Milk at Bedtime & Tooth Decay

Archived Q&A and Reviews

Exchanging bedtime bottle for sippycup - better?

Oct 2006

Our son is 25 months old. We just got him off the night-time bottle, at the very strong suggestion of our doctor, who suggested tooth decay could be an issue if we didn't stop. My wife has now swapped the bottle for a sippy cup with milk instead. To me, i see no difference between this and a bottle. Anyone with experience in this realm? I'm concerned about my son's teeth, but my wife insists its not an issue. THoughts? Tim

We have been giving our two boys (4 and 2) a sippy cup with milk in it before bed for while. What we have done however is water it down so they get ''water-milk''. There have been days that we've given them just water as we explained to them we ran out of milk and they were fine with that too after a little explaining. In general, what we've been doing most recently is giving them their milk and reading a story, then brushing teeth right before ''lights-out'' and this has been working well. They then may have a sippy cup of ice water if they are thirsty during the night. It just takes some ''re-training'', but they'll get it. Having all that sugar sit in your teeth during the night is not a good idea. anon

My 2.5 year old gets milk in a sippy cup at bedtime but I brush his teeth right afterwards. As far as tooth decay goes, there would be no difference between a sippy cup and a bottle, milk on the teeth all night will probably lead to decay. I'd suggest incorporating toothbrushing into the night time ritual. You've got to start some time, might as well do it now. Also, 2 years old is old enough to go to the dentist, we found a good pediatric dentist who has all sorts of tricks for getting into our son's mouth to clean his teeth. And he had no cavities!

My understanding from my ped. dentist is that any milk before bedtime (breastmilk, too, so you have to be diligent to rinse the baby's mouth with water) will destroy tooth enamel--the sugars in milk, which cause tooth decay, are still sugars despite the vehicle of delivery. My dear friend's daughter, when she was 3 (now 8), had 7 cavities, from drinking regular milk and breastmilk before bedtime and had to have the cavities taken care of under general anaesthesia. Traumatic for the mother and the child. So, yes, it's a problem. Why not solve the arguement with input from a ped. dentist? Good luck

My understanding from my ped. dentist is that any milk before bedtime (breastmilk, too, so you have to be diligent to rinse the baby's mouth with water) will destroy tooth enamel--the sugars in milk, which cause tooth decay, are still sugars despite the vehicle of delivery. My dear friend's daughter, when she was 3 (now 8), had 7 cavities, from drinking regular milk and breastmilk before bedtime and had to have the cavities taken care of under general anaesthesia. Traumatic for the mother and the child. So, yes, it's a problem. Why not solve the arguement with input from a ped. dentist? Good luck

I'm not sure if you are talking about having milk before going to sleep or having the sippy cup there during the night if the kid wakes up thirsty. Our son co-sleeps with us and we bring a sippy cup of water with us to bed and he often wakes up once a night to ask for a drink and he is very happy with water. To go to sleep, months ago we switched to letting him suck on our finger rather than a bottle. Won't hurt his teeth. Hope this helps

If your son isn't brushing his teeth after the milk, be it in a bottle or sippy cup, it's going to cause tooth decay. No if ands or buts. At two years old you should start taking him to a pediatric dentist, and he/she can put a quick end to you and your wife's disagreement. Switch to water at night. It will be hard at first, but remember you're the grownups and you're doing it for his own good. anon

I have been in the same boat! Our 2 1/2 yr old has been going to bed with his bottle and I knew deep in my heart that this was horrible for his teeth. He loves his bottle, though, and I just kept giving in. Then suddenly last week he wasn't feeling well and was throwing up. The milk in his bottle irritated his stomach and made him throw up even more. So we replaced the milk in his bottle with water and told him that this would help his tummy. The next day he was ''dying'' for milk in his bottle and I told him that I needed to ask the doctor first. So I pretended that I called the doctor and that the doctor told me that he couldn't have milk. He bought it! I can't believe it, but I finally have him off the milk. He's still drinking a bottle and my next step will be to replace that with a sippy-cup. So my solution pretty much fell in our lap and we ran with it. And you are correct: the milk is what is killing his teeth. JOJ

Your wife may be confused about two issues. 1) bottles too old -- jaw/tooth malformation 2) drinking in bed -- tooth decay The decay issue has to do with sugars pooling in the mouth if a drowsy child sips and sleeps without full swallows and rinsing with water. so a sippy is 100% as bad in that area. Switch to water (make it gradual if baby resists) a mom

I think you're right. The issue is over drinking milk before bedtime, not what your child drinks out of. Does your toddler brush his teeth yet? Maybe you could introduce that after he finishes his milk, therefore eliminating the concern? Or is the bottle/sippy cup actually going to bed with him? If that's the case it may be more of a comfort item and why your wife doesn't wish to stop the process....if so, try putting water in it instead. Either way, your child shouldn't be going to bed with any drink that can leave sugar on your childs teeth. Maybe your wife should speak to the pediatrician again to clarify this Agree with you

The main problem with milk and the teeth is that kids with bottles use them as a sort of pacifier, sucking for long and/or frequent times on the sugar-laden nipples (lactose is the milk sugar). The rule should be that your toddler uses the cup to drink milk ALL AT ONE TIME, then gives it up. Two-year-olds do not need to be fed during the night; in fact, if they are, it interrupts everyone's schedule as well as their intake of appropriate nutrients during the day. If your toddler NEEDS something to suck on (emotionally), then give him/her a cup of water, which won't mess with the teeth or the appetite. My experience is that toddlers usually reject the water (hmmm, they don't really need it after all!) and everyone gets more/better sleep a pediatrician

The problem with tooth decay is the milk itself, not the bottle. Milk contains lactose, which is a natural sugar. Switching to a sippycup will not help the tooth decay risk. What I've done with my own 3 kids is switch to water for the last sippy cup of the day. If your child won't drink it at first, slowly start watering down the milk, a little more water each day, till the last cup of the day is pure water. Heidi

It's very nearly the same thing. Try subbing a small bit of water into the milk. Every 2-3 nights add more water and less milk until the sippy cup is all water. Most kids won't be so interested in sipping on water for very long, and if he is, there's no tooth decay issue Paula

Bedtime sippy of milk = tooth decay?

