Why then is cup feeding potentially such a contentious subject and why devote a whole article and webinar to its debate when at first glance it appears so innocuous?

While advice from the WHO (1998) still recommends cup feeding (using unlidded cups) as the most suitable alternative, when direct breastfeeding is not possible, a more recent statement in the Cochrane review (2007, issue 2) reported that it could no longer recommend cup feeding as a method of supplementation for breastfeeding infants. Although these infants were more likely to be exclusively breastfed when they left hospital, this did not mean they were more likely to be breastfed three or six months later. Due to the need for a longer hospital stay, it was not regarded as cost-effective. This may prove to be a short-sighted reaction to the situation.

A number of papers linking use of lidded cups to dental caries have been published (Cone 1981, Eronat & Eden 1992, Kovesi & Levison 1992, Roberts et al 1993) and the terms ‘nursing bottle caries’, ‘sucking cup caries’ and ‘early childhood caries (ECC)’ (Reagan 2002) have been coined. These terms are now synonymous with inappropriate feeding practices (Ripa 1988).

So what are the advantages and disadvantages of cup feeding and do they have the potential to affect breastfeeding, speech, oral health and even the emotional development of our infants? Regarding the actual cups we use, what are the safest designs, how do we best care for them and what are the longer term consequences of poor dietary habits if left unchecked?

Log-on and join us on July 24th when Sharon Trotter, author of Cup feeding revisited (Trotter 2006) and Rachel Hilan, Infant Feeding Advisor at North Bristol Trust, will be joining the debate to discuss the pros and cons of cup feeding in relation to Baby Friendly accreditation.

References:


Cone TE (1981). The nursing bottle caries syndrome. JAMA 245(22):2334. Department of Health, Committee on Medical Aspects (1994). Weaning and the weaning diet. London: HMSO.


Eronat N, Eden E (1992). A comparative study of some influencing factors of rampant or nursing bottle caries in preschool children. Journal of Clinical Paediatric Dentistry 16(4):275-9.


Kovesi T, Levison H (1992). The ‘companion bottle’, a useful predictor of children at risk for the development of nursing bottle caries. Pediatrics 89(5pt1):976-7.


Reagan L (2002). Big bad cavities: breastfeeding is not the cause. Mothering. 113:38-47.


Ripa LW (1988). Nursing caries: a comprehensive review. Paediatric Dentistry. 10(4):268-82.


Roberts GJ et al (1993). Patterns of breast and bottle feeding and their association with dental caries in 1-4 year old South African children. Community Dental Health. 10(4):405-12.


Trotter S (2006). Cup feeding revisited. MIDIRS Midwifery Digest 16 (3):397-402.


World Health Organization (1998). Breastfeeding in paediatric units - guidance for good practice. http://www.babyfriendly.org.uk/paedunits.asp [Accessed 27 June 2006] (Published by the RCN ref: 000 884).