Saturday, February 28, 2009

The Sippy Cup Issue

What a great email I got today! An SLP forwarded me a link to an article on why “sippy cups” are not the best choice for transitioning kids off of bottles. In this article in Baby Talk they talk about the fact that to drink from a “sippy cup” the child has to use a suckle pattern. The best quote is from an SLP “There are only a few sounds we produce with the tongue out like ‘th.’ Most words are spoken with the tongue in, and the sippy cup does not encourage that.” Finally! I have been teaching this same information in my class, A Three-Part Treatment Plan for Oral-Motor Therapy, since 1992 but for some reason the message has not gotten out there. Even though Jonathan Eig wrote an article many years ago in the Wall Street Journal, in which I was quoted, this is the first resurface of the issue I’ve seen and I’m elated.

I have spoken with many dentists who also discourage the use of these cups as they foster an open bite. These cups are carried around and allow kids to have a sugared liquid in the mouth frequently throughout the day. For this reason the incidences of cavities is increased in kids who use them habitually. Many pediatricians don’t like them because a child can drink from them with the head tilted back allowing liquid to enter the Eustacian Tubes so these kids are at greater risk for ear infections.

There are so many reasons why they should not be used especially with our clients with tongue-thrusts which already impact negatively on their speech and feeding skill development. Using a recessed lid cup, Honey Bear with Straw or a Straw Drinking Hierarchy (admittedly biased source – other sources exist but I cannot vouch for quality) is a much better way to ensure adequate liquid nutrition, avoid spilling and actually improving oral placement and movements for speech.


  1. Sara, welcome to the blogosphere! Good to see you here. I'll go right now and send my readers over here.
    Miriam Kauk

  2. I love that you are now blogging! I have dedicated a 'blogspot' to food ideas for children--I would love to link yours to it as well. Many of my pediatric feeding articles are on there already but I think it would be great to have additional SLP blogging references!

  3. Kristina, I would be honored to be linked to your website. The more information we can share with therapists and parents the better.

  4. I am a mom to 4 children, the youngest of whom (age 2) has Down Syndrome and some associated oral motor issues. I am so excited to find out that you will be blogging!
    Our "favorite" (am I allowed to say that?!) speech therapist had so many wonderful ideas which she attributed to you. She had learned your methods in seminars and education courses, and had nothing but glowing recommendations for your work.
    She was fantastic!! We "lost" her about 2 months ago when she moved away and we have had no luck finding someone in our area that specializes in oral motor therapy. We do still have ST, but not like before. So I am looking forward to reading your blog and gleaning what I can from here.
    Thanks for sharing with us!

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  6. Sara,

    I am so glad you posted this message. I am a speech therapist in Canada as well as a great admirer and believer in your work. I keep trying to tell my clients and family members and friends why sippy cups are not a good choice. It is great to have an article to back me up!


  7. As a pediatric OT working with children with feeding problems,I heartily endorse and spread your message about the importance of getting children off the sippy cup. I have seen children who are excessive droolers stop drooling within 2 weeks of transitioning from a sippy cup to a straw. This is a great article to reinforce the message. It is nice to find other feeding therapists on-line.

    Debra Rabin
    Los Angeles, CA

  8. I am very excited that we have a new way to share and learn new information. Removing the sippy cup and using the honey bear straw and/or the recessed cup has had a great impact on so many of my clients. The Talk Tools techniques have really refined the structure of my therapy and enhanced the ability to measure the effects of the methods used with each child. Can't wait to read and share more!!!

    Pam Crosley
    Speech Therapist in Richmond, Tx

  9. I am so glad to find your blog! When my daughter was first born in June 2007 and we subsequently received her Ds dx, I learned quickly from other parents that sippy cups were not ideal (your teachings at work!). We also got some good info on oral motor tools from an ST before moving to a very small town with limited resources.

    Right now I'm tryng my best to find a good recessed lid cup, but I'm unsure of what to choose. M drinks very well from a straw and has for a long time. Unfortunately, what she gets into her mouth doesn't stay and I'm at a loss for what to do next.

    I'll continue to read and see if you have any suggestions.

    Thank you again for this forum!

  10. I would love to hear if you have any tips/tricks that you use for encouraging drinking. My 2 year old daughter has Down Syndrome and is just not motivated to drink. We have the cups with a nose cutout, the Honey Bear straw cup, etc, but haven't had luck. She will use a soft spouted sippy on occasion (water only), but often just spits the water back out. She basically drinks only 6-8 oz of liquid (milk) a day from one bottle in the we just cut her off?!

    Thanks for any advice!

  11. Sara,

    I am the father of four children, the youngest of which has Down's Syndrome. I am a PhD student in the UK (though American) and our Sara (now 2) has only been exposed to the ST's here in the UK under the NHS. Consequently, we are terribly behind in getting information regarding her speech. She excels in all other areas and although she is only two, our concerns are growing over her ability to develop good speech. Just reading this one post has helped considerably. You can imagine now how quickly I will be going to the store to get recessed-lid cups.
    Please do not stop blogging and know for certain that there are many out here who need your help and guidance. My family will be moving to Princeton, NJ this August and would love to know of any speech therapists you might suggest in that area. Thanks so much.

    Mark D. Mathews
    Durham, UK

  12. I would love to connect your blog to if that is okay? Janet

  13. So great to see you have a blog!!! YEAH!!! I'm still breastfeeding my 14 mos old son but we are slowly introducing him to fluids using a regular open cup as well as the honey bear. He loves to drink water from an open cup but he seems to inhale it a bit when he drinks from it. The honey bear is still new. He isn't sucking the straw but I am able to squirt some fluid in his mouth...most comes right out but I think a tiny bit gets in. Am I doing everything right? Is breastfeeding long term a benefit for oral/motor development or does it hinder progress?

  14. Thank you for this post! I have been struggling to get my little one to take something other than a bottle. I have a cupboard full of sippy cups and they are gathering dust.

    I don't really know how to get Lauren to drink from a straw though so would appreciate any and all tips. Thanks so much.

    Our SLP follows your techniques but we've not yet addressed the weaning issue, so any info would be appreciated. Also, I am sharing the link to your blog with all of my friends raising kids with Down syndrome.

  15. Sara,

    I have spent some time designing a sippy cup to help teach the mechanics of holding a cup, bringing it to the mouth, and slightly tilting. Which is more accurate to drinking from a regular cup, than any other sippy cup out there. I was wondering if you would be interested in trying out our sippy cup. I know you have a clear opinion on them, but the big companies don't care, and we are trying to build a better sippy cup. I can be reached at shandley @ kileymadison dot com

  16. Sara,

    I am so happy to have found your blog. I have a 19 month old daughter with DS and I live in India, and haven't had much luck with speech therapy. I met a therapist who gave me some mouth exercises after which I noticed my daughter started sticking out her tongue evn more. I didn't have a very good feeling about him, but we don't have much choice here, in the meantime I have stopped going to him. I was wondering of you could recommend any DVD's / books which could give me what I need, and teach me what I should be doing to help my daughter with speech, tongue protrution, eating etc. I know this is the time to help her, and just don't was to let the chance slip by until it's too late and more damage is done.
    Thank you for your help, my email address is
    any suggestions from your side would be much appreciated.

  17. Hello, I have made an appointment for my daughter to see you at the Moebius conference in Co.

    You website is not working?? and this is the only way I know how to contact you. please email me at