[julie anne]

Our (big 28 lbs) little guy (3/4 of the way towards finalizing our adoption) is 13 mos old. He has reflux and continues to only consume 4-5 oz per feeding. We've weaned him onto soy milk from Nutramigen & soy formula. I'm getting a lot of pressure to wean him to a cup instead of a bottle from WIC and EI. He's capable of drinking from a sippy for diluted juice or water; however, he really resists when it comes to his milk. I always hold his bottle and rock and hold him close. I have tried holding his sippy & doing the same thing, but he really doesn't want to take his milk that way & frankly, I'm fine with it. He has regulatory problems & SPD.

Has anyone done extended bottle-nursing with their SN child and how old was your little one before weaned to a cup for milk? Was it child-led weaning?

I would LOVE to know if there was any research somewhere to hand to WIC/EI to prove that a child, esp an SN child doesn't have to be weaned at 12 mos old (this is especially a peeve of mine since breastfed NT children have the recommendation from WHO for min 2 years to bf...why not bottle-nursed children??)

Side note/question--he's allergic to cow's milk (diarrhea) and has reflux. He still doesn't have a normal/consistent solid poop --beside a probiotic (which we use), can anyone recommend something that might be a healthier milk alternative than soy (a lot of controversy re: soy milk). Thanks for any help.

 

[USAmma]

My first child bottle nursed for 17 months and self weaned. My second dd has a condition that requires special formula. Many of the kids are on tubes or they take bottles for a long time, like up to 4 or 5, and no one bats and eye about it.

My daughter is on Neocate Jr. I know how frustrating it is to have a child with food limitations on top of everything else. I have started using Miralax with her and it's great stuff. It's OTC now. I heard that it's based on a pear extract.

The only person besides you who should have input about weaning is a feeding or occupational therapist. And my bet is that they would encourage it for a long time because of the sensory input and bonding.

 

[Sierra]

(Warning: Long)

We practice extended bottle-nursing (we too, by the way, are foster-adopt parents of children who have special needs). I am a big believer that many of the benefits of extended nursing apply when someone bottle nurses (which of course you and I differentiate from general bottle feeding). These benefits include bonding/closeness, which is oh so important when we are adopting, as well as additional nutrients particularly during common, periodic toddler hunger-strikes or periods when they obsess over one food in particular. The list goes on.

If you do a search on these boards, you will find posts from me as I was thinking about this exact question.

Quote:

how old was your little one before weaned to a cup for milk?

ds is 26 months. By the time he had teeth, we would make sure to give him a rinse with a water bottle after his formula bottle (also Nutramigen, though not soy because he is intolerant), especially at night. This is especially important if you practice extended bottlenursing, as formulas contain more sugars than breastmilk. If you can, it is good to brush their teeth after the bottles, though we bottlenurse ds to sleep and he would not tolerate the brush at that time-- but we did get dentist approval on the water rinse method.

Over time, he slowly reduced the number of times per day that he bottlenursed. Eventually, he would take a bottle at bedtime, and also some overnight. Only very recently, we've begun giving him primarily bottles of water. He is accustomed to taking water from the bottle, so it just happened naturally overtime that we just didn't always need to mix up the formula for him. He does get a formula bottle if he specifically asks for it. I'd say at this point he has formula maybe about once a week. I do have to say though that since the switch to water, he does wake and ask for "bottlenursies" more frequently at night.

He has been drinking water from an open cup since he was quite young, maybe even about ten months. We have juice only very rarely, and of course never in his bottles. Milk is tricky because he is intolerant (he too had SEVERE reflux for an extended period-- though it is generally gone now). When we enrolled him in preschool, they required him to have a milk with lunch. Since he is evidently intolerant to cow's milk, goat's milk, and soy, and we don't believe that rice milk has enough nutrients (especially not milk-replacement nutrients) to justify the sugar in it, we were in a bind. We asked them to try offering him formula in a cup, but he refuses to take it in a cup (um, yeah, I get that...it is "mama milk" aka something he only has snuggled up to mama). The requirement, however, is that they offer it to him, not that he drink it, so it has worked out. Meanwhile, I have been half-considering reintroducing daily formula bottles, though I am not entirely convinced children "need" milk, only because he is intolerant to milk, cheese (at least in substantive amounts, though he does eat some), yogurt, etc., and we are a vegetarian family.
----------------------------------------------

