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Developmental Trajectories of Bottle-Feeding During Infancy and Their Association with Weight Gain

Ventura, Alison K. PhD

Journal of Developmental & Behavioral Pediatrics: February/March 2017 - Volume 38 - Issue 2 - p 109–119
doi: 10.1097/DBP.0000000000000372
Original Articles
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Objective: To describe patterns of bottle-feeding across the first year postpartum and explore whether bottle-feeding trajectories are differentially associated with infant weight gain.

Method: Data came from 1291 mothers who participated in the Infant Feeding Practices Study 2. Mothers completed a prenatal questionnaire and monthly surveys of infant feeding and growth between birth and 12 months. Group-based trajectory mixture modeling was used to describe developmental trajectories of bottle-feeding intensities across the first year. Growth curve modeling was used to explore associations between bottle-feeding intensity trajectory group membership and weight-for-age z-score (WAZ) trajectories from birth to 12 months.

Results: Four qualitatively distinct trajectories of bottle-feeding were identified: (1) High-Stable: ∼100% of feeds from bottles across infancy; (2) Rapid-Increase: <30% of feeds from bottles during the neonatal assessment, increasing to ∼100% by 6 months; (3) Gradual-Increase: <10% of feeds from bottles during the neonatal assessment, gradually increasing to ∼100% by 12 months; and (4) Low-Stable: <5% of feeds from bottles across the majority of infancy. Bottle-feeding groups had significantly different WAZ trajectories across infancy; by 12 months, the High-Stable and Rapid-Increase groups had significantly higher WAZs compared with the Gradual-Increase and Low-Stable groups (p < .001). The association between bottle-feeding group membership and WAZ trajectories was not confounded by sociodemographic characteristics or the extent to which infants received breast milk.

Conclusion: High-intensity bottle use during early infancy may place infants at higher risk for excess weight gain. Supports and policies that help mothers delay high-intensity bottle use until later infancy are warranted.

Department of Kinesiology, California Polytechnic State University, San Luis Obispo, CA.

Address for reprints: Alison K. Ventura, PhD, Department of Kinesiology, California Polytechnic State University, One Grand Avenue, 43A-371, San Luis Obispo, CA 93407; e-mail:

Disclosure: The author declares no conflict of interest.

See the video abstract from the authors at

Received May 23, 2016

Accepted October 12, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.