Drinking:  Straw vs.  Cup 

Many feeding therapists will find themselves in a position to help their clients move from bottle, breastfeeding, or even tube feeding to cup drinking.

 

Which cup do you choose? Do you start with straw, sippy, or open cup? I don’t think that there is a right or wrong answer nor is the answer always clear cut. But there are many factors to consider.

The choice  should be made based on the  following:

• child’s ability
• medical history
• skill level
• desire
• oral and gross motor function.

 

Here are some ideas on how to guide your practice.

Choose a straw or sippy cup for:

• A tube fed child who actively sucks on a sippy or straw cup. If weight and growth are optimal, and  if the child can drink the formula going into tube feeding, it can be subtracted from the tube feedings and should be encouraged to assist with moving off the tube.

• An infant or toddler with delayed oral and gross motor skills (poor head/neck and trunk stability) who actively sucks, may have more success sucking on a soft spout or straw.

Note: prolonged use of the spouted sip cups can negatively effect a child’s oral development. Pretty much everyone agrees, sippy cups are a temporary drinking solution only. Caregivers like the no-spill option of a sippy cup, however, there are several good “spill proof” non spout toddler cups on the market now.

 

Choose a straw cup for:  

• The child with whom you want to encourage a chin tuck while drinking.

• The child who you want to encourage tongue retraction and lip seal. You can assist by using a straw cup that allows for squeezing small volumes in the mouth.

“The easiest drinking utensil is a flexible straw in a closed container, a straw bottle.” (from this post by Debra Beckman

http://www.agesandstages.net/qadetail.php?id=33)

 

Choose an open cup (or non spout toddler cup) for:

• The toddler who is stuck in a sucking pattern. We will use open cups to teach children to use a more mature oral pattern. The child must learn to control the flow, form a bolus and transfer.

• The older infant who needs to avoid spouts such as post cleft palate repair. A bottle or spout may rub against the repair and cause problems.

• The toddler who refuses the cup. I find the open cups are easier to teach a child to accept by bringing the cup to the child’s lips and delivering a sip into the child’s mouth (while the sippy and straw cups demand some active sucking unless you are squeezing liquid into the child’s mouth).

(This is where I put most of my energy with my feeding clients- working on open cup drinking! Check out my post on open cup drinking to see some cup options. http://pediatricfeedingnews.com/working-on-cup-drinking-the-benefits-of-using-an-open-cup/)

 

If you want to read more on this subject, check out these posts:

http://www.arktherapeutic.com/blog/post/299

http://www.talktools.com/honey-bear-with-flexible-straw/

http://www.agesandstages.net/qadetail.php?id=33

http://www.arktherapeutic.com/blog/post/tag/cup-drinking

http://www.raisehealthyeaters.com/2011/06/5-things-parents-should-know-about-starting-and-stopping-sippy-cups/

http://blog.asha.org/2014/01/09/step-away-from-the-sippy-cup/

http://www.drgreene.com/perspectives/the-surprising-reason-sippy-cups-can-hurt-your-toddler/

http://speech-language-pathology-audiology.advanceweb.com/Article/Part-I-Straws-Using-Simple-Tools-in-Oral-Motor-Therapy.aspx

http://www.communicationstationspeech.com/tongue-thrust-part-2-prevention/