dfd is a different matter. She is fifteen months old, and had reflux that unlike ds' reflux, resolved in a timely matter. She also is able to tolerate cow's milk, and we do offer that to her, as well as water in cups. However, she is unable to coordinating drinking from a cup.

We have always done open cups with ds because sippy cups if used a lot can, for some children, contribute to speech problems and ds already has enough setbacks in that regard. Also we use an open cup because we subscribe to the Montessori understanding. However, we have tried everything and dfd seems to *need* sippy cups, if she is to drink from a cup at all, so with her, we do the sippy cups. She can *sort of* do a sippy...she tips it back and lets the water drip into her mouth...either that or tries to suck it like a bottle which leads to her getting frustrated and throwing it. I worry more about keeping her hydrated than getting some kind of milk into her.

I plan to let dfd self-wean, should she remain with us, as I largely have done with ds. However, I am a bit more concerned with her teeth, as she has not been tolerant of water bottle rinses-- she hates it when her bottles have water instead of milk. So with her we have actually just started mixing more water into her formula to get her used to it in a slow way (more and more over time) in the hopes that eventually she will allow for water rinses. This may mean that she weans herself off formula more quickly, I recognize.

Some days she has as many as four bottles, other days she only takes a bottle at bedtime. We follow her lead.

Quote:

I would LOVE to know if there was any research somewhere to hand to WIC/EI to prove that a child, esp an SN child doesn't have to be weaned at 12 mos old (this is especially a peeve of mine since breastfed NT children have the recommendation from WHO for min 2 years to bf...why not bottle-nursed children??)

I am sorry I don't have a particular bit of research to share with you. What I can say is this.

I have shared in that same frustration.

I did some research and the primary place that the 12 months recommendation seems to come from is the dental implications. The risks and advantages to bottle feeding after 12 months seem to have been weighed as follows: Formula can reek havok on teeth, but (like children weaned from the breast at twelve months) kids can do okay nutritionally/developmentally if weaned from the bottle, wereas before 12 months it seems more statistically risky to wean (when they are not relying so much on solids).

This means that they did not take into account:
(a) That bottle nursing after 12 months might be dentally okay with precautionary practices including: bottleNURSING (many kids with baby bottle rot in the mouth walk around with a bottle in their own hands all day long), water rinses after bottles or more preferably, teeth brushing after bottles, etc.

(b) That even though kids, statistically, can do okay nutritionally/developmentally without formula or breastmilk after 12 months, there are benefits to extended bottleNURSING as I mentioned early in this post.

(c) That 12 months looks different from kid to kid. Some kids are walking by then, some aren't. Some are eating tons of solids, some aren't. Some kids are saying words, some aren't. Some have mature digestive systems, some don't. And so forth. Any strict age cut-off will be arbitrary as a result.

(d) That kids with special needs may need a different nutritional plan.

Quote:

I'm getting a lot of pressure to wean him to a cup instead of a bottle from WIC and EI.

The EI developmental specialist ds and dfd see (who is also an adoptive parent) totally gets why we want to do child-led weaning and extended bottlenursing. She has been supportive of it.

ds' feeding specialist (a speech pathologist with specialization in feeding issues) was unsupportive of us continuing to bottlenurse (he rarely sees her now, so it is a non-issue currently). She felt that the bottles were contributing to his reflux, which is a valid concern. Her alternative was to give him thickened drinks in a cup. She'd take baby food, for example, and water it down just until it was drinkable, and then give that to him. We do a little more of that with cup drinking while he still had such bad reflux (it is almost completely resolved now), but we continued to bottlenurse if he requested it. I basically just resolved not to voluntarily share information with the feeding specialist about his bottlenursing. If she asked about it, I would downplay it. I felt like we considered her knowledge about his reflux, and struck an appropriate balance considering his needs holistically...I didn't need the repeating lecture to wean him cold turkey right then and there.

