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Published on: February 5, 2019
Infant feeding bottle design, growth and behaviour: results from a randomised trial
M S Fewtrell1, K Kennedy, R Nicholl
1MRC Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK. m.fewtrell@ich.ucl.ac.uk
Insights
Infant bottle design may affect behavior, with one type reducing fussiness. However, no significant differences were found in milk intake or growth between the tested anti-vacuum bottles.
Area of Science:
- Pediatrics
- Infant Nutrition
- Clinical Trials
Background:
- The impact of anti-vacuum infant feeding bottle design on infant intake, growth, and behavior is not well understood.
- A randomized trial was conducted to investigate these effects.
Purpose of the Study:
- To determine if infant feeding bottle design influences milk intake, growth, or behavior.
- To compare a one-way air valve bottle (Bottle A) with an internal venting system bottle (Bottle B).
Main Methods:
- 63 healthy, formula-fed term infants were randomized to use either Bottle A or Bottle B.
- Infant weight gain was measured up to 4 weeks as the primary outcome.
- Secondary outcomes included milk intake, infant behavior (fussing), risk of infection, and breastfeeding continuation.
Main Results:
- No significant differences in infant weight gain were observed between the two bottle groups.
- Infants using Bottle A exhibited significantly less fussing compared to those using Bottle B.
- No other significant differences in milk intake, behavior, or infection risk were found.
Conclusions:
- Infant bottle design may have short-term effects on infant behavior, warranting further research.
- No significant effects on milk intake or growth were detected.
- The study's small sample size limits confidence in the findings, necessitating larger trials for confirmation.
Background:
Whether the design of an anti-vacuum infant feeding bottle influences infant milk intake, growth or behavior is unknown, and was the subject of this randomized trial.
Subjects:
63 (36 male) healthy, exclusively formula-fed term infants.
Intervention:
Randomisation to use Bottle A (n = 31), one-way air valve: Philips Avent) versus Bottle B (n = 32), internal venting system: Dr Browns). 74 breast-fed reference infants were recruited, with randomisation (n = 24) to bottle A (n = 11) or B (n = 13) if bottle-feeding was subsequently introduced. Randomisation: stratified by gender and parity; computer-based telephone randomisation by independent clinical trials unit.
Setting:
Infant home.
Primary Outcome Measure:
infant weight gain to 4 weeks.
Secondary Outcomes:
(i) milk intake (ii) infant behaviour measured at 2 weeks (validated 3-day diary); (iii) risk of infection; (iv) continuation of breastfeeding following introduction of mixed feeding.
Results:
Number analysed for primary outcome: Bottle A n = 29, Bottle B n = 25.
Primary Outcome:
There was no significant difference in weight gain between randomised groups (0-4 weeks Bottle A 0.74 (SD 1.2) SDS versus bottle B 0.51 (0.39), mean difference 0.23 (95% CI -0.31 to 0.77).
Secondary Outcomes:
Infants using bottle A had significantly less reported fussing (mean 46 versus 74 minutes/day, p < 0.05) than those using bottle B. There was no significant difference in any other outcome measure. Breast-fed reference group: There were no significant differences in primary or secondary outcomes between breast-fed and formula fed infants. The likelyhood of breastfeeding at 3 months was not significantly different in infants subsequently randomised to bottle A or B.
Conclusion:
Bottle design may have short-term effects on infant behaviour which merit further investigation. No significant effects were seen on milk intake or growth; confidence in these findings is limited by the small sample size and this needs confirmation in a larger study.
Trial Registration:
Clinical Trials.gov NCT00325208.
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