Prolonged bottle-feeding tied to kids' obesity
Prolonged bottle feeding, especially at night, could be providing infants with unneeded calories.
Tue, Jun 07, 2011 at 01:17 PM
NEW YORK - Two-year-olds who are still using bottles are more likely to be obese by kindergarten, a new study finds.
Researchers who studied 6,750 U.S. children found that toddlers who were still drinking from bottles at age 2 were one-third more likely than other kids to be obese at the age of 5.
The researchers do not know whether long-term bottle-feeding is directly to blame.
But they say their findings raise the possibility that weaning babies from the bottle around their first birthday could help prevent excessive weight gain.
Pediatricians already advise parents to wean children from the bottle to toddler-friendly cups when they are about 12 to 14 months old, or even earlier.
That, however, is largely because prolonged bottle-feeding, especially overnight, is thought to boost the risk of cavities. It may also contribute to iron deficiency.
The current findings, published in the Journal of Pediatrics, may offer parents added incentive to follow those recommendations, according to lead researcher Rachel A. Gooze, a doctoral candidate in public health at Temple University in Philadelphia.
And that incentive may be needed, she noted in an interview, since it seems that many 2-year-olds are still using bottles.
Of the children Gooze and her colleagues studied, 1 in 5 was still using a bottle at the age of 24 months — either at night or all the time.
And of those long-term bottle users, roughly 1 in 5 was obese at the age of 5, versus about 1 in 6 children who'd been weaned earlier.
The researchers then looked at a number of factors that could affect a child's risk of obesity — including the mother's weight, family income and education, and whether the child had ever been breastfed.
They found that prolonged bottle-feeding, itself, was linked to a 33 percent increase in children's risk of obesity.
The connection does not prove cause-and-effect, Gooze said.
But it's possible that for some kids, the bottle is providing unneeded calories.
"The bottle may be providing a source of comfort, rather than meeting nutritional needs," Gooze said.
And the extra calories could be substantial. As an example, Gooze noted that if an average-size 2-year-old girl drinks an 8-ounce bottle of whole milk at bedtime, that would meet 12 percent of her calorie needs for the day.
Prolonged bottle-feeding may also get in the way of toddlers having a varied, nutritious diet, according to Dr. Marc S. Jacobson, a member of the American Academy of Pediatrics' Obesity Leadership Workgroup.
"Parents often say that it's hard to get kids to eat vegetables," Jacobson noted in an interview.
One way to help with that, he said, is to "start early" — gradually introducing foods of different tastes, textures and colors into babies' and toddlers' diets.
In general, parents should start introducing solid foods at the age of 6 months. Before that, experts recommend exclusive breastfeeding — a practice that has been linked to a lower risk of childhood obesity, Jacobson pointed out.
Like Gooze, Jacobson noted that the current study shows an association, and not necessarily cause-and-effect. But he said the findings do turn attention to the importance of early life in the risk of childhood obesity.
"A lot of the public discussion about the obesity epidemic has been about fast food, junk food and soda," Jacobson said. "But there are also infant feeding issues associated with obesity."
Weaning babies from the bottle to the cup can be hard, Gooze noted, particularly from the "ritual" of the bedtime bottle.
Jacobson said that if parents are having a tough time, they can talk with their pediatrician about ways to smooth the transition. "That's what the pediatrician is there for," he said.
On the Web: Journal of Pediatrics, online May 5, 2011.2