Using Sippy Cups and Pacifiers- Will They Help or Hurt My Late Talking Toddler?

This topic was originally written at the end of another post, but the questions and comments I’ve received via -email warrant a more lengthy discussion. (By the way – If you’d rather send me an e-mail with a question or comment rather than post it on the site, the address is laura@teachmetotalk.com.)

When I’m in a social setting and people find out that I’m a pediatric speech-language pathologist, I get lots of questions about using pacifiers, sippy cups, and if they affect speech development in babies and toddlers.

Let’s tackle the sippy cup?question first. “Sippy cup mouth,” or a huge open bite, is quite common. Don’t mistake the word “common” for “normal.” When children have an open bite they have a gap between their upper and lower teeth when closing the top and bottom teeth together. Many times this dental malocclusion can be linked to prolonged sippy cup use. By prolonged I mean carrying a cup around all day and sleeping with one at night, or using this kind of cup exclusively after age 2 or 3. It can be worse if your child is using a sippy cup AND taking a pacifier because there’s something in his mouth essentially all of the time.

If your child is using a lisp as a toddler or preschooler, it’s likely he has an open bite. An approximation for the sound /s/ is very common in this age group, with or without an open bite. As children get closer to age 5, their/s/ should sound adult-like. If this doesn’t occur by age 5, children may need speech therapy to help learn a more mature production pattern for /s/. This is usually the only negative effect on speech development.

Although it’s messier than a sippy cup, your child should learn to drink from a straw by age 2 and an “open cup”before age 2 1/2 to 3. This takes a commitment from parents because it requires more supervision and clean up than using a no-spill cup. Not too long ago, we didn’t even have sippy cups, besides the slotted top kind from Tupperware. Actually that cup could still be a nice transition between sippy cups and an open cup. The skills to drink from a slotted opening are more mature than the sucking pattern required for the no-spill sippy cups.

Moving to a more complex cup is a great way to work on oral motor coordination than any set of “oral motor exercises.” This drinking practice is very functional, meaning that your child would have built-in opportunities to “practice” many times a day, rather than setting aside time to do special oral motor tasks.

Introduce the new cups (straw, slotted, or open) when he’s seated at a table, outside, or on a tile kitchen floor. Save the sippy cups only for times when making a mess is a big deal such as in the car, when he’s on carpet, or in any other place that would be a major hassle to clean.

Your child should NEVER go to bed with a sippy cup or bottle, no matter how convenient it is to help him to sleep. Leaving the cup or bottle between your teeth while sleeping is what leads to the open space AND tooth decay, especially if you’re using milk or juice. I’ve known several two-year-olds who have had to see a dentist due to a mouth full of greying teeth. Not a pretty site. If you can’t kick this habit just yet, at least switch to water in the cup at bedtime.

Straw drinking is wonderful for oral motor coordination and sensory skill development. Drinking  a cold, thick liquid from a crazy straw is just about the best way to improve tongue, lip, and cheek strength and coordination all in one! Look in the toddler dishes/utensils section of the major retailers for the many version of these cups, or save and use the plastic ones you get at sit-down restaurants. Sports water bottles are also a good option.

Now let’s tackle pacifiers. For some toddlers, pacifiers are not an issue since they never took one in the first place or easily gave it up as an infant. Sometimes not taking a pacifier hasn’t necessarily been a good thing either, since a child may not have found a successful way to self-soothe. Sucking is a very good way to regulate an out-of-control infant and toddler.

Many babies find their thumbs during this phase. While some parents and even experts prefer this habit, I think it’s a lot more difficult to kick, even for 6 and 7 year olds, because you can never truly get rid of it.

For some babies and toddlers (and their parents!), pacifiers are essential and even recommended. For babies with significant oral motor issues, learning to suck a pacifier and keep it in their mouths is a milestone. For cranky babies and toddlers with sensory integration differences, using a pacifier to soothe is the only thing that helps them calm.

Most children should be able to give up the pacifier between age 2 1/2 to 3, or at least relegate this for sleeping or calming only. Walking around all day with a pacifier in your mouth is not recommended as kids move closer to age 3, but not because it keeps you from talking. It makes you look like a big ol’ baby, but that’s another issue in and of itself, and one I’m not going to tackle today!

I think it’s a myth that pacifiers prevent children from talking. Most kids try to talk with it in their mouths and then take it out if their parents insist that they don’t understand them. If your toddler is not talking, is over age 2, and is addicted to his pacifier, try to limit the pacifier to naps, bedtime, and when he really needs it to calm down. You can monitor to see if having an open mouth during waking hours will help him vocalize more. In nearly every child I’ve seen in my whole career, the lack of language is the reason the kid isn’t talking, not because he takes a pacifier.

