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Spouted Drinking Cup Warning

Friday, February 01, 2013
There is an increasing belief, amongst numerous healthcare disciplines – orthodontists, dentists, speech therapists, occupational therapists, orofacial myologists to name but a few – that no-spill valves, and spouted drinking cups, are the cause of many childhood problems.  These include crooked or crowded teeth, tooth decay, speech impediments, speech delays, chewing problems, swallowing problems, otitis media (ear infections; also glue ear), and poor facial development.  Many of these problems are often discussed in connection with prolonged bottle use, so it is no surprise that many of these healthcare professionals describe no-spill drinking cups as ‘baby bottles in disguise’. These bottle substitutes often end up being used long past the age that is otherwise recommended for bottle weaning.

Whilst there are many areas in the field in raising children for which technology can be argued as having brought great benefits, drinking is one aspect that has been left behind.  More and more leading healthcare specialists are urging parents to go back to basics and drop the “no-spill” gadgets and valves.

UK-based mum of three, Sara Keel, has launched a range of drinking cups to serve exactly this purpose. ‘Babycup’ is a product that is as simple as you could possibly imagine. No lid, no handles, and best of all no spout.  Babycup is purely and simply a ‘cup-shaped cup’, but with the added bonus of being miniature, in order to be perfectly baby-sized. Made from durable, non-toxic plastic, Babycup “is BPA free” and “phthalates free”.  It fits neatly in the palm of a young child’s hand. 

Keel, was frustrated by the fact that infant cups are fairly large and for 6 month olds they are often the equivalent of an adult drinking from a bucket.  She also disliked the idea of her children constantly drinking from a spout or teat.  Working initially on motherly instinct Keel delved deeper into the subject and found an alarming body of “growing concern”, backing up her fear that spouts and no-spill valves were not just without any health benefits, they were potentially damaging for a baby or child’s developing teeth, jaws and palate.

Malocclusions and Dental Caries


Regular interference, such as pressure from an intruder like a thumb or spout, is thought to contribute to malformation of the hard palate, leading to malocclusions (incorrect teeth and jaw positions) and the need for “expensive” orthodontic work, in later years.

The Myofunctional Research Co. states on its website, that muscles are a significant factor in causing malocclusion1. MRCo. goes on to explain that incorrect arch form is responsible for the high prevalence of malocclusion, but the arch is primarily a product of the position of the tongue and function of the lips.  They write that the forces exerted on teeth by the lips, and tongue determine tooth position - giving the example that only 1.7 grams of pressure is needed to move teeth. Put this figure alongside their information showing the tongue can exert a force of 500 grams and it is easy to consider that altering the position of the tongue can alter the upper arch and the position of teeth.  MRCo. says that children develop most rapidly between the ages of 2 and 5 and that during this period 70% of the growth of a child’s face and jaw occurs. They cite dummies, thumb sucking and baby cups, (not meaning open cups), as contributing to poor facial and dental development. 

Another alarming problem is the potential for tooth decay, or ‘early childhood caries’ (also known as ‘baby bottle caries’, ‘nursing bottle caries’, or ‘sucking cup caries’1). Tooth decay develops when a baby’s mouth is infected by acid-producing bacteria. It also develops when the child’s teeth, and gums, are exposed to any liquids or foods (other than water) for extended periods.

Cups with lids and spouts, especially those incorporating spill-proof valves, are more likely to be given to children for them to carry around over extended periods, sometimes even being taken to bed.  Sugared liquids (that includes milk; but not breastmilk 3 4 5 6 7), from these receptacles, have been shown to increase tooth decay due to the likelihood of drinking beyond just mealtimes.  According to the American Academy of Pediactrics ‘tooth decay is the most common chronic infectious disease of childhood.’

The American Dental Association advises that to help prevent tooth decay children should be encouraged to drink from a cup, by their first birthday.

An infant and toddler forum factsheet, reviewed and supported by the British Dental Health Foundation, states that all drinks should be taken from a cup or glass, not a bottle. It also reports ‘by the time children are five years old, over 30% of them have dental decay’.

A change as simple as giving a child an open cup could help improve this worrying statistic. The same factsheet says: “it is easier to prevent decay than to treat it”.

Bacterial Contamination


Some studies demonstrate a hygiene, and illness concern, as children who drink from bottles, and sippy cups, are more likely to be drinking liquids that have not been freshly poured and spouts are more difficult to sanitise than an open cup. The World Health Organisation’s website advises that cups are less likely, than bottles, to be carried around for a long time (giving bacteria time to breed).

Unsteady Feet and Drinking On The Move – An Injury-Prone Combination


There are also some astounding statistics showing high levels of childhood injuries are due to toddlers drinking from spouted cups whilst walking. 8

Dr Derek Mohony continues on the problems caused by sipper cups but taking a look at the topic of  'Good Oral Health: Important In Childhood'.

Article by: Dr Derek Mahony(Specialist Orthodontist) and Dr Julian Keel (Cranial chiropractor)
Further information: Dr Derek Mahony – www.derekmahony.com and www.fullfaceorthodontics.com.au

1 Graber, TM. “The three M’s: muscle, malformation, and malocclusion.” Am J Ortho Dentofacial Orthop. 1963; June:418-450.
2 Reagan L (2002). Big bad cavities: breastfeeding is not the cause. Mothering 113:38-47.
3 Arnold RR et al (1977). A bactericidal effect on human lactoferrin. Science 197(4300):263-5.
4 Erickson PR, Mazhare E (1999). Investigation of the role of human breast milk in caries development. Pediatric Dentistry 21:86-90.
5 McDougall W (1977). Effect of milk on enamel demineralisation and remineralisation in vitro. Caries Research 40:1025-8.
6 Tinanoff N, O’Sullivan DM (1997). Early childhood caries: overview and recent findings. American Academy of Pediatric Dentistry.
7 Trotter S (2006). Cup feeding revisited. MIDIRS Midwifery Digest, vol 16, no 3, September 2006, p397-402.

8Injuries associated with bottles, pacifiers and sippy cups in the United States, 1991-2010 SA. Keim and MRW TePoel. Pediatrics Vol.129 No.6 June 1, 2012

 

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