Keith-Thomas Ayoob, EdD, RD, FADAHealth Blog - Nutrition

Babies and kids who hit the bottle are more likely to be obese

Published on 2011-05-24 by Keith-Thomas Ayoob, EdD, RD, FADA

We’ve all seen it – toddlers and young kids walking around with a baby bottle, taking a suckle here and there, almost as though they were holding a cocktail glass.  Well, a new study in the Journal of Pediatrics suggests that prolonged use of the baby bottle ties strongly to obesity by the time these children reach 5½ years of age.


Visualization is the courtesy of


This study looked at 6750 US children who born in the year 2001 and did assessments at age 9 months, 24 months, 4½ years and finally at 5½ years.  The results were disappointing.

The prevalence of obesity was 17.6%.  That means at least 1 in every 6 children is overweight before heading out to school.  (So much for the assumption that school meals are making kids overweight.  There obese before they get to school.)

Among children who were still using a baby bottle at age 24 months, that prevalence of obesity at 5½ years shot up to 22.9%, or about 1 in every 4 or 5 kids.  This study controlled for income level, whether or not the mother smoked or was obese herself, whether she breastfed the child’s birth weight, and on and on.  It was a well done study and the results deserve attention.

Now, if a child has a developmental disability and is unable to drink appropriately from a cup or glass, that’s understandable, and they would fall outside the scope of this study.  This study suggests however, that other children would strongly benefit from being weaned before 24 months of age – which also happens to be the recommendation of the American Academy of Pediatrics. 

The problem I see is often that the bottle is used for reasons that have little to do with a child’s hunger or nutrient needs and more to do with controlling a child’s behavior, especially crying or whining.  Using a bottle to comfort a child is inappropriate and is not the intended use of a bottle.  Moreover, a child should be encouraged to practice skills needed to drink from a cup or glass and this can start as early as 8 or 9 months.  Sure, they’ll spill and dribble, but that’s why practice is important.  It takes time and repetition to learn a new skill.  Parents need to accept that putting in this practice and teaching time with your kids is part of their job description.

Some children can already drink from a glass or cup but parents persist in giving the bottle because “if I don’t he won’t shut up all day.”  GREAT!  That’s what a two-year-old is SUPPOSED to do.  We like it when kids practice talking and speaking.  Practicing mouthing words and speaking is how they learn to develop good language and speech.

Most babies and toddlers will eat when they’re hungry and stop when they are full.  Their hunger is internally driven – IF parents learn to read a baby’s/toddler’s indications of hunger and fullness.  Those include getting fidgety or whiny, combined with some elapsing of time since the last eating occasion.  Using a bottle for reasons other than providing necessary nourishment is to override the child’s internal hunger cues and teaches the child that taking bottles (and also perhaps eating solid food) will also put you on the fast-track to comfort and that’s it’s OK to do that.  It’s not.  It reinforces real negative to an infant or child: when you’re upset of uncomfortable for any reason, eat or drink something.  

That will only contribute to excessive eating and drinking of calories.  As a nutritionist, it’s especially bothersome when I see kids walking around with baby bottles full of some liquid that’s the color of Windex and is likely nothing but sugar water.  

We owe our kids better parenting than that.  They need to get off the bottle by age two years, at the latest. 


REF: Gooze RA, Anderson SE, and Whitaker RC.  Prolonged bottle use and obesity at 5.5 years of age in US children.  Journal of Pediatrics 2011; epub April 27.


Keith-Thomas Ayoob, EdD, RD, FADA


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