Bottle or Binky in Bed: Bad Idea!

Have you done this? This is for you parents who said they’d never do it. Your toddler sleeps with a bottle or binky in her mouth. You said you’d never do it, but there it is! How did it happen?

The Slippery Slope

It’s a real thing, folks. When you step out on to the edge of the slippery slope you end up at the bottom before you know what happened. bottle or binky 2

I’ve been there. Trust me, I know what it’s like to suffer from toddler-induced sleep deprivation. You will do anything (within reason) to get the little one to settle.

Perhaps you’ve even said this to yourself: “I’ll give her the bottle or binky just this once. I don’t want it to become a habit. I just need to get to sleep!”

A week, maybe a month later, you remember what you said to yourself and the feeling of guilt creeps in. Because the binky is still in the toddler’s mouth, or the bottle is still in the crib. I’ve been there as well.

The Problems Bottle or Binky Cause

Things seem ok for now. She’s sleeping after all, isn’t she?

bottle or binky1
Is that juice in that bottle?

Yes. For now she is. But what if the binky falls out and she goes looking for it? If she doesn’t find it and wakes up fully, she’ll be pissed! This is because the object in her mouth has become a sleep association. That is to say, something that she associates with going to sleep. If that thing is no longer present when she arrives at a shallow sleep phase in a couple hours, she may go looking for it and fully rouse herself.

What about her new teeth? Could they grow in crookedly because of the rubber object in her mouth 8 hours straight? Yes, it could happen. She might also increase her risk for ear infections.

Then there’s the speech thing.

Don’t Talk With Your Mouth Full!

I have met dozens of mothers who worry that their toddlers aren’t speaking when they should. One look at the toddler can tell the story. If her mouth is full of binky, or if she has a bottle hanging from her lips at all times, she probably is going to have a tough time speaking! I’ve consulted on toddlers who do manage to learn to speak around their binkies, but I must say this is rare. Suffice to say these kids aren’t easy to understand. A friend who is a speech pathologist has managed more than one case by simply popping the binky out of her patient’s mouth!

More Teeth Problems

Another typical “slippery slope” story is the problem of “milk bottle cavities“. I’ve seen my fair share of kids who’s mouths look like this:

bottle or binky
Sorry for the disturbing photo, folks

It turns out that bacteria love sugar. When you bathe baby teeth in sugar for several hours at a time, bacteria that cause cavities have a feast! I know that these parents never wanted their toddler’s two top teeth to rot! I know they only wanted the little one to get to sleep and this was the “only way” to get it done. Well, of course it wasn’t the only way, but once you step out onto that slippery slope, you end up at the bottom before you know what hit you.

The sugar in breast milk or formula is fine for your baby; you’d have to admit it’s good for her! But it is meant to be sucked down and swallowed. Milk was never meant to pool in a human’s mouth for any length of time. The effect on teeth tells the story.

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What goes for milk goes triple for juice. Juice is not fruit. Juice is flavored sugar dissolved in water. There is no good dietary reasons for your baby to consume sugar. How much more so is there no reason for sugar-water to swirl around in her mouth. It does nothing but provide a tasty meal for those bacteria!

Bottle or Binky Before Bed?

As I’ve said before, I’m a big fan of the binky. It can be the breastfeeding mom’s best friend for the first six months of the baby’s life. Prior to 4-6 months, your baby needs some external source of soothing. Beyond this point, the baby is able to do it herself, so she doesn’t need soothing aids. This is when the binky becomes something much less than a friend. It becomes a habit that you desperately wish you had broken earlier. The longer you wait, the tougher it gets. A “window of opportunity” begins to close at around 9 months. By one year of life it takes a strong parent indeed to pry the window open again!

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Now see? She’s addicted to it!

As for the bottle, it has no place in the crib, ever.

If you absolutely must give a bottle to a toddler in a crib, it should be a bottle of water (sugar-free) and you should do this only on one particular situation (discussed in “The Three Temptations“). After the child has had her sip, she doesn’t need it any more and you can take it away.

Spiked Shoes

I once heard an ethicist say he wished he could climb down the slippery slope with spiked shoes. Sorry. You can’t do that. No one can. The best way to fix the problem of a toddler who won’t sleep without a bottle or binky is never to give either in order to make them sleep. For a binky, you have some leeway until 6 months. With the bottle, it should be easier:

Just. Say. No.

Climbing Back Up the Slope

But if you do find yourself at the bottom of that slippery slope, not all hope is lost. If your toddler really needs something with her in bed, you can replace the bottle or binky with another transitional (or comfort) object. Whatever it is, it should be something she can put in her mouth that will be safe for her. A blanket or stuffed animal can be a good substitute.

Another trick that works well for some parents is a “goodbye” ritual, timed to coincide with a big event like a birthday. My sister prepared a goodbye ceremony for her daughter’s binky when the girl turned 3. They went and threw away all the binkies in the dumpster, and then and bought a nice present for the little girl. My niece was very enthusiastic about the entire thing.

Of course, it’s ideal to be able to avoid transitional objects and goodbye rituals in the first place!

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Pacifier: Yes or No?

Should I give my new baby a pacifier or not? It’s a question you may have thought about even before bringing the little one home.  Let me break it down for you.

The pros and cons of the pacifier

First, a confession: I’m a big fan of the pacifier, up to a point. Prior to four months of age, a baby really needs something outside her body to help soothe her. Most babies satisfy this need to be soothed by sucking, and if they cannot suck on a pacifier they will use mom as a pacifier. Our second child did this for a year. My wife reports it was annoying, to say the least.

