"To sip or not to sip?…..That is the question."

A popular item often found in children's snack packs and lunchboxes is the "sippy" cup. A "sippy" cup can be described as a cup with a twist on lid from which there protrudes a spout containing a few holes from which the liquid can pass through. Parents find these cups to be wonderful conveniences for transporting liquids, as well as for minimizing accidental spills.

As a speech language pathologist experienced in feeding and oral motor issues, I find these cups to be particularly problematic. All outward appearances would suggest that drinking from a "sippy" cup is no different then drinking from a cup.

In fact there are some significant differences in oral motor characteristics. Primarily, the "sippy" cup tends to encourage an oral motor characteristic referred to as a "tongue thrust" (sometimes called a "reverse swallow"). Speech clarity, or articulation is dependent upon the tongue being able to make contact on specific points referred to as articulators. In order to this the back of the tongue needs to be stabilized in the back of the oral cavity. This is the starting point from which the tongue needs to be anchored before executing the movements necessary to produce speech sounds.

As children typically grow and develop they move through a series of stages regarding the kinds of food they eat (i.e. liquids to solids) and the manner in which they are consumed (i.e. suck/swallow to chewing). The child will also progress through a series of stages revolving around the use of utensils (i.e. breast/bottle, fingers, cup, straw, spoon, fork,). The child's ability to successfully master these skills and incorporate new ones is derived from the ability to simultaneously acquire the appropriate oral motor skill to execute them.

For example, a newborn moves the tongue forward (protrusion) from the resting position to perform the suckle necessary to extract liquid from the breast/bottle. When the child begins spoon and cup feeding the tongue predominantly engages in retraction movements. At this point in development the child is no longer sticking their tongue out during feeding.

A child should begin cup drinking between 15-18 months of age. By two years of age a child should be off the bottle completely. Reliance on the "sippy" cup appears to encourage tongue protrusion at a time in development when feeding skill acquisition is trying to establish tongue retraction.

An inability to perform tongue retraction may result in the child having difficulty producing /t/, /d/, /n/, /s/, /z/, and /r/. If additional sounds are produced with the tongue in a forward mouth position the overall result may be a negative impact on intelligibility.

Using the "sippy" as a practical device to transport liquids is fine, but when it comes time for the child to drink I strongly recommend removing the cap. If possible try to find something with a secure snap on/off lid.