Health & Baby

Bottle Feeding at Age 2 Raises Obesity Risk

Weight Gain After Bottle-Feeding continued...

At age 5 1/2, children were weighed and measured. If their height and weight put them above the 95th percentile on standardized body mass index (BMI) charts, they were classified as obese.

Mothers were asked if they had ever breastfed and, if so, the age the child stopped breastfeeding. They were also asked what age solid foods were introduced.

Of the 6,750 children included in the study’s results, 17.6% were obese at age 5 1/2.

Nearly one in four (22.3%) was a regular bottle user at 24 months of age.

The prevalence of obesity at 5 1/2 years was about 23% in regular bottle users compared to about 16% in children who were not using a bottle.

After adjusting their data to account for 13 factors that are thought to influence the risk of obesity -- including socioeconomic status, race, maternal education, mom’s weight, breastfeeding, age at introduction of solid foods, and birth weight, 2-year-olds who were regular bottle users were about 33% more likely to be obese than those who primarily drank from cups at that age.

“This is a well-done study,” Bonuck says. “The main caveat, and this is a limitation of a large national survey, is that it is hard to say exactly what or how much of the daily calories came through the bottle.”

Bonuck points out that bottles come in all different sizes and can be filled to different levels, something this study wasn’t able to take into account.

The researchers acknowledge a number of other things that were missing. They didn’t have data on children’s physical activity, for example, or specific aspects of diet -- like total daily calories, sugar-sweetened beverages in the diet, or information on whether or for how long infants were exclusively fed breast milk.

Previous studies have suggested that exclusive breastfeeding for six months or more may reduce the risk of obesity later in life.

Advice to Parents

“Prolonged bottle use has been shown to lead to tooth decay in children,” Gooze says. For that reason alone, she says, it’s a good idea for parents to try to follow existing guidelines.

The American Academy of Pediatric Dentistry states that infants should not be put to bed with a bottle and recommends that parents wean infants from bottles between 12 and 14 months of age.

Gooze says many toddlers find that parting with the comfort and security of a bottle can be difficult. But parents can ease the transition by reframing the bottle’s departure as a developmental milestone, something big kids don’t need.

Switching from milk or juice to water may also help, especially if the bottle isn’t replacing a meal.