Battle of the Bottle
Article by Janferie Dewar: Baby and Beyond Sleep Consultant, Registered Nurse, Breastfeeding Educator
TODDLERS AND NIGHT TIME BOTTLES
Sometimes what starts out as a great idea and short-term help can turn into one of the most common toddler sleep disruptions parents seek help for. I’m talking night time bottle battles and mini milk a holic’s. I’ve been there too – staggering into the toddler’s room at 4 am with a hastily made bottle in the desperate hope of a quick return to sleep – theirs and mine!
But what happens when that one bottle becomes 2 or 3 or even 4, and they are guzzling through over half a litre of milk and a huge calorie intake through the night hours over multiple wake ups. It’s no longer helpful for the toddler, or parents – with nappies and bedding soaked through, a habit of broken sleep and then daytime fussiness around food.
(If this sounds familiar – at Baby and Beyond our Consultants are experienced in looking at your toddler’s unique situation and your needs to form an individual Plan that will work to put the bottle battles behind you and get a lot more sleep).
Does a toddler need an overnight bottle? In most cases with a healthy growing child, the answer is no. Occasionally if they are recovering from being unwell and off their daytime food a night bottle can be useful short term. However, night bottles quickly become a source of comfort and a habit because many toddlers still like to suck if they are settling or in light sleep. The bottle becomes the ‘lovey’ that they find soothing, however being summoned from deep sleep night after night to get up and make a bottle isn’t soothing on the parents! And in doing so regularly the overnight bottles become exactly what your toddler will expect and call out for if they wake.
Your toddlers overnight sleep cycle can be disrupted by bottles, as the extra fluid and calories stimulate the digestive system into action and their bladder! Over time a toddler can develop a learned hunger through the night, so that they do in fact wake feeling hungry. They aren’t to know that 2 am isn’t a desirable time for a liquid meal.
So how much milk does your toddler need? The recommendation is around 500+ mls or about two full measuring cups, your toddler may be getting additional milk on cereal or dairy in the form of cheese, yogurt or desserts as well. I recently worked with a toddler who was having up to 4 bottles and 700 mls from bedtime through to breakfast time on some nights. And that meant they had a reduced appetite during the day and lack of interest in food, not to mention a tired mum!
There are some very good health reasons why sorting out the night bottle habit is important- these include your toddlers iron levels, teeth and preventing ear infections and over tiredness.
It is desirable for our toddlers to be eating a wide range of food from the food groups, and similar food to the rest of the family – although it may be presented differently. Milk while an essential and complete food for babies, is low in the fiber a toddler needs. You will have heard how important iron is for our toddlers and preschoolers but did you know the calcium in milk makes iron harder for the body to absorb?
Iron is an essential mineral for a child’s growth and development and helps move oxygen from the lungs to the rest of the body and helps muscles store and use oxygen.
In 2016 research published by Paediatricians at Star Ship Child’s Health found that, “around 14% of urban New Zealand (Auckland) children between 6 and 23 months have iron deficiency”.
Prolonged iron deficiency can result in widespread impairment in body functions. The most important adverse effects of iron deficiency in childhood involve learning, behavior and cognitive function. Iron deficiency also results in anemia, abnormalities in weight gain, appetite, gastrointestinal function, exercise tolerance and immune response to infections.”
What about those cute new pearly whites in their mouth, can excessive night milk consumption cause decay?. Unfortunately yes – in fact it has a formal name “Baby Bottle Tooth Decay” when liquids with natural sugars (like cow’s milk, formula, and fruit juice) cling to teeth for a long time. Bacteria in the mouth thrive on this sugar and make acids that attack the teeth. Also, during sleep the natural rinsing action of saliva diminishes, allowing baby’s teeth to be bathed in the milk or formula, leading to decay.
Bottles that are given in the cot or bed can also affect a toddler’s ears, this is because when they lie flat, the eustachian tube—the tube that connects the back of the throat with the middle ear—is more horizontal. This allows fluid and germs to travel more easily from the back of the throat to the middle ear. Fluid, formula or milk in the middle ear can act as a culture medium, basically growing the germs that cause ear infections.
You might be surprised to know this: just 230 ml of whole fat cows’ milk contains a little over 7g of protein, or half the daily recommendation of protein for a toddler. That means if toddlers have two or more 230 ml servings of cows’ milk, they’ve already exceeded their 15 g of protein without including any solids or additional dairy e.g. yogurt, cheese, etc.
Parents aren’t the only ones experiencing the ill effects of those night wake ups! Our toddlers can become over tired too. This can mean they are grizzly during the day and seem even harder to get to sleep though they are SO tired. One of the reasons is that the stress hormone cortisol can be raised from lack of sleep which makes them ’wired’ so it is harder for them to go to settle and stay asleep. This can become a cycle of chronic night waking- tiredness- leading to less restorative sleep and cranky daytime behaviour.
It is common for parents to have feelings of exhaustion and frustration around the night bottle dilemma and this stress and lack of sleep flows on to impact the day with other children, work performance, the parent’s relationship and mood.
Unsure how to resolve the bottle issue? parental disagreement and an inconsistent response from night to night will strengthen the toddlers resolve to demand a bottle in the wee hours. Perhaps one parent is more likely to give in than the other or doesn’t see it as a problem (usually the one not getting up!)
Remember, a toddler can’t go and get their own bottles, you as parents are doing this for them, Baby & Beyond Consultants will talk with you about your feelings around the night waking and support you with a plan that works to change this. We will include tips that will suit your parenting style and toddler’s temperament to phase out the bottles, introduce some great new sleep associations and how to cope with any night-time protesting your toddler might have to the new ‘bottle-less’ regime (and I don’t mean ear plugs!)
With the help of a Baby & Beyond Consultant, it is so much easier to follow through and achieve better sleep for everyone.
Reference:
https://www.starship.org.nz/for-health-professionals/starship-clinical-guidelines/i/iron-deficiency/
https://www.webmd.com/oral-health/guide/what-is-baby-bottle-tooth-decay#1
https://www.verywellfamily.com/risks-of-drinking-too-much-milk-2634575
Gemini Study https://www.bellybelly.com.au/toddler/toddler-diet-increasing-risk-obesity/
To learn more about Janferie, click here 