Some SLPs disagree with this and insist that a toddler be weaned as soon as they begin therapy. I usually advise parents to keep the pacifier until we find other ways to help a kid self-soothe. I think taking away the only method some kids have for calming down is too traumatic when they are also struggling to learn to communicate. I am not into torture, not for the kids I see, and especially not for their parents!

I will add that I don’t let children keep pacifiers in when I’m in their homes seeing them for therapy unless they are falling apart without it. Many children I see work so hard during treatment that they need it to calm down after we’re finished, and I think this is alright.

Parents of children with sensory issues tell me that they need the pacifier for times when no other option works to wind down a jacked-up toddler or end a tantrum. If your toddler, even at 3, still needs the pacifier to help calm his sensory system, keep it and don’t feel guilty. As a mom, I’m just fine with that. As a therapist, I’m fine with it too, but I’d like to see them learn to self-soothe in other more mature ways as they turn 3, and especially by 4, if at all possible.

Options that I’ve seen work are finding a special blanket, stuffed animal, or doll. You are still transferring dependence to an object, but usually one that won’t hurt your teeth, or cause grandma and the neighbors to raise an eyebrow or make those nasty, condescending comments that cause us all to cringe.

Kicking these habits aren’t easy, but it’s all part of growing up, for your baby and you!

m4s0n501

Comments

  1. Laura says

    Thanks to all our faithful readers who have posted a link to our site on their favorite boards, blogs, and sites or e-mailed a link to friends and family who might find this information helpful. Our statistics tell us that you’re out there helping spread the word about this site. If you’re a professional and want to share these strategies with your clients’ families, be our guest! The main purpose of this site is to educate parents with techniques that work to improve a toddler’s communication skills. We appreciate your help! Now go forth and spam! Laura

  2. Josie says

    Thank you for this article about pacifiers and all your other articles. We have been trying to get rid of the pacifier but like your article stated, a child with sensory issues sometimes needs it to calm down.
    I just found your website last week and it has been very helpful.
    I read your articles on a regular basis and shared your website with our childs speech therapist.

    Josie – Northern California

  3. Evaine says

    Good post. You make some great points that most people do not fully understand.

    “Some SLPs disagree with this and insist that a toddler be weaned as soon as they begin therapy. I usually advise parents to keep the pacifier until we find other ways to help a kid self-soothe. I think taking away the only method some kids have for calming down is too traumatic when they are also struggling to learn to communicate. I am not into torture, not for the kids I see, and especially not for their parents!”

    I like how you explained that. Very helpful. Thanks.

  4. Sam says

    Great post. What about straw cups that have no-spill valves, like the Munchkin Cupsicle with straw?

  5. Laura says

    A straw is better no matter what. It promotes a more mature sucking pattern than a sippy cup, so you can’t go wrong! Glad you enjoyed the article! Thanks for commenting! I LOVE feedback! Laura

  6. says

    This is great information for parents. If you don’t mind, I am going to write a little something about this on my blog and link to this post. I am a speech therapist also and have a blog to help parents understand development and different issues that may warrant an evaluation by a speech therapist. I had a friend ask me just the other day about his 18 month old not saying many words and if this could be related to him using a pacifier. I answered pretty much the same way you did here in your article. So I would love to link to this article on http://speechtherapyweb.com. I’d love you to come visit my blog and leave a comment!

    Thanks,
    Tami

  7. Carmen says

    I am a speech language pathologist who like Tami is asked questions
    about pacifiers and sippy cups all the time. I am glad to see the information we provide parents seems rather consistent across the board.
    I also promote the use of straws. A little over a year ago I began distributing one-way valve straws. They provide the child with more control, less spillage and it limits the amount of air the taken in.

  8. Robyn says

    I wish I had read this article months ago! Our therapist demanded we take the pacifier away when he turned 2. Not only was it VERY traumatic for him and us, but he started sucking his thumb. Try taking that away………

  9. Laura says

    Ohhhhh Robyn! I wish she had read this first! Maybe you can share this with her, but maybe you’ve already moved on. I started this site to debunk myths and provide practical, realistic advice for parents and therapists. I hope you find the info useful for you. Welcome to our site! Laura

  10. Holly says

    Just to add my two cents….my son never used a pacifier, sucked his thumb, drank from a bottle or sippy cup only a cup with a straw and he has apraxia. Just my opinion but I don’t think it really matters in younger children or affects their speech in toddler years. I agree totally with you Laura based on my own experience.

