Bottle-weaning Intervention and Toddler Overweight

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.