As for WIC, let me just say that if anyone should be supportive of their work, it is me. I am a former public health practitoner with a specialization in maternal child health. My education involved all kinds of WIC-related research.

However, though foster children qualify for WIC, it didn't take me long to decide not to take my children there (even though it means we have spent an arm and a leg on formula, particularly with the Nutramigen). It wasn't worth it, and besides, we couldn't get formula with lipil from them.

Our practices rely on different assumptions from those of WIC. For example, when ds was about four months old, I brought him in for a WIC appointment, at which time they said he was essentially getting too fat (Hardly! His weight and height were in proportion, both 90th percentile...it wasn't as if he was 30% percentile for height and 90th for weight). Then they looked at the intake sheet with his average formula intake (which is always a big estimation because he bottlenurses on demand and it can vary from day to day depending on how active he is, what he is working on, etc.) and they said, "Oh, this is probably part of why he is putting on so much weight. You are feeding him above the recommended amount. You should reduce what you give him." I held onto my belief that he knows what he needs, and sure enough, a few days later, he shot up in height (hardly any weight gain in comparison to what he got in height)! He was going through a dang growth spurt, and if I had followed their recommendations, the poor kid wouldn't have had the necessary calories.

WIC also has a finanicial interest in you weaning him, especially since Nutramigen is so expensive.

I simply don't do WIC. If a social worker was to ever ask about it, which hasn't happened, I would explain that the kids get weighed and measured at their well-baby visits, and that we don't mind paying for the formula. If we had gone over an extended period, I probably would have explained the same thing to the WIC worker and let them know that we were done.

 

[Jennifer3141]

Sierra, your post was absolutley fascinating. I've often wondered if foster/adopted bottlefed AP kids just magically were willing and able to give up the bottle at that fabulous 12 month mark.

I seem to be following you around today, Julieanne but again, with an
SPD kid I think if you've found something that comforts and relaxes him that you should continue to do it for as long as you are able.

DS is a frequent night nurser still. This means we had to fix 5 cavities under general anesthesia this month. It means we go to the dentist 4 times a year for DS. And it means I wrestle DS down a couple of times a day to do a complicated brushing system. But without night nursing, DS would probably get about 3 hours of sleep a night.

My advice to you is to take as good care of his teeth as you are able and to not let your DS walk around with a bottle full of milk - which you're not doing anyway! You are nursing your son from your description. And that is much less damaging to his enamel than if you were bottle feeding him all day long.

 

[Terabith]

I have a 3 1/2 yr old, who is only very mildly special needs (SPD), who still drinks her milk from a bottle. It is comforting to her. She drinks more milk and more water that way and hence is more hydrated. If she were breastfeeding, I wouldn't bat an eye, so I feel it is hypocritical to take it away. We've talked about not using bottles anymore, and she gets very sad and kinda depressed. (We took them away once for a couple days. She didn't complain, but she was pathetically depressed ALL THE TIME.) She drinks a bottle in the morning when she wakes up, one while cuddling and reading before nap, and one while cuddling before bed. Every once in awhile if she is having a hard time waking up after nap she will have a small one after nap. She has water in bottles while sleeping, tho they don't stay in her mouth after she falls asleep.

She's got good teeth. I know someday we'll have to get rid of the bottles, but frankly I'm slightly dreading it, because I know it will be harder to keep her hydrated.

 

[LynnS6]

If extended breastfeeding is OK, extended bottle feeding should also be fine. It's a time to cuddle and connect. (What WIC and the peds don't want is kids walking around with bottles in their mouth.) Offer an open cup (or cup with a straw) at meal times, and a bottle at the usual cuddle times. Then when they ask, you can say "he drinks from a cup at mealtimes" if you want to add "and we use a bottle as part of the bedtime routine just before brushing teeth" you can. A cup with a straw or an open cup is better for oral development.

