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Avoid putting baby down with bottle?
Q: I have always heard you should not let a baby go to bed with a bottle. I know juice and milk or formula can cause tooth decay, but what about water?

My 8-month-old cries when I put her to bed, but I've found that 4 oz. of water in a bottle seems to soothe her. I check on her frequently when she has a bottle. Am I causing or risking something by doing this?
A: Nicole, thanks for your question about putting your baby to sleep with a bottle.

You're right that it's best to avoid putting your baby to sleep with a bottle of milk or juice, since this can cause serious tooth decay. The other main reason not to put your baby to bed with a bottle is that it can cause ear infections. This is because the fluid from the bottle—and whatever germs it picks up in your baby's mouth—can drain into your baby's Eustachian tubes at the back of her throat, which lead to her middle ear. Although ear infections are more likely to result from milk or juice in the bottle, since they're a sugary breeding ground for germs, water in the bottle can also carry germs to the middle ears. Another concern about giving your baby a bottle of water for bed is that she could choke on the water.

When you give your baby the bottle at bedtime, maybe it's not the water but rather the sucking that's comforting her. Try giving your baby a pacifier instead of the bottle at bedtime. Even if she doesn't take the pacifier at first, keep trying with the same pacifier for a couple weeks, and even try different shaped pacifiers to see if you can find one she likes.

Also, take another look at your evening schedule. A regular, calming routine every night can help your baby wind down and fall asleep more peacefully. After dinner, play quietly and avoid too much excitement and stimulation. You might turn down the lights, give her a warm bath, read to her, sing to her, rock her in your arms, and give her the pacifier. Look for her signs that she's ready to fall asleep, like rubbing her face, pulling on her ear, yawning, or fussing. Put her to sleep when she's ready, rub her tummy, say goodnight, and give her a kiss. Over time, she'll be safer and more comfortable falling asleep without the bottle.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician