(OR05-03-23) A Pilot-Feasibility Study of Effects of Opaque Bottles on Maternal Sensitivity, Infant Intake, and Infant Weight Status

Objectives: To examine whether providing mothers with opaque infant feeding bottles that remove visual cues related to how much milk is left in the bottle is feasible and leads to greater maternal sensitivity to infant cues, lower infant intake, and less 3-month change in infant weight-for-length z-score (WLZ).

Methods: Randomized clinical trial; participants (N = 76) were randomized to use conventional clear bottles (Clear group, n = 38) or opaque bottles (Opaque group, n = 38) for approximately 14 weeks. Feasibility of recruitment and retention, participant adherence to assigned bottles, and perceptions of assigned bottles were assessed. At baseline and follow-up, maternal sensitivity to infant cues and infant intake were assessed during feeding observations. Measured infant weight and length were used to calculate age- and sex-specific WLZ based on the World Health Organization standards.

Results: 842 women were screened and, of those, 608 (79%) were ineligible and 158 (21%) declined to participate. Primary reasons for ineligibility were low or no bottle use or infant was too old. Only 7 (4%) women declined to participate because they did not want to use the study bottles. Similar proportions in the Clear (21%, n = 8) and Opaque (13%, n = 5) groups were lost to follow-up (p = 0.36). Use of assigned bottles was similar for the Clear (89.1% ± 30.2 of daily feedings) and Opaque (90.6% ± 23.0 of daily feedings) groups (p = 0.86). The majority of participants in the Clear (92%, n = 24) and Opaque (80%, n = 24) groups indicated they would continue to use their assigned bottle after study conclusion, with no differences between groups (p = 0.37). Preliminary analyses suggested there were no group differences in maternal sensitivity to infant cues (Clear = 12.2 ± 0.4 vs Opaque = 12.2 ± 0.4, p = 0.97) or infant intake (Clear = 114.5 ± 10.1 ml vs Opaque = 114.2 ± 10.1 ml, p = 0.98) at follow-up. Infants in the Opaque group had significantly lower WLZ at follow-up compared to infants in the Clear group (Clear = 0.69 ± 0.15 vs Opaque = 0.22 ± 0.16, p = 0.02).

Conclusions: Findings of this pilot feasibility study suggest replacing conventional clear bottles with opaque bottles is a feasible intervention and use of opaque bottles may support healthier weight outcomes for bottle-fed infants.

Funding Sources: NICHD