When to wean a child from the bottle can be a tricky call for parents, but new research appears to support a decision of sooner rather than later.
Prolonged bottle use was associated with obesity at the age of 5 1/2, according to the findings published Thursday in the Journal of Pediatrics.
The U.S. study used data on 6,750 youngsters born in 2001 from the Early Childhood Longitudinal Study, Birth Cohort.
“We found that the children who were drinking from a bottle at two years of age were about 33 per cent more likely to be obese at 5 1/2,” said co-author Rachel Gooze, a doctoral student at the Center for Obesity Research and Education at Temple University in Philadelphia.
“The other finding that rather surprised us was how common the practice of bottle use was at two years of age.”
Twenty-two per cent of the children studied were still using a bottle as their primary drink container at the age of two and-or they were being put to bed with a bottle.
That’s despite recommendations from the American Academy of Pediatrics that parents avoid putting their child to bed with a bottle to prevent tooth decay.
Almost 23 per cent of the prolonged bottle users were obese by the time they reached 5 1/2 years old, even after the researchers took into account other factors such as the mother’s weight, the child’s birth weight and feeding practices in infancy.
The prevalence of obesity in the 5 1/2-year-olds who were not bottle feeders at age two was 16 per cent.
Gooze said the findings could become part of the conversation between parents and pediatricians when babies are around six months to a year old.
“They could also include this in the discussion, and say ... additional amount of calories coming from the bottle might not be what your child needs for nourishment and nutrition; if it’s a source of comfort or a routine, what are some other ways, strategies for transitioning away from that,” she said.
“It might be helpful for parents to think of moving from the bottle to a cup, much like they think about the transition from crawling to walking — so as a developmental milestone or something to celebrate.”
Dr. Arya Sharma, chair in obesity research and management at the University of Alberta, said liquid calories tend not to have the same effect on satiety, or feeling full, as solid calories.
“In an older infant, it’s usually that the calories in the bottle are on top of what that kid might be eating,” Sharma, a professor of medicine, said from Edmonton.
“And that kid is very likely to eat whatever it eats anyway because those liquid calories have virtually no effect on satiety or hunger.”
Sharma also mentioned that a child who is breastfeeding is in control and drinks until he’s full, whereas control is with the parent when a child is bottle-fed. Even if the child is satisfied and pushes the bottle away, a caregiver might continue insisting that it be finished.
He noted the study was longitudinal, which never proves causality, and more research needs to be done.
The study gives the example of a 24-month-old girl of average weight and length who is put to bed with a 250-millilitre (eight-ounce) bottle of whole milk.
She would receive approximately 12 per cent of her daily caloric needs from the bottle.
A bedtime bottle might be fine if the child is eating 88 per cent less calories in regular meals throughout the day, Sharma said.
“But what happens in reality is the kid will eat 100 per cent of the calories it needs, and then you’re adding another 12 per cent at night because you’re giving her the bottle to put her to sleep.”
When kids are at this crucial stage of development, issues of satiety, appetite, hunger and a reward system are being hard-wired into a child’s brain, he said, and they’re very hard to undo.
“I think it makes a lot of good sense not to be drinking your calories in the first place once you can move to actually eating your calories,” he said.
“Food is not a narcotic, it is not a sedative ... and here, you’re using food to put someone to sleep. That’s like taking a sleeping pill. You’re using it as a narcotic. That’s not a good use of food or calories. And that’s not a good habit to get into in the first place.”