Sippy cups, bottles and pacifiers cause injury

At my office, regardless of the time of day, I see toddlers walking around with sippy cups, bottles or pacifiers. I’ve always wondered why it seems that snack or mealtime always hit when children were at the office, but now I realize that many children have access to these items all the time.

I guess I shouldn’t have been surprised when I read the recent report in Pediatrics that about one child every 4 hours sustains a mouth injury severe enough that a parent seeks emergency care from one of these objects. When I first saw the study title about sippy cup injuries I almost laughed. I thought before I read the article that these pediatricians must be desperate to publish a paper if this is the best research question they could come up with. After reading the study, though, I was amazed at the frequency that these injuries occurred and realized I needed to specifically discuss this issue with families as their children get mobile.

The message I intend to begin sharing is that children don’t need to walk around with constant access to fluids and certainly, once they’re starting to really vocalize, pacifiers either. I wonder if part of the problem with the obesity epidemic we’re facing stems from the fact that children from a very early age have constant access to drink (at least). If meals and snacks were scheduled and sippy cups or bottles only offered at that time for 10-20 minutes at the most, many fewer injuries would occur.

In addition to a lower rate of mouth and teeth trauma, I suspect dental issues like cavities would diminish too. The mouth has to have periods without food or drink to allow the pH to change and discourage the growth of the bacteria that cause cavities. I also suspect toddlers and preschoolers notorious for being picky eaters, would find that they are hungrier when the meal or snack is presented and may actually eat healthier stuff as a result.

Even if you are at the playground and it’s 85 degrees out, your child doesn’t need constant access to water or other fluids. Bring a water bottle if you’re going to be out for an hour or more and take a short break to allow the child to have a drink before returning to play but don’t feel the need to have that access to fluids unfettered.

A pacifier can cause some injuries, too, if a child falls with it in his mouth. After about 9 months of age as real language emerges, pacifier use can actually delay speech. I suggest leaving the pacifier in the crib at that point and use it only to assist in soothing to fall asleep.

Given the risks of injury coupled with the appetite suppression of constant access to fluids and the dental issues this trickle of fluids can result in, I urge parents to schedule meals and snacks and not just let their child graze.

Boredom, fussiness or anxiety (all possible in my office while you are waiting to be seen) should not be the impetus to pull out food or drink to soothe your toddler. Get out a book or sing a song instead. Your mouth will thank you.