Association Between Bottle Size and Formula Intake in 2-Month-Old Infants
Charles T Wood1, Asheley C Skinner1, H Shonna Yin2
1Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
Insights
Using larger bottles for infant formula is linked to higher daily intake. This may increase the risk of overfeeding and childhood obesity in formula-fed infants.
Area of Science:
- Pediatrics
- Nutrition Science
- Public Health
Background:
- Infant feeding practices significantly influence growth and long-term health outcomes.
- Understanding factors associated with infant formula consumption is crucial for preventing obesity.
- Bottle size is a potential, modifiable factor in infant feeding volume.
Purpose of the Study:
- To determine the range of infant bottle sizes utilized.
- To investigate the association between infant bottle size and total daily infant formula consumption.
Main Methods:
- Cross-sectional analysis of baseline data from the Greenlight cluster randomized trial.
- Included healthy, term infants exclusively formula-fed at 2 months.
- Parents reported volume per feed, feeds per day, and bottle size (dichotomized as <6 oz or ≥6 oz).
- Statistical analysis adjusted for infant age, sex, weight, race/ethnicity, and WIC enrollment.
Main Results:
- 44% of 865 infants were exclusively formula-fed at 2 months.
- 46% of infants were fed with larger bottles (≥6 oz).
- Parents using larger bottles reported feeding an average of 4 oz more formula daily (34.2 oz vs. 29.7 oz).
Conclusions:
- Larger bottle size is associated with increased reported formula intake in exclusively formula-fed infants.
- This association suggests a potential risk of overfeeding when using larger bottles.
- Overfeeding may contribute to increased risk of obesity in infants.
Objective:
To determine range of bottle sizes used and examine the relationship between bottle size and total daily consumption of infant formula.
Methods:
Cross-sectional analysis of baseline data collected as part of Greenlight, a cluster randomized trial to prevent childhood obesity at 4 pediatric resident clinics. The Greenlight study included healthy, term infants. For our analysis, parents of exclusively formula-fed infants reported volume per feed, number of feeds per day, and bottle size, which was dichotomized into small (<6 oz) or large (≥6 oz). We identified determinants of bottle size, and then examined relationships between bottle size and volume fed with log-transformed ordinary least squares regression, adjusting for infant age, sex, birth weight, current weight, race/ethnicity, and enrollment in Special Supplemental Nutrition Program for Women, Infants, and Children.
Results:
Of 865 participants in the Greenlight study, 44% (n = 378; 21.8% white, 40.6% black, 35.3% Hispanic, 2.4% other) of infants were exclusively formula fed at 2 months. Median volume per day was 30 oz (interquartile range 12), and 46.0% of infants were fed with large bottles. Adjusted for covariates, parents using larger bottles reported feeding 4 oz more formula per day (34.2 oz, 95% confidence interval 33.5-34.9 vs 29.7 oz, 95% confidence interval 29.2-30.3, P = .03).
Conclusions:
Among exclusively formula-fed infants, use of a larger bottle is associated with parental report of more formula intake compared to infants fed with smaller bottles. If infants fed with larger bottles receive more formula, these infants may be overfed and consequently at risk for obesity.
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