Friday, July 26, 2013

Bottles at Bedtime for Older Babies and Childhood Obesity

It’s possible that putting your baby to sleep with a bottle could have long term effects on your child’s health, according to a recent study.

Over 8,000 children who were part of the US Early Childhood Longitudinal Study were included in a recent study about feeding and obesity risk. Researchers, from Brigham Young University in Utah, found that putting an older baby to bed with a bottle could increase his or her chance of childhood obesity by 36 percent. How can this happen? Researchers hypothesized that when older babies are fed a bottle at bedtime on a regular basis or as part of their bedtime routine, babies become used to this and will take the bottle whether they are hungry or not. It can become a pattern. The problem is that this can discourage babies from being able to self-regulate their intake and result in their taking bottles at bed and naptime out of habit rather than when they need the calories. If babies eat more calories than they need every day, they gain too much weight.This pattern of needing to eat before sleep may continue into childhood or adulthood.

Research Meets Reality

We know that many families give bottles at bedtime and understand why you do. Nine percent of breast fed babies and 40% of formula fed babies were “put to bed with a bottle” at 9-months of age according to this study. However, it is unclear whether that means that these babies were given a bottle at bedtime by the parent or given a bottle to self-feed in the crib. It’s also not specified in this study whether or not these babies were put to bed with a bottle of breast milk or formula and breastfeeding to sleep is not mentioned at all. Therefore, we think these study findings need to be interpreted with caution since the question asked the parents in this study was vague.

But, the study findings are straightforward, bottles at bedtime increase older babies' risk of becoming obese. So, what are you supposed to do if bedtime bottles are already a habit?

Helpful Tips if You Do Put Your Baby to Bed with a Bottle

The problem is not the bedtime feeding itself but the excess calories. You want your older baby to learn to eat when he is hungry, not out of habit after he has had enough to eat during the day. The researchers recommended including feeding before bed only if the baby is showing hunger cues and to stop feeding when baby shows fullness cues. They also recommend not forcing your baby to finish the bottle so that he will sleep longer. Overfeeding past the baby’s fullness cues can also cause the baby to override his own body’s hunger cues making it easy for your baby to gain too much weight. 

Alternatives to the Bottle at Bedtime

If you do decide to stop giving a bottle at bedtime, we know that you may be worried that changing your feeding pattern will negatively affect your baby’s sleep. You will need some new tools to help your baby get used to sleeping without a bottle! A consistent bedtime routine will help your baby get to sleep and stay asleep more easily. Babies need help to relax and rest at the end of the day. Bedtime routines can be used to help your baby get so sleepy and calm that she can get the rest she needs. For examples of how to start or change a routine, click here. It’s also helpful to wait until you see signs that your baby is tired before starting your routine; that way she will fall asleep more easily.

AAP Recommendations on Weaning

You may be wondering when your baby should be off of the bottle completely. The American Academy of Pediatrics (AAP) recommends weaning your baby from the bottle before 18 months of age. This is important not only to prevent tooth decay but also to limit the amount of milk your child is drinking. It’s probably a good idea then to start weaning your baby off the bottle as soon as they are eating enough solid food at dinner time so that they don’t need milk at bedtime for nutritional purposes. For most babies, that's around 1-year of age.

We hope that we have provided you with enough information to be able to make an informed decision about feeding at bedtime. We know that this is a challenging topic and hope that the alternative tools we provided above are helpful if you do decide to change your bedtime feeding practices.


Gibbs BG, Forste R. Socioeconomic status, infant feeding practices and early childhood obesity. Pediatr Obes. 2013 Apr 2. [Epub ahead of print]

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