Q&A: cutting a toddler off so much milk

A reader writes:

"My two-year-old is not a great eater. In fact, I think he's a milk addict. He has always had a strong need to suck (great breastfeeder in the early weeks, pacifier for a short time, still makes sucking noises in his sleep). He much prefers a bottle of milk to any food. Yes, he is still on a bottle. Most of the time during the day he will accept a cup (especially with no lid), but when sleepy or upset only a bottle will do (efforts by mommy otherwise met with great knashing of teeth). Advice on cutting down the milk intake? I would like more variety in his diet and also (ideally) dropping the 3:00 am bottle."

You know, I think there are a lot more 2-year-olds who are still on the bottle than most pediatricians think there are. And somehow they (like kids who nurse to or past the age of 2) seem to come out emotionally and physically normal. Amazing, isn't it? As long as you brush his teeth with a xylitol toothpaste and he doesn't fall asleep with one in his mouth, no harm will come of still using a bottle.

But the problem is his milk consumption, not bottle use. I think you'll have a big trauma if you try to cut out milk completely, so you'll have to decide how much milk you want him to drink and come up with some rules about that. Probably the easiest thing to do would be to decide that he can have a bottle of milk before bed and when he wakes up in the morning (and when he's really upset). The rest of the time offer him water to drink. You didn't mention if he'll drink water willingly or not. If he doesn't, you can always do the cheat of putting in a splash of juice to make it just a little bit sweet. Once he's hooked on the deliciousness of water you can cut out the juice splash.

Once he's reduced his milk consumption during the day, you can move on to the night. If you can figure out what the 3 am bottle is about you'll have better success cutting it out. Is he hungry? Thirsty? Looking for human contact? If he's hungry, you can leave him a little snack that he can feed himself (crackers and some raisins, for example) in the middle of the night. Make sure he's got a nightlight so he can find the snack when he wakes up.

If he's thirsty, leave him a sippy or bottle of water for when he wakes up. (Remember those old-fashioned cup-holders that would hook onto the window of your car? If they still made them they'd be perfect to hook onto a crib rail to hold a cup of water.)

If he's looking for human contact, you'll have to slowly taper him off of that with a lovey or music or something else that helps him self-soothe. A crib music player (like those aquarium toys), a CD player or radio playing music he likes, a stuffed animal that plays music, etc.

Whichever one of these things it turns out to be, make sure during the day to talk about what's going to happen with him at night to reinforce it. "When you wake up and are thirsty in the middle of the night, you can drink your own water like a big boy!" or "If you're scared in the middle of the night, hug your bear and sing the ABC song," etc. He's definitely old enough to be able to remember and act on what you've talked about when he wakes up in the night.

If you make very clear rules about when he can and can't have milk (before and after bed, for example, not just deciding on a case-by-case basis) it'll be easier for him to deal with the reduction. In a few weeks he won't even remember that he used to drink so much milk.