  11. Mary says

    While I appreciate this article, I think the deleterious effects of malocclusion, such as an open bite resulting from prolonged pacifier use, are underemphasized. My two-year-old son was recently diagnosed with open bite, which may or may not resolve itself. It’s not just about speech development, it’s also about jaw bone and dental arch formation and, in extreme cases, even the formation of the shape of a child’s face.

    Had I known all of this, the pacifier use would have been curtailed a long time ago.

    mk

  12. Laura says

    Mary – I think you misunderstood the intent of the article. I never advocate that toddlers use a pacifier all day, every day. Just like extensive sippy cup use, a pacifier in your mouth may affect your teeth.

    However, for parents with a child with extreme sensory issues, a pacifier may be the only thing that brings about calming. From the parents I’ve seen with children who fall into this category, they’ll take the chance of possible dental issues in the future. If the child needs orthodontic work, then he’ll fit in with most of his peers who also have braces. I’m not immune to this issue since I am now paying for my 3rd set of braces in 5 years for our own 3 children. (Let me also add that 1 of them had oral surgery to remove teeth, and one had a jaw malformation which required extensive orthodontics, so again, I speak from experience, and I am not making light of yours.)

    The intent of the article is to inform parents that it’s a myth to think that pacifiers in and of themselves CAUSE language delays, to let parents of children who require pacifiers for sensory regulation “off the hook” for using one, and to inform parents that prolonged sippy cup use can also be a reason for dental problems.

    I’m sorry you have had a negative outcome. Thank you for posting your experience.

    And just so you and all our readers know – every article on this site is written from the perspective of impacting speech-language development.

  13. Chris says

    My 15 month old is attached to the pacifier and a blanket. And is really aggressive if you take either away. She sometimes refuses to try to use her words even though she has them. I have limited pacifier to car trips, naps, and total meltdown. Speech improved a little but aggression is off the chart. Only trigger is setting limitations, she does not deal well with being limited in what she does, where she goes, and what she playes with even if its a sharp pointy object. Really don’t know what to do with aggressive behavior.

  14. Laura says

    Chris – Try redirection or distraction when she’s about to do something you don’t want her to do instead of a verbal limitation since this is what behavior experts recommend. Some parents balk at this and think it’s “wrong” to not state limits firmly and function as the clear “authority” figure all of the time. However, with children who are prone to fall apart or overreact negatively, keeping the peace and helping her learn to self-calm are also very important as well -especially for YOUR sanity! These points are not mutually exclusive either. If you can prevent a full-blown meltdown by distracting her with an appealing alternative, by all means do this. Just so you know – distraction and redirection are the ONLY disciplinary strategies recommended by experts until a child is 24 months old. Until then cognitively you can forget about helping them understand “consequences.” For this reason time out shouldn’t be used until that age. It doesn’t mean you don’t say “no,” but you may have to save it for when it really matters – say with the sharp pointy objects!!

    Unless the comfort objects of the pacy and blanket are prohibiting participation in play or daily routines, I’d also let her have those pretty liberally as well. Look at these as self-calming strategies rather than a “crutch” or something you need to limit for the time being. When she’s a little more emotionally mature, then you can start to limit their use. For now, if she’s playing happily and is having a good day, you can try to temporarily put them away. But don’t punish yourself! When she needs them, use them!! I’ve known parents who would give their right arms to have ways to help their child calm down! You know what works for your little girl, so use them, and don’t feel guilty! Sucking is very regulatory for children – especially for toddlers short fuses! Blankets – or anything soft & silky – is also very calming. Again, use these and don’t feel guilty! No one goes to kindergarten with a binky & blankie, and I doubt she will either!!

    In my opinion, pacifiers do NOT prevent children from talking. Most kids with pacifiers learn to talk with them in their mouths or take them out when parents say things like, “Take your pacy out and tell me.” When she’s playing happily, remove it, but don’t make a bigger deal out of it, or it will likely turn into a battle ground for her. She sounds like she’s really does need it to help her calm down, and 15 months is still fine for this. At her 3rd birthday you can take it away with a cute routine like “giving it to the new babies” or something like that, but until 3, it’s really fine.

    Hope these ideas help! Laura

    P.S. For more info about disciplinary challenges with children with language delays, check out my DVDs Teach Me To Listen and Obey 1 and 2.