June 2003

Our 21 month old has what I would call ''sour'' smelling breath after naps and upon waking in the middle of the night or in the morning. This may be perfectly normal, but I have a feeling it isn't. I'm worried that it is a signal of tooth decay...can toddlers this young even have tooth decay?

We have a very consistent tooth brushing regime every night, but we just started it about 6 weeks ago. We also do something that I think is counterintuitive in our bed time routine. That is *after* we brush teeth/change into jammies/read a couple books, we rock in the rocking chair and I sing to her while she drinks a milk sippy...

I have a feeling the pre-bed milk sippy has a lot to do with the breath, and it can't be a sound practice for the future. However, she is not a good eater at all, but has managed not to waste away by taking in a lot of protien, etc. via the milk at these pre-bed times. We have and continue to work at getting her to eat better suppers and lunches and lots of healthy snacks, but she remains relatively uninterested in most foods. She is allowed to have tiny bits of sweets, and in fact after two or three bites loses interest in these too (I'm not going to complain about that!). Also, don't most kids this age still have a night time sippy or bottle? She's a very determined and opinionated child already, and I can't imagine she'll submit to having a pediatric dentist take a look. So I'd rather hear from others who may have experienced bad breath in their very young kids to have a sense of whether we should go that probably very traumatic route of checking for tooth decay. want to do the right thing

I don't think sour breath is necessarily a sign of toddler tooth decay. My daughter also has sour breath after sleeping. She also sometimes has milk before bed after brushing her teeth. She is 3 years old and just had her first dentist appointment. The dentist said her teeth are fine and that as long as one practices basic dental care the condition of one's teeth is mainly genetic. anon

i don't have advice about the tooth decay itself, but i do about the dentist: go ahead and take her to a pediatric dentist. we really enjoy our visits to ''dr. bob,'' robert khalil, at 906 ensenada (528-1546). we talked a bit to our 3 yo before we went, about what the dentist would do, and she got to sit on my lap in the chair--i was concerned that she wouldn't open her mouth, but it all went very well! i know your child is younger than mine was on her first visit, but i wouldn't worry about her behavior there--better to try and have her not open her mouth than to let possible tooth problems go undetected... my two cents! jessica

If you change the bedtime routine a bit- we do bottle/sippy while we read then pjs and brush teeth- you'll have less sour breath. Also, having only started brushing recently she might have tartar build up on her teeth. Our daughter did. Her 1st dentist appt at 2ish required a little scraping of it off of her front teeth. If you go to the right pediatric dentist (ours has a dog in her office which greatly pleased our daughter) it might not be as traumatic as you think. Especially since it's such a big girl thing to do. And she'll probably get her choice of chocolate or bublle gum flouride treatment and to pick a prize at the end. good luck another mom

In addition to brushing, make sure you floss. Also, do not underestimate the pediatric dentists. If the first one you go to can't handle your offspring, find another. Ento

I have no idea whether her sour breath means she's already got tooth decay, but your intuition is correct: A sippy cup of milk after tooth brushing is a very bad idea. To avoid tooth decay, you need to start cleaning a baby's teeth as soon as they come in, and the baby shouldn't eat ANYTHING, with the possible exception of breastmilk, between tooth brushing time and bedtime.

I say the possible exception of breastmilk because it's been shown that its natural antibacterial properties mean breastmilk does not cause tooth decay. However, if there is other food present on the teeth, the sugars in the breastmilk can attach to it and add to the mess as it were. So a bedtime nursing session is probably all right ONLY if you've done a very good job of toothbrushing beforehand.

Cows' milk has no such protections and shouldn't be given at bedtime -- although you are quite right that many toddlers are given it, simply because their parents choose the short-term benefit of getting them to sleep over the longer-term risk of dental problems. A sippy cup is a better choice than a bottle, certainly, but I expect the first time you do take your daughter to the dentist, you're going to hear that you ought to eliminate it.

Genetics has a lot to do with whether and when anyone will have cavities, also. Your daughter may just be lucky -- or not. Try simply giving her the sippy cup of milk BEFORE you brush her teeth. Afterwards, a fresh sippy of water is fine. (My son uses one of those ''Sipp'n Sav'r'' bottles with a straw.) Holly

You sound content for your daughter to have some milk before going to sleep, and so the simple solution is to brush her teeth afterward. Explain to her that you need to make this change. She won't understand completely, but she'll get the idea. I know you don't want to ruin the mood (i.e., don't want to go from cuddling in a dark room to the cold, bright bathroom to brush teeth), so why not try having the toothbrush already in her room, and then brush her teeth in your lap while you sing a lullaby?

That said, I'll add that I really do think she will get the calories, etc. she needs at other times of day if she no longer has the sippy at night and naptime. They get what they need as long as you make it available to them. Like I said, it sounds like you're happy with the current situation (vis a vis the sippy, that is) so I wouldn't change it -- but I wouldn't kid yourself that it's essential to her growth, etc. either. Good luck!

Have you tried (gently) switching the bedtime sippy to water? We did it while our twins were still taking bottles, but I imagine you could use a similar technique with cups. Water down the bottle (or cup) slowly (an ounce more water and less milk each night) until its just water. Try giving milk after meals instead. Our kids now take sippy cups of water to bed with them (after they have brushed their teeth). Good luck! Debbie