Ditch the Bottle, Prevent Childhood Obesity

baby phat

In the Journal of Pediatrics, Brigid Huey begins by explaining this particular aspect of the childhood obesity puzzle:

Experts agree that obesity prevention should begin before children enter school. But due to a lack of conclusive data, health care providers often have trouble advising parents about which interventions are the most beneficial.

In other words, what works? It’s the same question Childhood Obesity News has been exploring in many forms. We have looked at school lunches and hyperpalatable foods. We have also discussed many aspects of the breastfeeding versus bottle-feeding controversy. Bottle-feeding as a separate subject? Not so much. So here goes.

Researchers have analyzed a pile of data derived from the Early Childhood Longitudinal Study. The specific question they had in mind: if a baby is still on the bottle at 24 months, what are the chances that, by age 5½, we will be looking at an obese child? Short answer: don’t bottle-feed for too long. One member of the team, Rachel Gooze of Temple University’s Center for Obesity Research, believes that 1 year is about right. Others say a child should be weaned from the bottle by 14 months, maybe a year-and-a-half. But that bottle should definitely be phased out by age 2.

Skipping over to Temple University’s own website, we find reporter Renee Cree observing that prolonged bottle use can also lead to other bad outcomes, like cavities in the teeth. She includes a quotation from another team member, Dr. Robert Whitaker:

Children may over consume due to the comfort and security that a bottle provides, but at two years old, calories and nutrients can and should be coming from sources other than a bottle.

The third team member was Dr. Sarah Anderson, who hails from the College of Public Health at Ohio State University. Together they establish a definition of “bottle user,” which means at 24 months, the child was mainly still drinking from a bottle, and maybe also being tucked in bed at night with a bottle full of calorie-laden liquid refreshment. Examination of 6750 records showed that 22% of the kids in the study were prolonged bottle users. Now, out of those prolonged bottle users, 23% of them were obese 3½ years later.

For simplicity’s sake, let’s say there were 100 children, because it’s easier to do percentage math in your head if you start with 100. Then everything else falls into place. Still on the bottle at age 24 months: 22 kids. And of those 22, 23% grew obese, which is about a quarter of that population. 4 into 22 is 5½, so say 5.

Out of 100 babies, a certain number of them (22) are at risk for obesity if they approach their third year with a bottle in their mouth. Five of them will fulfill that prophecy by being obese at age 5½.

To save 5 out of 100 children is a worthy goal, especially when it doesn’t cost any taxpayers’ money. All that is required is to convince parents to cease bottle-feeding well before the age of 2. Come to think of it, that probably will cost some money. But as a preventive measure against childhood obesity, this could be a solid lead, and it’s doable.

Sy Kraft of Medical News Today reminds us that there is such a thing a too much milk, which could displace solid food, causing the child to miss out on important nutrients such as iron. Speaking of doability, he endorses the idea of early separation from the bottle and offers practical encouragement:

By the time they’re a year old, kids have the motor skills to sit up, hold a cup, and drink from it, so they no longer need a bottle, at least not for nutrition. One-year-olds are much less stubborn, have a shorter memory, and are more interested in pleasing their parents than a child just six months older.

Bill Taylor of ParentCentral.ca quotes a couple of experts on the “how” part of weaning. First, Dr. Catherine Birkin, who is a researcher in childhood obesity, counsels medical professionals:

So you change that trajectory. When they come to their doctor at about 9 months, you say, ‘Here’s a cup; stop using a bottle.’ Or if the mother is still breastfeeding, you move the child straight from there to using a cup. This is something we can do right on the spot and very easily.

Taylor also quotes Dr. Eddy Lau who is, when it comes to childhood obesity, an advocate of prevention rather than cure:

Adults can get through the night without eating and babies, from 6 or 7 months onward, can do without it, too… change the whole gestalt, break the bottle habit and get them to use a sippy cup. That automatically cuts their milk intake.

Your responses and feedback are welcome!

Source: “Study Suggests Prolonged Bottle Feeding Increases the Risk of Obesity,” Journal of Pediatrics, 05/05/11
Source: “Temple-led study finds prolonged bottle use may contribute to childhood obesity,” Temple University Communications, 05/05/11
Source: “Weaning Baby Off Bottle Key In Curbing Future Childhood Obesity,” Medical News Today, 05/05/11
Source: “Doctors target roots of childhood obesity,” ParentCentral.ca, 05/05/11
Image by Monster Pete (Peter M), used under its Creative Commons license.

5 Responses

  1. You don’t specify whether the experiments looked at bottle-fed babies on pumped breast milk or formula, do you? I’ve heard doctors describe formula as little milkshakes, the stuff includes so much sugar. Would you have the same effect with pumped breast milk?

    1. Hi Cat,
      I know there’s more on the subject in another post. I put “pump” in the search and got quite a few results back – but I don’t remember which post addressed that particular question!

  2. One-year-olds are much less stubborn, have a shorter memory, and are more interested in pleasing their parents than a child just six months older.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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