Somewhere between your baby's first spoonful of oatmeal and their second birthday, you will be told that sippy cups are terrible. The claim arrives with confidence and with specifics: that spouted cups delay speech, push the tongue forward, cause tongue thrust, and were invented for the convenience of parents rather than the development of children.
Some of that reasoning is sound. Almost none of it has been tested. And the version of the argument that circulates online is considerably stronger than the evidence underneath it — which matters, because a parent who believes a sippy cup is doing damage is a parent being pushed toward guilt over something the national guidelines list as acceptable.
Here is the honest version of this comparison: what the guidelines say, what the research has actually measured, where the oral-motor concern comes from, and what deserves more of your attention than the lid.
Three Cups, Three Different Jobs for the Mouth
The mechanics are the one part of this comparison that is not controversial.
An open cup asks the most. The upper lip has to come down to meet the rim, the jaw has to stabilize, the tongue tip stays back and down while the back of the tongue manages the liquid, and the child has to coordinate a swallow with breathing while controlling how fast the cup tips. It is the adult pattern, and it is the pattern a child will use for the rest of their life.
A straw cup asks the lips to form a seal around a narrow target and the tongue to stay behind the teeth while suction moves the liquid. The tongue tip is not loaded by anything resting on it.
A spouted sippy cup behaves differently depending on the lid. A valved, truly spill-proof lid requires suction — and the AAP is blunt about what that means: "Many sippy cups have a valve under the spout to stop spills. But kids have to suck to get any liquid from them, which is just like drinking from a baby bottle." A non-valved spout flows when tipped and asks for much less. Either way, the spout sits on the tongue, which holds the tongue in a lower, more forward position than an open or straw cup does.
That is the whole functional case against the spout, and it is a reasonable one. It is also, as of now, a mechanism argument rather than a measured outcome. Hold that thought.
What the Guidelines Actually Recommend
This is where the online version of the argument and the published guidance part company.
The AAP's guidance on discontinuing the bottle sets a timeline rather than banning a cup type. It advises parents to "offer your child a cup when they start eating solid foods, usually around 6 months," then to "reduce the number of bottle feedings slowly, completing the transition sometime between 12 and 18 months." Its position on the open cup is specific and worth writing on the refrigerator: "It's healthiest for kids to drink from an open cup by about 2 years of age."
On the spouted cup, the AAP's line is about duration, not prohibition: "Sippy cups should be used only while little ones are learning."
Now the part that surprises most parents. In 2019, four organizations — the American Academy of Pediatrics, the American Academy of Pediatric Dentistry, the American Heart Association, and the Academy of Nutrition and Dietetics — published a joint consensus statement on healthy beverage consumption in early childhood. On cups, the panel wrote: "For 6 to 12-month-olds, offering a small amount of plain water (4-8 ounces total per day) in an open, sippy, or strawed cup is recommended."
Open, sippy, or strawed. Three options, no ranking. The AAP repeats the same phrasing in its own guidance on starting solid foods: "Use an open, sippy or strawed cup and limit water to no more than 1 cup (8 ounces) each day."
If spouted cups were understood to cause developmental harm, a four-organization expert panel would not have listed them beside the open cup without comment. They did.
What the Research Has and Has Not Tested
The research picture is thinner than either side of this argument admits.
What has been studied is how much children drink from containers and what is in them. A 2015 study in Maternal and Child Nutrition by Ben-Avraham and colleagues followed 299 low-income families in the Bronx through their children's second year and tracked the share of daily calories consumed through bottles and sippy cups. That share fell from 52% to 33% between ages 1 and 2 — meaning that at 12 months, half of these toddlers' calories were still arriving through a spout. The authors' closing sentence is the most useful line in the whole literature for a parent trying to decide about cups: "Evidence-based guidelines are needed to determine the appropriate use of those feeding methods."
That was written in 2015 and it is still true. There is no randomized trial comparing spouted cups against open or straw cups for speech outcomes, resting tongue posture, swallow patterns, or bite. The handful of studies that touch sippy cups directly are about diet quality, tooth decay risk, prevalence, and injuries — not oral-motor development.
The claim that most often gets attached to cups actually belongs to bottles. The AAP's bottle page notes that children who keep drinking from a bottle well past the first year "may also have tooth alignment problems and even speech delays." That is a statement about prolonged bottle use, and it is routinely quoted as though it were a statement about sippy cups. It is not.
So when a feeding therapist — including this one — tells you an open or straw cup is the better default after 12 months, understand what kind of claim that is. It is a judgment built on how the mouth works, not a finding from a trial. It is a good reason to shift your habits. It is not a reason to feel that a spouted cup has already cost your child something.
