Educational intervention to modify bottle-feeding behaviors among formula-feeding mothers in the WIC program: impact on infant formula intake and weight gain

J Nutr Educ Behav. 2008 Jul-Aug;40(4):244-50. doi: 10.1016/j.jneb.2007.01.002.


Objective: Formula-fed infants gain weight faster than breastfed infants. This study evaluated whether encouraging formula-feeding caregivers to be sensitive to infant satiety cues would alter feeding practices and reduce infant formula intake and weight gain.

Design: Double-blind, randomized educational intervention, with intake and growth measured before (at 1 to 2 months) and after (4 to 5 months) the intervention.

Setting: Women, Infants, and Children (WIC) clinics in Sacramento, California.

Participants: 836 caregivers of young infants were screened; 214 were eligible, and 104 agreed to participate.

Intervention: Intervention subjects received education promoting awareness of satiety cues and discouraging bottles containing more than 6 ounces before 4 months of age; intervention and control groups received education regarding introduction and feeding of solid food after 4 months of age.

Main outcome measures: Formula intake (mL/24 hours) and weight gain (g/week).

Analysis: Differences between groups evaluated using 2-way analysis of covariance (ANCOVA).

Results: Sixty-one subjects completed baseline records, 44 attended class, and 38 completed the study. Despite a positive response to the educational intervention, there was no change in bottle-feeding behaviors (formula intake at 4 to 5 months was more than 1100 mL/day in both groups). Infant growth in the intervention group was greater than in the control group (P < .01), contrary to the hypothesis.

Conclusions and implications: The intervention improved knowledge of the key messages, but further research is needed to understand barriers to modifying bottle-feeding behaviors.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Bottle Feeding*
  • Child Health Services
  • Cues
  • Female
  • Health Promotion / methods*
  • Humans
  • Infant
  • Infant Formula / administration & dosage*
  • Infant Nutritional Physiological Phenomena / physiology*
  • Infant, Newborn
  • Male
  • Maternal Health Services
  • Mothers / education*
  • Mothers / psychology
  • Poverty
  • Public Assistance
  • Satiation / physiology*
  • United States
  • Weight Gain*