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Worth a try

I had been taught that a baby would either take a pacifier or she wouldn’t.  I offered a binky to our first baby when he was a few days old, to try and help him sleep.  He spat it right out. I thought “Oh, well, I guess is the kid who won’t take it!”

But a couple days later, I thought “You know, this kid just isn’t settling. Why don’t I try it again?”

Sure enough, he took it and it was a good thing.  At that point in his life he and his mother needed it!

Breast-fed vs. bottle-fed babies

If you’re going to breast feed, seriously consider the binky. Some babies need to suck much more often in order to self-settle. Trust me, you don’t want to end up as your baby’s human pacifier.  For bottle-fed babies, the stakes are not as high, so if your baby doesn’t really need something in her mouth at all times, you might consider trying to wean off the pacifier early.  Here’s why:pacifier

A life saver becomes a bad habit

Too much of a good thing, right? As I’ve said in other posts, at some point the baby will learn to self-settle. For boys this happens by 6 months, for girls around 4 months. After that point, if the baby still uses a binky, she’s at risk of developing a bad sleep association. The binky changes from being something necessary to being a bad habit. I recommend tossing the little buggers out by six months.  I mean throw them outside the house.  You want to reduce your own temptation to go get it when the baby cries!

If you don’t get rid of it soon after the baby learns to self-soothe, it becomes progressively harder to do so.  And you’ll smack yourself in the forehead wishing you had done it sooner!

So What Do I Do?

  • Try it. If your baby won’t take a binky at first, don’t give up. Try different sizes and shapes. If you hit on something she likes you’ll be glad you made the effort.
  • Just be sure you throw away the pacifier at six months. If you keep it in longer than that, it will become a habit that some day you may regret not breaking sooner.
pacifier
I like this one. It’s pink. Too bad I gotta throw it away!

The Three Temptations

This is a story about The Three Temptations.  And it’s a true story: one hundreds of parents have told me.
Mom and Dad will buy a phone consult about their nine-month old daughter.  It turns out that nobody in the house has had a good night’s sleep since baby was born. They are physically and emotionally exhausted – you can hear it in their voices. They are fairly begging for relief. All they want is a few hours in a row of sleep!

I listen to the story and remember my own sleep deprivation when our boys were this age. I remember how that physical and emotional exhaustion can take a toll on relationships.

At one point in the story, the parents tell me a key piece of information: Baby girl falls asleep at the breast.  Boom.  I believe we’ve found our answer. It all has to do with a temptation that can be irresistible in the middle of the night when mom and dad are exhausted, but it’s critical to solving baby’s sleep problem.

When parents tell me that their baby (four months or older) wakes up every two hours during the night, one of the first things I ask about are sleep associations. I want to know what surrounds the baby at the moment of sleep, since these are the things we want surrounding the baby when she moves into shallow sleep every two to three hours.

  • Is the baby in the place where you plan to have her sleep throughout the night (hopefully!)?
  • Is she nursing or taking a bottle while she falls asleep?
  • Does she have a binky (pacifier) in her mouth?
  • Is she making contact with mom’s or dad’s body while she falls asleep?
  • Was some kind of moving mobile or sleep-toy on that turns itself off?

If the answer to any of these question is yes, we probably have found why the child wakes so frequently at night. The solution is to remove the bad association sooner rather than later. In my experience, cold-turkey is the only effective approach. Weaning a baby away from most bad sleep associations turns out to be more difficult than it sounds.

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For example, it’s notoriously difficult to wean a baby off a pacifier. As long as the binky remains in the house, the temptation to give it back to the baby for any reason is simply too strong.

Think about this: is there any way to wean a baby off of becoming used to falling asleep in your bed, when you want her to spend the night in her crib?

Nursing to sleep, on the other hand, lends itself much better to weaning because the object of the exercise is to increase the amount of time between the last feeding and the moment the child falls asleep. In practice, however, the toughest and most important step is the first one: taking the baby off the breast or the bottle before she is asleep!

To troubleshoot sleep associations, take inventory.

See what things she’s surrounded by at the moment of sleep and make sure those are the things that will be there in two to three hours. If any of those things are difficult or impossible to reproduce in two to three hours, it’s best to work at changing or removing them.

The Three Temptations, and How to Avoid Them

For a baby who has developed her own internal soothing mechanisms but who wakes in the middle of the night and demands attention, I recommend a strategy I call “Avoiding the Three Temptations.” The temptations are:

  1. Going in to the baby
  2. Picking her up, and
  3. Giving her something to eat.

I counsel parents that if they cannot resist the temptation to go in to see their fussy baby, they should resist the temptation to pick her up. Instead, I recommend stroking the baby’s back and talking to her calmly and reassuringly.

But if mom cannot resist the temptation to pick the baby up, she should resist the temptation to feed her. Instead, she should make calm sounds and gently rock the baby.

But if mom/dad cannot resist the temptation to give the baby something to eat, they should not breast-feed or formula-feed the baby!

Instead: give the baby a bottle of water. (Note: Never give pure water to a baby younger than four months of age; there’s a small but measurable risk that the baby’s blood may become diluted.) The baby does not want water. Since most babies are smart enough to reject less-than-enticing incentives for waking up, eventually, usually after a night or two, the baby realizes that waking up for water is not worth her while. Then the parents can work on resisting the first two temptations! The three temptations are too many.