Randomized Controlled Trial of Bottle Weaning Intervention: A Pilot Study

Kahn, Richard; Bonuck, Karen; Trombley, Michelle

doi:10.1177/0009922806290073

Cited by 11 publications

(22 citation statements)

References 34 publications

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“…(2008), USA, low income WIC attendees [ 53 ] √ √ RCT 61 3- 10 weeks Unclear 4 m Low -formula feeding, 1° Aim: Improve formula feeding practices and reduce rapid weight gain -anthro Kahn et al . (2007), USA, predominantly low income Hispanic WIC attendees [ 54 ] √ √ RCT 48 18-30 months Nutritionist 2 m Low +bottle weaning 1° Aim: Bottle weaning Klohe-Lehman et al . (2007), USA, low income WIC attendees [ 57 ] √ √ √ √ Before and after 235 1-3 years Dietitian 2& 6 m Low +diet, +PA -anthro 1° Aim: Improve diet and PA of mothers and children Davison et al .…”

Section: Resultsmentioning

confidence: 99%

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

et al. 2014

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BackgroundChildren from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families.MethodsSearches of major electronic databases identified articles published from 1993–2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity.ResultsThirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m2 to -0.54 kg/m2 for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3–5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery.ConclusionThere is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required.Trial registrationPROSPERO Registration no: CRD42013006536.

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Section: Resultsmentioning

confidence: 99%

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

et al. 2014

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“…Site nutritionists collected data from a convenience sample of all parents/caregivers (‘parents’) of children aged 12–60 months presenting for certification or recertification during a 3‐week period in March 2006. Four nutritionists administered a brief survey [previously pilot tested by the investigators (Kahn et al . 2007)] asking whether the child currently drinks milk from a bottle.…”

Section: Methodsmentioning

confidence: 99%

“…Our primary outcome is bottle use. To estimate sample size and power for this outcome, we conducted a pilot intervention study (Kahn et al . 2007).…”

Section: Part III Description Of Fycsmentioning

confidence: 99%

“…In part II, we describe a pilot study of bottle use and weight from one of the two FYCS sites, conducted to derive recruitment rate and sample size estimates for FYCS. To reduce the burden upon the busy WIC site nutritionists collecting these data, and because 85% of bottles in a similar population contained milk (Kahn et al . 2007), we only collected data on milk (vs. juice or other beverages) bottles.…”

Section: Introductionmentioning

confidence: 99%

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Inappropriate bottle use: an early risk for overweight? Literature review and pilot data for a bottle-weaning trial

Bonuck¹,

Huang²,

Fletcher³

2010

Maternal &Amp; Child Nutrition

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Identifying early risk factors for childhood obesity is critical, as weight in infancy and early childhood tracks to later periods. Continued bottle use - primarily from excess milk intake - is emerging as a potential risk factor for early childhood overweight. Over three fourths of US infants drink from bottles beyond the recommended weaning age of 12 months, and two thirds of UK infants use a bottle at 18 months. This paper is divided into three parts. Part 1 reviews the literature on beverage intake, weight and bottle use in young children. Part II describes pilot data on milk bottle use and weight in 12-60-month-olds, collected prior to a randomized controlled (RCT) trial of a bottle-weaning intervention. Median daily milk bottle consumption at 12 months was 5.0 (interquartile range = 3-6). Among 12-36-month-olds, current users were significantly more likely to be >95th% weight-for-height (19% vs. 0%, P < 0.02), and more were >85% weight-for-height (27% vs. 11%, P < 0.11), vs. non-users. In contrast, current bottle use was not associated with either overweight or obesity in 37-60-month-olds. Part III describes the RCT, begun in fall 2008. It is enrolling 464 parent/12-month-old dyads from a nutrition assistance programme for low-income families. Children's bottle use, anthropometrics, dietary intake and nutrient density (via 24 h recall) are assessed quarterly through 24 months of age. For the intervention, site nutritionists employ a project-developed, visually attractive flip chart. An observational study nested within the RCT will describe dietary changes during this period of feeding transitions.

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“…A striking paucity of research has focused on improving the feeding practices of bottle‐feeding mothers during early infancy (Bonuck, Avraham, Lo, Kahn, & Hyden, Bonuck, Huang, & Fletcher, ; Kahn, Bonuck, & Trombley, ; Kavanagh, Cohen, Heinig, & Dewey, ; Maguire et al, ). In response, our previous research explored whether a simple intervention—covering bottles with an opaque, weighted sleeve—could improve bottle‐feeding interactions by more closely approximating the breastfeeding experience.…”

Section: Introductionmentioning

confidence: 99%

Effects of opaque, weighted bottles on maternal sensitivity and infant intake

Ventura

Hernández

2018

Maternal & Child Nutrition

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Caregivers' abilities to assess how much is in the bottle may lead to encouragement of infant bottle emptying and overfeeding. The present study assessed whether use of opaque, weighted bottles (as compared with conventional, clear bottles) improves feeding outcomes. Mothers with infants <32 weeks of age (n = 76) were assessed on two separate days. Mothers fed their infants from an opaque, weighted bottle on 1 day and a clear bottle on the other; conditions were counterbalanced. Blinded raters certified in the Nursing Child Assessment Feeding Scale scored all videos to determine maternal sensitivity. Infant intake was assessed by weighing the bottle before and after each feeding, and feeding outcomes included infant intake (mL), intake per kilogram body weight (mL/kg), meal duration (min), and feed rate (mL/ min). Mothers exhibited significantly greater sensitivity (p = 0.041), fed their infants fewer millilitres per kilogram body weight (p = 0.049), and fed their infants at a significantly slower rate (p = 0.009) when using opaque compared with clear bottles. Infant clarity of cues was a significant moderator of effects of bottle type on intake per kilogram body weight (p = 0.028): Infants who exhibited greater clarity of cues were fed less during the opaque versus clear conditions whereas infants who exhibited poorer clarity of cues were fed similar amounts during both conditions. Effects of bottle type were not moderated by bottle contents (expressed breast milk vs. formula). In sum, promotion of opaque, weighted bottles for infant feeding may be a pragmatic approach to improve the quality and outcome of bottle-feeding interactions.

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Randomized Controlled Trial of Bottle Weaning Intervention: A Pilot Study

Cited by 11 publications

References 34 publications

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

Inappropriate bottle use: an early risk for overweight? Literature review and pilot data for a bottle-weaning trial

Effects of opaque, weighted bottles on maternal sensitivity and infant intake

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