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Prolonged bottle-feeding damages child’s development
Published on: Tuesday, April 02, 2024
By: Sidney Skinner
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Left: Pamela Thomas Joseph. Right: It is natural and very possible to wean a child off the bottle within a month, with some strategies, lots of encouragement and determination both for the youngster and parents.
The Sabah Chapter of the Malaysian Association of Speech-Language and Hearing (MASH) wants to create a greater awareness about the damage which prolonged bottle-feeding can have on a young child’s development.

To this end, the Association has launched a “Cool Kids Use Cups Campaign 2024”, to provide new parents with the encouragement and determination they might need to get their toddlers to give up their milk-bottles when it was right to do so.

Campaign Head Pamela Thomas Joseph said a “neurotypical developing child” should cease drinking from a bottle altogether by 12 months.

“Unless a child has other developmental concerns, for example they are unable to eat solids or are not growing according to their age, then there is good reason to work towards teaching a youngster to use a cup,” she said.

She recommended training kids to drink from a cup when they were between six to eight months of age.

“This coincides with the time when they are beginning to consume semi-solid and solid food. [During this period], children develop bilateral control of their hands and begin to be able to hold simple covered cups, with or without handles, in their hands.”

Joseph said the reliance on milk-bottles beyond 12 months limited the development of youngster’s oro-motor structures such as the jaw, teeth and lips.

“This practice also has an impact on a kid’s tongue movement as well as mouth shape.”

A survey of 700 Sabahans with young kids, conducted by MASH earlier this month, found that most aimed to get their children to start using cups when they turned two.

The respondents hailed from Kota Kinabalu to as far afield as Kinabatangan, Pitas and Semporna. 

Joseph said 32.4 per cent of parents felt that it sufficed to stop bottle-feeding by their children’s second birthday, while 30.1 per cent intended to do this when these youngsters turned three or four.

She said 8.5 per cent planned to start instilling the use of cups when their kids were five or six years old.

Another 5.3 per cent targeted weaning their children off the bottle by the time they entered Standard One at age seven, according to her.

She said 6.5 per cent, on the other hand, didn’t give much thought as to when this happened. 

Only 17.2 per cent of the mothers and fathers surveyed were aware of the normal trajectory of feeding development, she said, which is for toddlers to drop the use of baby bottle by their first birthday.

Joseph said there was good reason to motivate young children to drink from a cup.

“It is typical for youngsters to begin using a cup between the ages of six to eight months.

“This coincides with the time when they are beginning to consume semi-solid and solid food. During this period, children are developing bilateral control of their hands.

“They begin to be able to hold simple covered cups, with or without handles, in their hands.”

When asked why prolonged bottle-feeding was not encouraged, she explained that it could lead to youngsters having affected speech patterns, middle ear infections, poor teeth alignment and developing dental cavities.

As regards the disrupted speech patterns, she said when a child was on the baby bottle, “it puts the tongue in a learnt infantile position as the tongue is lying down on the floor of the mouth”.

“Some children also retain a tongue thrust that should have gone away. Furthermore, the malocculusion of the jaw also promotes a lisp in their speech in later years.”

As for middle ear infections, Joseph said prolonged bottle-feeding caused difficulties in eustachian tube function.

“Children become more prone to ear infections as they are often lying down and drinking milk.

“The negative pressure in the bottle causes the baby to suck excessively and the intraoral negative pressure is subsequently transmitted to the middle ear via the eustachian tube. 

“The formula milk can go up the eustachian tube, irritating or swelling it. The sugar in the milk, on the other hand, causes germs to grow.”

On top of this, she said, the lack of hygiene of the teats promoted repeat infections. 

“When a child has a middle ear infection, they experience temporary hearing loss, causing them to lose at least 40-50 decibels of speech signals in their developing years.

“This may cause speech delays, as well as poor speech articulation from lack of auditory feedback.”

Where poor teeth alignment was concerned, she said, there was a tendency for the upper and lower teeth of toddlers, who had been bottle-fed for long periods, to develop in a typical ways.

“Such kids, for example, develop an overbite or crossbite or open mouth postures.

“Sometimes, the teeth not being able to meet, makes it more difficult for these youngsters to learn how to chew solid food.

“On top of this, some children get into the habit of dangling their bottles from their mouths which causes their upper teeth to stick out.”

Joseph said protracted dependence on milk-bottles could also cause kids to develop poor eating habits which put them at risk of becoming obese, not to mention stunting their emotional maturity.

She said over reliance on bottle-feeding gave rise to the inability to chew, which in turn caused these children to reject solid food.

“Developing children, before the age of one, are typically practising and working hard on their jaw muscles to chew. This results in the good development of incisors which pop up between eight to 10 months of age.

“In urban societies, where bottle milk is an easy go to, these incisors take time to grow due to the lack of practice. They become ‘unneeded’, thus, slowing down the emergence of the first baby teeth. 

She said this affected dental development in “an unnatural way”.

“These children simply haven’t had the practice of biting down and chewing on bananas, guavas, carrots, melons and ‘jambu air’.”

Drinking from a baby bottle provided many parents with a feeding option which was both easy and generated the least fuss, according to her.

“These parents only come to realise later that the easy feeding option has caused their children to have a preference for infantile feeding as opposed to typical eating development.

“These kids, for example, are partial to porridge or rice and soup, which solidifies a restricted diet and picky eating habits. 

“They lack the early experience of taste and textures, not to mention the hand motor skills which come with feeding themselves.

On top of this, Joseph said, toddlers who refused to give up their bottles often found it difficult to move on to the adequate consumption of solids.

“As a result, they drink a lot more calories than needed through their baby milk. 

“This is mainly seen as an urban problem, where families can afford high caloried, more frequent formula milk as a go-to option.”

Where emotional maturity was concerned, she said bottle-fed youngsters remained immature for longer as compared to their cup-fed peers.

“They have a subconscious idea of remaining infantile for a longer duration, often lying down to consume their milk.

“They also lack self-soothing mechanisms, as well as the experience of regulating their emotions. Because their parents are constantly offering them the bottle, the locus of calming control is placed on their elders.”

The “Cool Kids Use Cups Campaign” runs till the end of May, with information and advice for parents available on Instagram account for the Sabah Chapter of MASH: coolkidsusecups_sabah2024.

Those who complete the Association’s project are invited to post a photo of their children successfully using a cup, together with a message, on its social media platform.





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