Where the Myofunctional Concern Comes From
The reason this topic sits at the intersection of feeding therapy and orofacial myofunctional therapy is that the four things a myofunctional evaluation looks at are the same four things a cup loads: lip seal, tongue tip position, resting tongue posture, and the swallow.
A spout that rests on the tongue encourages the tongue to sit low and forward while the child drinks. The concern clinicians raise is not that one cup of water does anything, but that a pattern repeated dozens of times a day for a year or two is practice — and the low-forward tongue position is the position associated with a tongue thrust swallow pattern, which is a learned habit rather than a structural problem.
Two honest qualifications belong next to that reasoning. First, nobody has shown that a spouted cup produces a tongue thrust; tongue thrust has multiple well-documented contributors, including mouth breathing and prolonged thumb and pacifier habits, and cup type has not been separated out from any of them. Second, if your child is already drinking from an open cup at meals and using a spouted cup in the stroller, the pattern argument barely applies to you.
What the reasoning is good for is choosing a default. If one cup is going to own most of the day's drinking after the first birthday, an open cup or a straw cup is the one that practices the pattern you want.
What Actually Deserves Your Attention
Shift the question from the lid to the liquid and the clock, and the guidance gets much firmer.
The American Academy of Pediatric Dentistry's beverage guidance gives three rules with no hedging in them:
- "Avoid consumption of sugar sweetened beverages from a sippy cup or other training cup."
- "Wean young children from a bottle by age one."
- "Do not put children to bed with a bottle containing anything but water."
Note what the first rule targets. The problem the AAPD names is not the spout — it is a sweetened drink delivered slowly, in small sips, over a long stretch of time, bathing the teeth repeatedly. A lid that makes all-day carrying easy makes that pattern easier. The lid is the accomplice, not the culprit.
And all-day carrying is the norm, not the exception. A population survey in Ontario published in the Journal of Pediatric Nursing by Sealy and colleagues found that 69.7% of children aged 1 to 4 were currently using a sippy cup, rising to 94.4% when past use was included — and that diluted fruit juice was the most frequently reported liquid in the cup, at 58.2%. More than one in ten 4-year-olds were still using a baby bottle.
A spouted cup of plain water, offered at meals and put away afterward, is a fundamentally different object from an open cup of juice carried around the house all afternoon. If you only change one thing after reading this page, change what is in the cup and when it is available — not the cup.
One Real Safety Difference
There is one measured difference between these cups, and it is not about speech.
A 2012 study in Pediatrics by Keim and colleagues at Nationwide Children's Hospital analyzed 20 years of national emergency department surveillance data for children under 3. They estimated 45,398 injuries related to bottles, pacifiers, and sippy cups between 1991 and 2010 — an average of 2,270 a year. Bottles accounted for 65.8% of them, pacifiers 19.9%, and sippy cups 14.3%.
The mechanism is the part parents can act on. "The most common mechanism was a fall while using the product (86.1% of injuries)." Lacerations were the most common diagnosis at 70.4%, the mouth was the most frequently injured area at 71.0%, and 1-year-old children — new, unsteady walkers — were injured most often. Product malfunctions accounted for just 4.4% of cases.
In other words: the hazard is a rigid spout in a toddler's mouth while that toddler is walking. The authors' recommendation follows directly, and it applies to every cup with a hard spout on it. Drinking happens sitting down.
A Sequence That Works
None of this requires choosing a side. It requires a sequence.
Around 6 months, with solids. Introduce a small open cup with a half-inch of water at meals, held by you, for a few sips. This is skill practice and nothing more — the AAP caps water at this age at 4 to 8 ounces a day, and most of it will end up on the highchair tray. That is fine. Spills are how the skill gets built.
6 to 12 months. Add a straw cup if you want a second option. A short straw and a cup you can squeeze gently to deliver the first taste usually shortens the learning curve. Keep the spouted cup, if you use one, for the car and the diaper bag.
12 to 18 months. This is the window the AAP names for finishing the bottle transition. As bottles leave, decide deliberately what replaces them. If the replacement is a valved sippy cup carried everywhere, you have swapped one sucking container for another. If the replacement is an open cup at meals and a straw cup for water between them, you have moved forward.
By about 24 months. The AAP's target: drinking from an open cup. Not perfectly, and not exclusively — but routinely, at meals, without a lid.
If your child is older than this and still on a spout, nothing is ruined. Move the open cup into the meal slot, keep the lid for transport, and expect a few messy weeks.
