Assessing Better Bottles for Babies

Duke University76 enrolled

Overview

This study will use a 2 x 2 factorial design to test impact of two intervention strategies (bottle size and bottle opacity) on infant weight gain.

Infants who gain weight rapidly have over 4 times higher odds of developing obesity as a child or adult; infants who are predominantly bottle-fed are at higher risk for excessive infancy weight gain and childhood obesity, yet there are not effective interventions to reduce excessive weight gain among infants who are bottle-fed. The investigators' preliminary work suggest that two novel intervention strategies are feasible and may reduce excessive infancy weight gain: reducing bottle size; and increasing bottle opacity. The investigators aim to test the independent and joint efficacy of these two intervention components among exclusively bottle-fed infants in a randomized, full factorial clinical trial. The investigators' primary objective is to measure the change in conditional weight gain z-score (CWGz) from birth to four months by study group. 4 groups are composed of two conditions: smaller bottles and opaque bottles, independently and in combination, via a 2x2 factorial trial design.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Pediatric Obesity Weight Gain Trajectory Infant Obesity

Interventions

Small Bottle SizeBEHAVIORAL

Small sized bottle

Standard Bottle SizeBEHAVIORAL

Standard sized bottle

Clear BottleBEHAVIORAL

Clear bottle

Opaque Bottle

Eligibility

Sex: ALLMin age: 3 DaysMax age: 1 Month

Medical Language ↔ Plain English

Inclusion Criteria: * Child is 3 days old to 1 month old * Greater than 37 weeks gestational age at birth * Birth weight greater than 3% for sex-specific WHO growth standard * Caregiver must plan to use local clinic as infant's primary medical home for first 6 months of life * Caregiver must speak English or Spanish as primary preferred language * Caregiver age 18 years or older * Caregiver must agree to use intervention bottles assigned during randomization and agree to stop using their existing bottles during the study period Exclusion Criteria: * Multiple gestation * Significant congenital anomaly or acquired or inherited condition directly affecting feeding, physiology, metabolism, or growth * Feeding with soy-based, hydrolyzed, lactose-reduced, or elemental formula * Weight loss greater than 95% for population reference in the first two weeks of life

Locations (1)

Duke University

Durham, North Carolina, United States

RECRUITING

Outcomes

Primary Outcomes

Conditional weight gain z-score changes (CWGz)

CWGz scores will be calculated for each participant as the residual of the actual weight-for-age z-score at 4 months minus its predicted z-score from linear regression of the 4 month z-score on birth weight z-score. Intent-to-treat analyses will include regression models, stratified by sex, with CWGz score as the outcome.

Time frame: Birth to 4 months

Secondary Outcomes

Formula volume per feed

At the time of in-home video recordings, the volume per feed will be measured from the pre- and post-weight of bottles by a food-grade scale calibrated and accurate to the nearest 0.01g.

Time frame: Birth to 4 months

Caregiver sensitivity to cues as measured by the Nursing Child Assessment Feeding Scale (NCAFS)

The Nursing Child Assessment Feeding Scale (NCAFS) measures discrete behaviors scored as "presence" or "absence" of each behavior/item. We will calculate feeding behavior scores on the "Sensitivity to Cues" subscale (score range 0 to 16) and "Responsiveness to Caregiver" subscale (score range 0 to 11). Score of 0 on a subscale means that none of the behaviors/items were observed, higher scores indicate more behaviors on the subscale were observed.

Time frame: Birth to 4 months

Central Contacts

Janna B Howard, MPH

CONTACT

919-620-4793 janna.howard@duke.edu

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.