  15. Sue says

    I am a speech therapist in an Early Intervention program, providing services within family homes, and am also frequently asked about pacifier use. I strongly discourage frequent, free-access use of the pacifier in preschoolers with speech-language delays. I have never told a family their child is not talking due to use of a pacifier, or that they will talk if it is removed, but I do always tell them this: your child can not engage in vocal and oral play as they move about the house with a pacifier or “plug” in their mouth. I explain the significance of this oral and vocal play. I encourage them to use the pacifier only at nap or bed time, or when the child is very fussy and unable to be soothed. Unfortunately, I often see several pacifiers scattered around the home, serving as a benefit for the parents, NOT the child. Some children will meet me at the door with the pacifier in their mouth; they always let me remove it from their mouth, no fuss. This tells me a lot: the child doesn’t need it near as much as the parents think the child does. And I HAVE had several parents tell me their children began to engage in a much higher level of vocal and oral play after they began to limit pacifier use/wean. This play, of course, leads to experimentation with speech sounds, etc. I wish the author had addressed these issues, vocal and oral play, and not true word use, which is further down the road.

  16. Bhuvana says

    hi laura

    thanks for this article…..we have started using a toy as a dependence object instead of the pacifier….. i am trying to not feel guilty whenever someone gives a nasty comment about the use of the pacifier :)

    Bhuvana-India

  17. Carrie says

    Hi Laura,

    I just found your website and was excited when I did. I have 5 of my own children but have been working in Early Childhood for about 16 years. I never thought that way about the straw as you described, I know it helps but I had parents bring their children in when they were trying to wean them from the bottle when they would be about 1 years old with the biggest sippy cup that has the straw instead. The problem that I found in my experience with this is that it delayed the children to use their self help skills to lift the cup or tilt it in order to drink, because with a straw there is no need for that. Of course this was with children who did not suffer from speech delays or anything.

    SO I found that if they started on the traditional sippy cup first just to learn the basics then progress to the straw the child will then have all of the skills (when it comes to using a cup or otherwise. Once again this is in my experience not clincally proven just my own theory. I found that for many of the parents it seemed as a safe bet for them. But I would also let the parent know that their child did not need that cup (which was about 10oz or so) full of juice or milk in one sitting, to sleep with or just to have.

    Thank you for posting this article as it has been helpful to read. Your site is a blessing as I have just begun working with a 20 month old who cries through everything and babbles. Many of the things he displays are that of a early toddler just about to turn 1. So I was looking for ways that I could help this child. I believe I share the same philosophy as you…language, language , language…what I always say is “use your words” and I pronounce everthing and repatition is key.

  18. Elise says

    Hi Laura, Thanks for the great article. I have a 12 month old. Can you tell me if nursing for extended periods at night will cause the same problem as extensive sippy cup or pacifier use? I have a friend who insists that there are language developmental delays that come with bottle/pacifier/nursing after the age of 1.

  19. Laura says

    Elise – The theory is that anytime a child has something in his mouth for an extensive period of time, there’s a risk of altering dentition and oral structure. Laura

  20. Laura says

    When a child has a language delay, it’s usually due to other issues – he doesn’t understand language, he’s not connected socially, he’s a late talker due to an expressive language delay, etc… not the nursing/pacy/bottle per say. However, if a passive kid that may have some risk factors for a language delay, if has something in his mouth 24/7, he may not try to vocalize as often as an infant. If he doesn’t get vocal play or have the initial desire to try to imitate sounds, he’s likely not going to develop language as quickly as his peers. The converse is equally true. If a child doesn’t have many risk factors for a language delay, using a pacifier or sippy cup or even nursing for longer periods is not likely to deter his language development. The thing is – we don’t always know which babies are predisposed for a delay and which ones aren’t. If your almost one year old isn’t interested in other people, isn’t trying to communicate with you with some early gestures and using other early gestures like waving or pointing, and isn’t try to imitate familiar words, do everything you can do eliminate any other contributing factor. Get his hearing checked. Treat chronic ear infections. Play in a way that facilitates language development, etc… The website and my DVD series is full of ways to help you learn how to do that. Good luck with your baby! Laura

  21. Sarah says

    Hi Laura,
    What is your opinion on thumb sucking? My son sucks his thumb, and is very attached to his thumb. He is only a little over 2, but seems to be relying on his thumb more now than when he was 1. We don’t want it to become a habit that’s very hard to break. Do you have any strategies for helping a child stop sucking the thumb?
    Thanks,
    Sarah

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