Aug. 8, 2008 — -- In an era when young celebrity mothers are coming under increasing public scrutiny for how they are treating their kids, Katie Holmes' decision to let 2½-year-old Suri Cruise suck away on her bottle may seem like a minor infraction.
But pediatricians say kids who continue to feed from a bottle past the recommended age may be at higher risk of a number of ills including speech problems, tooth erosion and deformation, and, not surprisingly, trouble letting the bottle go.
Although breast-feeding for 12 months is the gold standard in infant nutrition, pediatricians say introducing a sippy cup between 6 months and 12 months is fine and can be followed by drinking from a regular cup.
"You use different muscles in the mouth" using a cup, compared with a bottle, said Dr. Jennifer Kaplan, a pediatrician in private practice in Washington, D.C. "It helps with speech development."
But some doctors are more concerned with how bottles can promote a dangerously dirty mouth. Dr. Miriam Labbok, director of the Center for Infant and Young Child Feeding and Care at the University of North Carolina at Chapel Hill, points out that a child with a bottle will often hang on to the nipple and hold milk longer in the mouth where the sugars can cause tooth and gum damage. Sucking on the nipple can, over time, cause the position of teeth to shift in the gums.
In addition, long, slender bottles can be more difficult to clean than cups, causing bacteria to build up in crevices.
"Bottles are not innocuous," Labbok said. "I don't think it's a healthy habit to continue for a long period of time... as early as a child can handle a cup the better."
Experts also recommend dispensing with bottles early, around age 1, because of attachment. The longer a child uses a bottle and incorporates it into their routine, the more difficult it can be to finally give it up.
Holmes isn't the first mom to be slow to wean her kid off the bottle, however. Lynette Ciervo, a 46-year-old mother of two daughters living in Rockville, Md., said she let both of her children continue to drink from bottles until they were age 3.
Ciervo notes, though, that she had practical reasons to allow her kids to keep using a bottle. She initially breast-fed her eldest child -- also her only biological child -- but medication that she required for an unrelated health condition forced her to stop after a month. Ciervo bottle-fed her second girl, who was adopted, from infancy.
When she tried to wean them off bottles, Ciervo found her girls rejected milk completely. Her pediatrician concluded that it was more important that the kids get milk than go off their bottles and told Ciervo to keep up the bottle-feeding until age 3.
"Both my girls loved bottles," Ciervo said. "It was a soothing part of the routine, a way to transition into the mornings and before bedtime. ... It's like me with my morning coffee."
But even though her kids are off the bottle now, they are still averse to milk. Her eldest, now 10, won't touch the stuff -- and the youngest, at age 5, only drinks flavored milk.
As some kids may need to twirl their hair, carry around a blanket or cuddle with a favorite toy, sucking on a bottle or pacifier is a soothing behavior for many kids. Breaking the bottle habit can be made easier for children with strong sucking needs when parents recognize and are sensitive to those.
"It's important that parents tune in to their individual child and what the bottle means to them," said Claire Lerner, director of Parenting Resources at Zero to Three, a parenting resource Web site. "It's not a monolithic response."
Transitioning a child from a bottle to a sippy cup or a regular cup using goodbye rituals or stories of a "bottle fairy" that took it away might be a way for a parent to honor and respect a child's needs.
Lerner pointed out that, if sucking on a bottle was the primary soothing thing a child did, that it was a parent's responsibility to meet that need in another way or the transition will be more difficult.
But not all are convinced of the cons of bottle-feeding. Ciervo said she never noticed any speech problems in her girls, despite her younger daughter only giving up her pacifier one week ago.
"It was really hard," Ciervo said. "But you know, when it's time, they do give it up eventually."