Terabith - can you offer a water bottle along with the regular bottle and see if she takes to that? Our kids both had little water bottles with straws that they loved when they were little. We've now graduated to big water bottles. It keeps the whole family hydrated.

We got that pressure too, and our son is also only mildly special needs (and we didn't know he was special needs until he was 5). The push among all peds is to wean from a bottle at 12 months, for all the reasons Sierra so carefully outlined above. For our ds, he breastfed until 16 months, and was bottle fed (first with pumped milk and after 12 months with cows milk) while I was at work. After we night weaned him, my milk supply dipped and he no longer wanted to nurse much (he was a bit of a lazy nurser always). But we continued to bottle feed him until he was 2 1/2. He gave up the bottles more or less spontaneously -- in that he had a cold and milk made him throw up. So, we substituted a cup of juice for his night time bottle, and he never asked for a bottle again. They were still in the cupboard, he just didn't ask and didn't care.

I'm still nursing our 3+ year old typically developing child. We're talking about weaning (and have gone down to once or twice a day). I'm really hoping to wean this summer. Why should a bottle be different in your case?

 

[sbgrace]

Wow. Sierra is fantastic--what an enlightening response and really I can't add anything to what others have already said.
I can say, though, that our pediatrician was adament that I bottle wean my sons at 12 months. My reflux kiddo whose intake was poor anyway was a particularly bad choice but really it wasn't good for either boy. I wish I hadn't listened.

Yes, it worked and wasn't overly traumatic for us but it also wasn't (imo) necessary and his already terrible intake got worse. Also, both of my boys would have probably benefitted from the safety net of calories. In our case I still held my relux/sensory/autism guy to drink..and I still am at three actually though in the last month he has wanted to do it more himself. I did that with a sippy cup (Nuby..which is no much different than bottles so if you are looking for something to convert to due to pressure and still bottle nurse a silicone spout sippy cup is not a bad choice. Nuby has changed their tops and they are hard to drink out of now for my son who is low tone so I can't say Nuby is a great choice anymore but I think there are others out there). I think some push it because it is harder probably as a child gets older and more attached/aware. But I personally don't think that is terribly compelling. I dare say it won't be a problem when the child hits school age. Some drs. aren't nearly as impatient for kids to wean.
I am a freak about toothbrushing and would say that precaution is needed for bottle feeding. However, walking around all day with a bottle vs. a sippy is equally bad on teeth and both aren't good for mouth development. You aren't doing that anyway--I think sessions of bottle nursing would be of no concern personally. Overnight perhaps you would want to follow with something for cleaning teeth.
As far as suggestions about what to use instead of soy milk--when my sons were taken off dairy (later 18 months though only because it took that long for my ped. to admit there was a problem with allergies) I actually started making my own drink. You do have to be careful with the ratios of fat/carbs/and the vitamins and minerals. And without soy you have to watch calcium supplement too. But you can in my opinion make a healthy drink yourself though it is less convenient. I use vegetable juice, homemade rice milk (which is just brown rice or another grain and water blended to a drink consistancy), and added protein and fat (coconut oil or ghee because it is saturated fat and I like warm drinks for better digestion which is really important for reflux kiddos but I also use avocado and olive oil for fat and those go fine in colder drinks; you in my opinion need a saturated fat in the diet at this age somewhere whether drink or food and it is harder to do that without dairy so you have to think about it more). Protein I've used all kinds of things from powders which I really don't like now that I know more to chicken/meat blended up to smitherines to avocado and other similar proteins. A really good blender will make a drink out of anything and once you get a recipe down it isn't too much trouble but of course more trouble than pouring in milk (or formula which might not be a terrible alternative for you given his age and allergy/digestion restrictions...) Oh, and if I had it to do over again with my reflux kid I would have started digestive enzymes a long, long time ago. Especially important for those kids on reflux medications which inhibit digestion (but are necessary for some kids-like my son who is just now weaning off at age three).
Anyway, it sounds gross but my boys love the drinks even now at three. As far as soy and his age--I personally am a bit uncomfortable with soy for young boys but I know lots of people use it without a problem. Without dairy make sure you are getting adequate saturated fat somehow and the vitamins and minerals he needs no matter what you decide to do. Soy blocks iron absorption pretty heavily so that is something to think about in terms of soy as a main beverage all day.
I'm saying too much I know; but just keep in mind you can be really inventive with this stuff!

