Bottle-weaning intervention and toddler overweight

Karen Bonuck, Sivan Ben Avraham, Yungtai Lo, Richard Kahn, Christel Hyden

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Objective To evaluate 3 research questions: (1) Does a Women, Infants, and Children (WIC)-based counseling intervention reduce (milk) bottle use?; (2) Does this intervention reduce energy intake from bottles?; and (3) Does this intervention reduce the risk of a child being >85th percentile weight-for-length? Study design Parents of n = 300 12-month-olds consuming >2 bottles/d were randomized to a bottle-weaning intervention or control group. Nutritionists at WIC Supplemental Feeding Program sites delivered the intervention. Researchers assessed dietary intake and beverage container use via computer-guided 24-hour recalls, and anthropometrics at 15, 18, 21, and 24 months old. Intent-to-treat analyses controlled for baseline measures of outcomes and months post-baseline. Results At 1 year follow-up, the intervention group had reduced use of any bottles (OR = 0.23, 95% CI = 0.08-0.61), calories from milk bottles (OR = 0.36, 95% CI = 0.18-0.74), and total calories (β = -1.15, P =.043), but did not differ from controls in risk of overweight status (ie, >85th percentile weight-for-length (OR = 1.02, 95% CI = 0.5-2.0). The intervention group's decreased bottle usage at 15 and 18 months was paralleled by increased "sippy cup" usage. Conclusion A brief intervention, during WIC routine care, reduced early childhood risk factors for overweight - bottle use and energy intake - but not risk of overweight. The intervention group's increased use of sippy cups may have attenuated an intervention effect upon risk of overweight. Toddlers consume a high proportion of their calories as liquid. Parents should be counseled about excess intake from bottles and sippy cups. WIC is an ideal setting for such interventions.

Original languageEnglish (US)
Pages (from-to)306-312.e2
JournalJournal of Pediatrics
Issue number2
StatePublished - Feb 2014


  • BMI
  • Body mass index
  • FAB
  • FYCS
  • Feeding Young Children Study
  • Food Amounts Booklet
  • NDSR
  • Nutrition Data System for Research
  • RA
  • RCT
  • RR
  • Randomized controlled trial
  • Relative risk ratio
  • Research assistant
  • WHO
  • WIC
  • Women, Infants, and Children
  • World Health Organization

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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