title: Bottle-weaning intervention and toddler overweight.
abstract: 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?
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY. Electronic address: karen.bonuck@einstein.yu.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Bonuck
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Sivan Ben
authors.initials: SB
authors.lastname: Avraham
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Yungtai
authors.initials: Y
authors.lastname: Lo
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Richard
authors.initials: R
authors.lastname: Kahn
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Christel
authors.initials: C
authors.lastname: Hyden
mesh_terms: D001903:Bottle Feeding / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D050177:Overweight / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014886:Weaning; D015430:Weight Gain
keywords: BMI; Body mass index; FAB; FYCS; Feeding Young Children Study; Food Amounts Booklet; NDSR; Nutrition Data System for Research; RA; RCT; RR; Randomized controlled trial; Relative risk ratio; Research assistant; WHO; WIC; Women, Infants, and Children; World Health Organization