When It Is Worth Asking Someone
Most cup transitions are a matter of practice and patience. A few are not, and the difference shows up in specific signs rather than in a general sense that it is going slowly.
Worth an evaluation: coughing or choking on thin liquids from any cup, a wet or gurgly voice after drinking, most of the liquid consistently escaping from the lips past about 24 months, a child who gags at the sight of a cup, or an open cup that is still impossible at 3. Our guide to gagging vs. choking in babies and toddlers covers how to tell a normal protective reflex from a real airway event, which is the first thing to sort out.
Thin liquids are harder to control than purée, not easier, and a child who manages solids well can still struggle with a cup. That combination is worth a look. Feeding therapy for infants covers the early oral-motor foundations — lip seal, suck-swallow-breathe coordination, transitioning to solids — and feeding therapy for toddlers covers the second-year version of the problem, when the issue is often as much about mealtime behavior as about mechanics.
What We Do With This at Bloom
Laura Friedman, MS, CCC-SLP, QOM holds both a CCC-SLP and a Qualified Orofacial Myologist credential, which is why cup questions get answered here with both lenses: what the child can do with a cup right now, and what pattern the cup is practicing.
In a feeding therapy evaluation that means watching your child drink — from the cup you actually use at home, not a clinic cup — and looking at lip closure, tongue position, loss of liquid, pacing, and whether the swallow is coordinated. Sometimes the answer is a different cup. More often it is a change to positioning, pacing, or what is offered when. And sometimes the answer is that nothing needs to change, which is an answer we will give you plainly rather than selling you a plan.
Sessions run in person at our Dallas office and by telehealth nationwide, and cup work translates well to a screen because the coaching is directed at the parent holding the cup.
Frequently Asked Questions
Are sippy cups bad for my child?
Not in the way the internet suggests. Both the AAP and the 2019 four-organization beverage consensus list an "open, sippy, or strawed cup" as an acceptable way to offer water to a 6- to 12-month-old, without ranking them. What the AAP does say is that "sippy cups should be used only while little ones are learning," and that a valved lid makes a child "suck to get any liquid from them, which is just like drinking from a baby bottle." The concern is duration, not permission.
Do sippy cups cause speech delays?
No study has shown that they do. The claim usually borrows a sentence about prolonged bottle use — that children who keep bottles well past the first year "may also have tooth alignment problems and even speech delays." No trial has compared cup types for speech outcomes, and the 2015 Maternal and Child Nutrition study on bottle and sippy cup use concluded that "evidence-based guidelines are needed to determine the appropriate use of those feeding methods." The mechanism is plausible and untested.
When should my baby start drinking from an open cup?
Offer one around 6 months, when solids start. The AAP advises completing the bottle transition "sometime between 12 and 18 months," and says "it's healthiest for kids to drink from an open cup by about 2 years of age." Early practice is a few assisted sips at meals, not your child's full fluid intake.
Is a straw cup better than a sippy cup?
The guidelines treat both as acceptable, so this is a clinical judgment. The mechanical reason many feeding therapists prefer a straw: it asks the lips to seal while the tongue tip stays back, whereas a spout rests on the tongue and holds it low and forward, much as a bottle nipple does. If one cup is going to own the day after 12 months, a straw or open cup is the better default.
What matters more than the type of cup?
What is in it, and how long your child carries it. The AAPD's guidance says to "avoid consumption of sugar sweetened beverages from a sippy cup or other training cup," to "wean young children from a bottle by age one," and not to put children to bed with a bottle containing anything but water. In the Ontario survey, diluted fruit juice was the most common sippy cup liquid at 58.2%.
Are sippy cups a safety risk?
The risk is falling while drinking. The 2012 Pediatrics analysis estimated 45,398 bottle, pacifier, and sippy cup injuries in children under 3 over 20 years, with falls while using the product causing 86.1% of them, the mouth injured in 71.0%, and 1-year-olds hurt most often. Product malfunctions were 4.4%. Keep drinking seated.
My toddler refuses an open cup. What now?
Use a tiny cup with a half-inch of water at the end of a meal, when your child is not thirsty enough to be frustrated, and accept the spills. If an open cup reliably produces coughing, a wet voice, heavy loss from the lips past 24 months, or genuine distress, that is a reason for a feeding evaluation rather than more home practice.
Not Sure Whether the Cup Is the Problem?
Bring the cup you actually use. Schedule a free consultation with Laura Friedman, MS, CCC-SLP, QOM — in person in Dallas or online nationwide — and we will watch your child drink and tell you plainly whether anything needs to change.