Larger Bottles Associated with Greater Weight in Infants


Am Fam Physician. 2016 Dec 1;94(11):936-937.

Clinical Question

Is the size of the bottle used to feed infants associated with weight gain?

Bottom Line

In nonbreastfed infants, using large bottles (at least 6 oz [180 mL]) to feed infants two months of age was associated with greater weight gain by six months of age. The authors did not report adverse effects associated with bottle size. This is an interesting study that suggests that smaller bottles may prevent overfeeding. (Level of Evidence = 2b)


The data for this study were obtained from a study aimed at preventing childhood obesity. The U.S. authors identified 386 infants who were born at least 34 weeks' gestational age, weighed at least 1,500 g (3 lb, 5 oz), and were exclusively formula-fed. The infant population was 41% black, 35% Hispanic, and 23% white. At the two-month visit, parents of 44% of the infants reported using large (at least 6 oz) bottles. White parents and parents of boys were more likely to use larger bottles. All infants were examined again at six months. After adjustment for birth weight, time between visits, and other variables, infants fed with large bottles had 0.21 kg (95% confidence interval, 0.05 to 0.37) more weight change at the six-month visit. The study did not randomly assign bottle sizes to children, and the authors did not report on children older than six months, although other studies have shown that weight gain between two and four months of age predicts the likelihood of being overweight at two years of age. This is a preliminary study that suggests that using smaller bottles at an early age might prevent overfeeding.

Study design: Cohort (prospective)

Funding source: Government

Setting: Outpatient (primary care)

Reference: Wood CT, Skinner AC, Yin HS, et al. Bottle size and weight gain in formula-fed infants. Pediatrics. 2016;138(1):e20154538.

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at https://www.aafp.org/afp/poems.



Want to use this article elsewhere? Get Permissions

More in AFP

Editor's Collections

Related Content

More in Pubmed


Jan 2022

Access the latest issue of American Family Physician

Read the Issue

Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article