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If you go down any feeding aisle in any baby store, you are sure to see about 30 different types of cups. Don't even start typing it into Amazon! You will be in a never ending rabbit hole of drinkware. But when and what type of cup to get? How soon is too soon? Let's dive into the details! WHAT DOES A TYPICAL SIP OF LIQUID LOOK LIKE? By 12 months of age, your child will begin to develop a mature swallow pattern rather than suckling with their tongue, which is used when your baby is breastfeeding or feeding from a bottle nipple. When taking a sip from an open cup, the head is in a neutral or slightly tucked position. The tongue is initially retracted, then the tip of the tongue will elevate to touch behind the teeth to swallow the liquid. The tongue should not go into the cup and does not rest on the rim of the cup. When taking a sip from a straw, the head is again in a neutral or slightly tucked position. The straw will touch the lower lip, then the lips will round around the straw. The tongue again stays initially retracted, then the tip of the tongue elevates to touch behind the teeth to swallow. The tongue should not stick out and the tongue should not wrap around the straw. It is important that your child elevates their tongue tip behind the teeth to ensure safe and effective chewing and swallowing. If the child pushes their tongue forward when taking a sip or if they continue to rest their tongue on the rim of the cup or straw, they may develop a low resting tongue posture and/or tongue thrusting over time. These immature postures can cause significant feeding, airway, and speech and language difficulties. when to start straw & open cups with your child When first introducing a cup to your baby around 6 months of age, start with an open cup where they can take small sips a few times throughout the day, such as during mealtime. Then, between 6-9 months of age, introduce a straw cup that assists their ability to sip through a straw by priming liquids into the straw (e.g., Honey Bear Straw Cup or Rubbermaid Juice Box Straw Cup). After they can successfully and consistently take sips from this type of cup with a straw, you can start to introduce more advanced straw cups that require your baby to independently sip through the straw.
It is recommended that you continue to offer a variety of cups (i.e., open cups and straw cups) that promote a mature swallowing pattern and appropriate tongue placement rather than focusing on use of a single cup. This allows your baby to learn to use and become comfortable with various cups, just like us. If you have concerns related to your baby’s feeding and/or swallowing, reach out to your pediatrician or to a speech language pathologist in your area, or contact our office. If you’re interested in how your baby’s development relates to feeding and swallowing, you may want to check out, “Feed Your Baby & Toddler Right: Early Eating and Drinking Skills to Encourage the Best Development” by Diane Bahr.
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 So your little baby is growing up fast, and it's already time for them to start drinking from a cup! At 6 months of age, we want to start teaching them how to use cups and straws, right when they start solid foods!
Just because a cup is on the market doesn't mean that it's good for your baby. In fact, many cups on the market today HINDER your baby's oral motor development. It’s best to avoid cups that promote continued use of an immature swallow pattern which utilizes the tongue for control as opposed to the lips and other facial muscles. This can lead to a prolonged tongue thrusting pattern that eventually is no longer developmentally appropriate. This behavior has the potential to lead to additional difficulties later related to eating, drinking, speech, and more. Here are some examples of items to avoid: Spouted sippy cups are very common, however, they are not ideal for mouth development. Spouted sippy cups promote jaw thrusting when sucking and require the tongue to protrude out under the spout to engage in a suckling pattern to take a sip of liquid. This promotes your baby to maintain use of an immature sucking and swallowing pattern and can lead to prolonged tongue thrusting. In addition, the head must tilt back, which extends the neck. This can open the airway and allow liquids to enter the airway rather than traveling down the esophagus. Cups with a top membrane, such as the Munchkin 360 cup, may also promote an immature swallow pattern. Your baby must tilt their head and extend their neck to take a sip, similar to a spouted sippy cup. Additionally, you must press your upper lip into the top membrane of the cup and suckle the rim of the cup to take a sip of liquid, which again promotes an immature sucking and swallowing pattern. While we have discussed some straw cups recommended for your baby, be careful when choosing a straw cup. There are some straw cups that promote suckling and immature swallow patterns. Here are some considerations when choosing a straw cup: Consider the length of the straw. Short straws promote a mature swallow pattern and reduces the likelihood of the child biting the straw or using the straw on one side of their mouth. Instead, the child must use their lips as well as their supporting facial muscles to take a sip and a short straw ensures use of the straw in the center of the lips which supports balanced facial muscle development. Avoid cups with soft straws, such as the Dr. Brown’s straw cup which has a soft, silicone straw. Soft straws often collapse when you try to take a sip as expected (i.e., straw touching the lower lip and the lips rounding around the straw) and therefore no liquid will go through the straw. However, if you suckle the straw, you’re able to get sufficient liquid through the straw, prompting continued use of an immature sucking and swallowing pattern and tongue thrusting. There are additionally some weighted straws that similarly collapse while your child takes sips of the liquid from their cup causing them to rely on sucking. It’s recommended you try out the straw ahead of time to ensure that the straw does not collapse or require suckling to access the liquid. Also consider the diameter of the straw. Monitor your child’s sips. Straws with a large diameter are great for drinks such as smoothies, but a larger diameter allows for a greater amount of a thin liquid, such as water, to move through the straw. You may need to choose a straw with a more narrow diameter to restrict the flow of liquid if your child is coughing or showing other signs that the amount of liquid is overwhelming. As a parent, I know how much worry and planning goes into every detail of your child’s life. We want the best for them at every turn, and there are so many decisions to make! Hopefully, we have helped narrow down some options for this one topic, and guided you on the right path so you can check this off your list!
We also want to give you recommendations for straw cups that promote healthy oral-motor skills:
For some of the options above, your baby can squeeze each of these cups to help prime the liquid into the straw, which encourages and eases them into straw drinking. You might be asking, why the emphasis on short straws? Short straws will continue to promote a mature swallow pattern through facilitating the use of lips and other facial muscles when swallowing; not the tongue. For the more advanced straw users: These options of cups with straws are great for a child with a more mature swallow pattern, where they are able to utilize lip and jaw strength with more consistency and have moved away from the suckling pattern with the tongue. Some are faster flow, which also requires more control and strength.
Tell us about what cups you use with your little one in the comments below!
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November 2021
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