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Nowadays ‘no spill’ cups are advertised as essential equipment for modern child rearing, saving your furnishings from ruin, and promoting independence for growing babies and toddlers. But there is a bewildering choice of feeding cups available, and parents can face a dilemma when deciding which drinks are the healthiest.In fact, there are growing concerns among dentists that the way these ‘no spill’ cups are used may be damaging children’s teeth.

Frequently sipping squash or juice throughout the day means that a child’s teeth and gums are constantly bathed in sweet, acidic liquids, leading to tooth decay (dental caries) and erosion.

What does your child need to drink?

In the early days it’s straightforward – babies who are not on solids rarely need additional fluids. In hot weather, however, your baby may seem thirsty. If you’re bottle feeding your baby and don’t think that she needs more formula, you can offer her cooled, boiled water from a bottle or cup.

Breastfed babies can be fed more frequently because the energy content of breastmilk changes as the feed continues. Once weaning begins at around six months, older babies and children who are allowed to drink any fluid other than plain water freely throughout the day may fill up on calories from these drinks, reducing their appetite for milk or solid foods.

This makes it difficult for the child to get enough nutrients, and may lead to deficiencies over a period of time, especially anaemia due to lack of iron. Dieticians recommend that babies should be introduced to drinking from a cup by six months at the latest, and the use of a bottle actively discouraged after one year.

How does tooth damage occur?

Tooth decay occurs when the bacteria in our mouths digest some of the sugar from our foods and drinks, forming acids that can weaken the tooth enamel. As the enamel on milk teeth is thinner, babies and children are vulnerable to tooth decay and the process can begin before teeth are fully erupted, which is why it is important to clean your baby’s teeth and gums.

Untreated decay spreads quickly, and can result in an infection or toothache.Although there are many natural foods and drinks other than pure sugar that can cause tooth damage, artificial sweeteners are not permitted in foods for children under three years of age.

It is the acid, which is present even in sugar-free varieties of fruit juices, fizzy drinks and squashes, that causes dental erosion – the gradual wear of the surfaces of the teeth. These drinks are so popular that nearly half of children in the UK have some dental erosion by the age of six.

Don’t panic

There is no need to panic and ban all sugary or acidic drinks from your child’s diet, but it is a good idea to limit their consumption. It is the frequency with which such drinks are consumed which determines the danger of tooth decay and erosion.

Dentists advise that thirsty children are given only plain water to drink between meals, with other drinks kept for supervised consumption during meal times, and then in open cups.

Parents and carers should be particularly wary of allowing babies and children of any age to fall asleep sucking on a bottle or cup containing any sugary drink – including milk.

During sleep the flow of saliva decreases, allowing the sugary liquids to pool around the child’s teeth for an extended period of time.

Fruit juice

Fruit juice can be an occasional addition to your childs diet during the weaning period as it contains vitamin C, which aids the absorption of iron.

Fruit juice is often seen by parents as a healthy alternative to squash, but it still contains sugars and acids that can harm tooth enamel. Juice should be given to your child sparingly and well diluted, as part of meal times.

One Community Dental Service suggests that the juice to water ratio should be one part juice to ten parts water.

Choosing and using a cup

The latest advice from dentists is to avoid no-spill designs, instead choosing a cup that spills when tipped – either an open cup, or a lidded design that allows liquid to flow freely.

Teaching babies to drink straight from an open cup is time consuming and messy, but it avoids the need for further and unnecessary transitions from bottle, to spout, to open cup.

Sarah panicked when she was due to return to work and her six month old daughter refused to use a bottle or trainer cup, but she followed advice to try an open cup instead, ‘Hannah continued to refuse bottles and spouts, but staff at her nursery were able to feed her my expressed milk a little at a time from an open cup.’

Babies can begin drinking from an open cup from birth. Midwives sometimes suggest that if a breastfed baby requires any supplementation, milk is given from a cup rather than a bottle to avoid the possibility of nipple confusion.

Young babies drink with a lapping action, which gradually develops into drinking. Initially, your baby will continue to get most of her liquids as milk from either breast or bottle, so don’t worry if she becomes frustrated and wants to stop after only a tiny amount.

Later on, if she wants a drink between meals, whenever practical offer her plain water from a cup. Gradually, drinking from a cup will become second nature.

Remember: Try to make things at your baby’s pace, offering a drink from a cup as part of each meal - when possible for you and without pressuring her! Take care over cleaning all parts of cups, particularly awkwardly shaped valves and spouts, as they can rapidly become a breeding ground for bacteria.