Resident Weill Cornell Medicine - NewYork Presbyterian Weill Cornell Medicine New York, New York, United States
Background: The prevalence of obesity among infants less than 2 years of age has increased 60 percent over the last 30 years. Obese infants and toddlers are at an increased risk for staying overweight into adolescence and adulthood. Overfeeding as early as the first day of life (DOL1) is a risk factor for obesity. Our current study extends this research by exploring the impact of using smaller feeding bottle size in the newborn nursery on reducing overfeeding and later life overweight and obesity.
Objective: To explore if implementation of smaller feeding bottle size given to new parents on DOL1 reduces overfeeding practices and subsequent risk of becoming overweight or obese.
Design/Methods: Retrospective chart data was collected for children born between January 1st 2008 and December 31st 2018, and who continued care at one academic institution including BMI data from Well Child Checks (WCC). Volume of formula consumed by the newborn during the first day of life was collected from EMR, and associated with BMI at annual WCC. An overfeed was defined as a single feed greater than or equal to 30mL on DOL1. Statistical analysis was performed to determine if smaller bottle size (10mL capacity) reduced overfeeding practices at this academic center, and subsequent risk of becoming overweight or obese.
Results: We analyzed 5183 infants born at Loyola, including both pre-intervention newborns (those who used the standard 60mL capacity feeding bottle) and post-intervention newborns (those who used the smaller feeding bottle with 10mL capacity). The average feed volume on DOL1 before bottle size reduction was 22.6mL, while average feed volume after this intervention was 16.1mL (p<0.001). In the subset of infants overfed every feed on DOL1, there was an 8.5x increased risk of presenting to their 4th or 5th year WCC as overweight or obese. In the subset of infants overfed 2 or more times on DOL1 there was a 1.7x increased risk of overweight or obese at 4 years of age (p= .01). Conclusion(s): Utilization of a smaller bottle size significantly reduced average feed volume, which is a risk factor for later life overweight and obesity. The present study suggests that smaller feeding volumes encouraged by smaller newborn nursery bottle size can have a positive impact on childhood obesity.
Authors/Institutions: Brittany Watchmaker, Weill Cornell Medicine, New York, New York, United States; Emily Decicco, Loyola University Chicago, Forest Park, Illinois, United States; Kaavya Adam, Loyola Stritch School of Medicine, Berwyn, Illinois, United States; Lara Dugas, Loyola University Chicago, Forest Park, Illinois, United States; Bridget Boyd, Loyola University Medical Center, Maywood, Illinois, United States
