Bottle Weaning & Dehydration in Older Babies

Hi Amy! Turning to you yet again for advice on our bottle/milk transition.

My daughter just turned one, and I was really hoping to ditch bottles by this time. I think we did great weaning the emotional attachment, and now she’s down to just one afternoon bottle and her nighttime bottle, both whole milk, neither an emotional thing at this point.

The problem: She won’t drink milk from the cup. She’ll do water just fine, but not milk. I’ve tried multiple cups, multiple kinds of milk, multiple temperatures, etc. All a No.

We’ve incorporated daily yogurt, oatmeal, etc. to make sure she’s getting the nutrients and calcium she needs. But some days she barely wets more than 1-2 diapers all day, and I’m worried she’s dehydrated. We offer water constantly, but obviously can’t make her drink the times she’s not interested. So at this point, I’m not cutting out those last two bottles just because I don’t want to dehydrate her completely.

Any thoughts here? Should I be worried about the dry diapers, or just let her do her thing? Any other tricks for transitioning to milk in a cup?

Thank you!!!

Dehydration in babies and toddlers

So here’s my go-to resource on dehydration and babies/toddlers, since it’s one of those things that can be very, very serious, but can ALSO be very misunderstood. (See: my MIL being absolutely convinced that all my newborns were severely dehydrated simply because I wouldn’t let her give them straight bottles of plain water.)

That said: When you say 1-to-2 wet diapers “all day,” do you mean in a full 24-hour period, or just during her awake hours?

If we’re talking one or diapers in 24 hours, that’s…yes. Yikes. She’s dehydrated and should be seen by a doctor ASAP.  Your pediatrician will likely give you the blessing to keep offering the bottles until you can figure out other ways get fluids into her consistently (foods with high-water content, super-watered-down juice or an electrolyte supplement, etc).

But…with that low-wetting rate, I suspect she’d be presenting with other symptoms of dehydration, like dark or bloody urine, no tears when crying, dry lips and mouth, etc. Since you don’t mention those, I’m guessing by “all day” you’re actually talking about a 12-hour-ish daytime period.

(If I’m wrong, by all means stop reading this and get your child to the doctor!)

One diaper all day IS pretty low, though! As a general rule, after the 12-month mark, you want to see a wet diaper every six-to-eight hours during the day. (I personally felt more comfortable with every four-to-six hours post-weaning, so I feel you here.) It’s normal for babies this age to occasionally wake up from naps dry, or for their morning diaper to be the only “super” wet one of the day. Babies and toddlers who are generally considered to be “heavy wetters” can also go through fewer diapers because they tend to pee a lot all at once vs. smaller, more frequent outputs.

But your situation still sounds pretty borderline. Is her urine really foul smelling or have you noticed any changes in color/odor, or is it still a light hay-type color with a mild smell?  How’s her pooping (rock-hard dry turds vs. pretty normal)? Again, these are important signs to look out for if you do suspect possible dehydration beyond just the number of wet diapers.

Ideas for foods with higher water-content

If the diaper count is the only big red flag, yeah, it seems like she might be getting a little (but not dangerously) dehydrated because she’s not drinking enough fluids beyond her bottles. Start offering her foods with a high-water content at every meal and snack along with her water. Fruits like watermelon, cantaloupe, strawberries and peaches have very high water percentages and are all (usually) a really easy sell for toddlers. Mine all loved cucumbers and carrot/celery sticks, which are also good watery-filled choices.

Test out homemade fruit and veggie smoothies in her cup, as a more interesting (but naturally sweet) alternative to boring old water. Blend up her favorite fruits with water to start, then try adding plain yogurt or milk and see if she’ll go for it. Then you can start getting REALLY sneaky with other high-water/fiber stuff like green leafy veggies. My oldest child steadfastly refused to touch ANY fruit beyond a banana (still does, honestly), so fruit-and-veggie-packed smoothies have been a staple of his life ever since his first birthday for a variety of digestive and dietary reasons. (His current favorite is a weird mango/yogurt/spinach concoction with coconut water.) Again, don’t add any additional sweeteners — no honey, agave, etc. — to these. Just keep them simple with straightforward “real” fruits and flavors.

Focus on consuming more fluids during the day

For now, I’d focus less on the bottle/milk issue and more on how you can get more fluids into her during the day beyond just offering water. (I’m 41 years old and still resist having my fun interrupted for a hydration break, unless it’s super tasty hydration, like bacon cheese fries.)  Once you feel confident that she’s no longer getting dehydrated — and with blessing/guidance from your pediatrician! — you can start cutting back on one bottle at a time and continue to replace those nutrients with solid-food alternatives. (Just remember to brushhhhhh herrrrrr teethhhhh after the bottles!!!)

The reality is that tons of toddlers and children eventually abandon milk as their primary source of nutrition and hydration — my 10 year old hasn’t consumed a cup of plain milk of any variety since he turned three, when he suddenly deemed it disgusting — though it can seem “wrong” for them to reject it this young. It’s really not! She can easily get all the nutritional benefits of cows milk from other foods. The key is just to figure out what those foods are and then get her to eat (or in her case, drink) them.

You can still keep trying though. Some toddlers refuse milk in any kind of sippy or toddler cup and then one day decide it’s acceptable out of an open cup, or with a regular old straw, or one of those shelf-stable milk box things. You never know, and neither do I.

Sources: 
1.Dehydration and Your Child by The Cleveland Clinic
2. 19 Water-Rich Foods That Help You Stay Hydrated by Healthline

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