Article Text

  1. M S Fewtrell1,
  2. K Kennedy1,
  3. R Nicholl2,
  4. G Khakoo3,
  5. A Lucas1
  1. 1Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
  2. 2Neonatal Unit, Northwick Park Hospital, Harrow, London, UK
  3. 3Neonatal Unit, The Hillingdon Hospital, Uxbridge, Middlesex, UK


Rapid growth in infancy may have adverse consequences for later cardiovascular health and obesity. Factors influencing infant milk intake and growth may therefore have long-term as well as short-term effects.

Objective To test whether the design of an anti-vacuum infant feeding bottle (one-way air valve (Bottle A; Philips Avent) versus internal venting system (Bottle B; Dr Browns; requiring less infant effort to obtain milk) affects: (i) milk intake and growth; (ii) infant behaviour.

Methods 63 healthy, exclusively formula-fed full-term infants were randomised to Bottle A or B. The primary outcome was infant weight gain to 4 weeks. Secondary outcomes were (i) length and head circumference gain; (ii) milk intake from 0–2 weeks; (iii) infant behaviour at 2 weeks from a validated 3-day diary recording the time spent asleep, awake & happy, feeding, fussing, crying or with colic; (iv) maternal opinion of bottle.

Results There were no significant differences in infant milk intake or growth between randomised groups. Infants using bottle A had significantly less reported fussing (mean 46 versus 74 minutes/day, p<0.05). Mothers using bottle A awarded significantly better scores for ease of assembly (p = 0.02) and cleaning (p = 0.004). A significantly greater number of mothers using bottle B reported leaking bottles (p = 0.04).

Conclusion Bottle design did not influence early milk intake or growth, suggesting later health effects are unlikely. However, bottle design may have short-term effects on infant behaviour and maternal satisfaction which merit further investigation.

The study was supported by a research donation from Philips Avent.

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