Relationship Between Feeding to Sleep During Infancy and Subsequent Childhood Disease Burden

J Pediatr. 2023 May:256:85-91.e3. doi: 10.1016/j.jpeds.2022.11.042. Epub 2022 Dec 11.


Objective: To investigate the association of feeding to sleep during infancy and subsequent childhood health burdens.

Study design: Information was collected from the parents of children who participated in the national health screening survey when the child was 9-12 months old. The exposure group included participants who were fed to sleep. The primary outcome was all-cause hospital admission (inpatient care, intensive care unit [ICU] admission, or general anesthesia) after age 24 months. Secondary outcomes were subsequent childhood diseases (ie, adenoidectomy and/or tonsillectomy, nasal polyps, allergic rhinitis, acute otitis media, asthma, pneumonia, and aspiration pneumonia), and growth status, as measured by weight-to-age and height-to-age z-scores.

Results: The study cohort consisted of 224 075 children who participated in the health screening program, 29 392 of whom (13.1%; 51% males) were fed to sleep. Exposure was associated with an increased risk of all-cause hospitalization after age 24 months (hazard ratio [HR], 1.05; 95% CI, 1.03-1.07), but not with admission to an ICU or receipt of general anesthesia. This also was related to adenoidectomy and/or tonsillectomy (HR, 1.08; 95% CI, 1.01-1.15), dental caries (HR, 1.32; 95% CI, 1.23-1.40), asthma (HR, 1.14; 95% CI, 1.14-1.24), pneumonia (HR, 1.10; 95% CI, 1.07-1.13), overweight (HR, 1.06; 95% CI, 1.03-1.09), and obesity (HR, 1.11; 95% CI, 1.06-1.16).

Conclusions: Several adverse health outcomes are related to feeding to sleep during early childhood.

Keywords: bottle feeding; children; epidemiology; feeding performance; oral feeding.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoidectomy / adverse effects
  • Asthma* / complications
  • Asthma* / etiology
  • Child
  • Child, Preschool
  • Cost of Illness
  • Dental Caries*
  • Female
  • Humans
  • Infant
  • Male
  • Sleep