a bit of sweetener like honey, coconut sugar or maple syrup if desired. Freeze in popsicle molds until set.
  • Use novelty (just like we teach in our online course)​ to encourage more sipping! Break out silly straws, have your child use a clean medicine syringe or eye dropper to pipe water into his mouth, whip out small cups or unique drinking glasses, or even practice drinking water out of an ice cube tray using a straw. You can also make up a funny dance or song every time your child takes a drink. 
  • Serve broth-based soups or cold soups like gazpacho.
  • Make water more flavorful with creative water infusions, such as strawberry and lemon, watermelon and lime, or blueberry and orange.

Happy start of summer, and happy drinking (water, that is)!
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    Authors

    Megan and Judy, co-owners of Feeding Littles, bring you helpful info on food, nutrition, picky eating, and feeding young children. Megan McNamee MPH, RDN is a Registered Dietitian Nutritionist based in Scottsdale, Arizona. Judy Delaware, OTR/L is an Occupational Therapist specializing in feeding therapy with children 3 and under in Boulder, Colorado. Megan and Judy are both moms of two and love helping families develop a healthy appetite for all foods! 

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