title: Infant feeding bottle design, growth and behaviour: results from a randomised trial.
abstract: BACKGROUND
  Whether the design of an anti-vacuum infant feeding bottle influences infant milk intake, growth or behavior is unknown, and was the subject of this randomized trial.
  
  
  METHODS
  
  
  
  METHODS
  63 (36 male) healthy, exclusively formula-fed term infants.
  
  
  METHODS
  Randomisation to use Bottle A (n = 31), one-way air valve: Philips Avent) versus Bottle B (n = 32), internal venting system: Dr Browns). 74 breast-fed reference infants were recruited, with randomisation (n = 24) to bottle A (n = 11) or B (n = 13) if bottle-feeding was subsequently introduced. Randomisation: stratified by gender and parity; computer-based telephone randomisation by independent clinical trials unit.
  
  
  METHODS
  Infant home.
  
  
  METHODS
  infant weight gain to 4 weeks.
  
  
  RESULTS
  (i) milk intake (ii) infant behaviour measured at 2 weeks (validated 3-day diary); (iii) risk of infection; (iv) continuation of breastfeeding following introduction of mixed feeding.
  
  
  RESULTS
  Number analysed for primary outcome: Bottle A n = 29, Bottle B n = 25.
  
  
  METHODS
  There was no significant difference in weight gain between randomised groups (0-4 weeks Bottle A 0.74 (SD 1.2) SDS versus bottle B 0.51 (0.39), mean difference 0.23 (95% CI -0.31 to 0.77).
  
  
  RESULTS
  Infants using bottle A had significantly less reported fussing (mean 46 versus 74 minutes/day, p < 0.05) than those using bottle B. There was no significant difference in any other outcome measure. Breast-fed reference group: There were no significant differences in primary or secondary outcomes between breast-fed and formula fed infants. The likelyhood of breastfeeding at 3 months was not significantly different in infants subsequently randomised to bottle A or B.
  
  
  CONCLUSIONS
  Bottle design may have short-term effects on infant behaviour which merit further investigation. No significant effects were seen on milk intake or growth; confidence in these findings is limited by the small sample size and this needs confirmation in a larger study.
  
  
  BACKGROUND
  Clinical Trials.gov NCT00325208.
authors.affiliation: MRC Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK. m.fewtrell@ich.ucl.ac.uk
authors.forename: M S
authors.initials: MS
authors.lastname: Fewtrell
authors.forename: K
authors.initials: K
authors.lastname: Kennedy
authors.forename: R
authors.initials: R
authors.lastname: Nicholl
authors.forename: A
authors.initials: A
authors.lastname: Khakoo
authors.forename: A
authors.initials: A
authors.lastname: Lucas
mesh_terms: D001903:Bottle Feeding / Q000295:instrumentation*; D001942:Breast Feeding; D004435:Eating / Q000502:physiology; D004867:Equipment Design; D005260:Female; D006801:Humans; D018730:Infant Behavior; D041943:Infant Formula; D007231:Infant, Newborn; D008297:Male; D008895:Milk, Human; D014618:Vacuum; D015430:Weight Gain