 

[mom3b1?]

Quote:

Originally Posted by julie anne Thanks for any help.

I'm sorry that you are put in this position by such silly attitudes. My eldest had a LOT of trouble eating when he was little. He had a lot of reflux. He had such a struggle to get the food into him, and then it'd come right back out. He was born a bit early, with gross motor issues, sensory issues, and some other things. Now we know he has Asperger's, and one of the clearest dx's of that the specialist had ever seen.

Getting him onto a sippy cup was also a big mess. I ended up buying dozens of kinds before I found one that worked. I think I had to enlarge the hole of the rubber valve in it too. We had to fiddle with bottle nipples too, as he just couldn't coordinate well, even with all sorts of expert help. Once it clicked for him, he was able to switch from bottle to sippy cup, and I guarded the one he liked with my life!

Personally I don't see how the sippy cup is that different from a bottle. It doesn't make a lot of sense to me that WIC or anybody else cares one way or the other, KWIM?

One of the issues I worried about with A. is that he is very sensitive to people's attitudes about him. At that time he was around his paternal grandmother a lot, daycare workers, and others who made an issue of it. I didn't care a bit about their opinions, but I did care about how they were affecting him. by treating him differently. Since I wasn't, at that time, able to get him away from them (had to work and pay the bills, was sole supporter of the family at the time) I pushed the sippy cup more than I would have wanted to. I hope this isn't an issue for it, but if it is it's something to think through.

I hope this all makes sense. Just use what applies or works for you. Your little guy is wonderful, and I think he should be able to use the bottle as long as he needs to. His getting enough to eat is way more important than ignorant people.

Kiley

 

[bri276]

my dd will be 2 next month and no bottle-weaning in sight. I am perfectly comfortable with continuing the bottle until she self weans from it, whether that be next week or next year.

I, too, am concerned about her teeth. The best solution I find is to finish giving milk before bedtime, then brush, then if she needs anything else to drink, only water. She usually does need her bottle to fall asleep. It took a while to get her used to anything besides ebm/goat's milk/cow's milk in a bottle, but eventually she was fine with it. VERY rarely I'll give her OJ cut with water, other than that it's only milks or plain water. Juice is a big problem with bottles & teeth.

DD was born with a cleft palate; though it's now repaired, she can't create suction normally, so most sippys don't work for her at all, and open cups are hard for her, though she loves trying it and I give them to her regularly, she'll probably get two or three real mouthfuls from an open cup and then starts sticking her hands into it and pouring it all over the place

she'll get it someday. I know people give me looks sometimes but they have no idea what we've been through and especially what DD has been through. I am just happy to see her find security in the bottle since she was unable to nurse- it's an emotional connection for her to be held and given her "baba" and I'm not going to sacrifice her little feelings for conventional wisdom based on nothing- as long as I can keep her teeth in good condition.

 

[lactationlady]

Quote:

Side note/question--he's allergic to cow's milk (diarrhea) and has reflux. He still doesn't have a normal/consistent solid poop --beside a probiotic (which we use), can anyone recommend something that might be a healthier milk alternative than soy (a lot of controversy re: soy milk). Thanks for any help.

We use fresh goat milk for my dairy/soy intolerant dd. We also occasionally use almond or oat milk that I add CLO to. My dd has problems with weight gain, so a milk with plenty of fat is essential for her.

 

[mamaverdi]

My ds is 3.25 yrs. No cavities, and we rarely brush. Knock on wood. He gets breastmilk in a bottle. And he can drink from his bottle until he feels done. And then we will need a tube.