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Five-minute talk 'can change child's health trajectory'

An innovative Canadian study shows that a brief, pointed bit of advice to parents can lead to babies being weaned from bottle feeding months earlier.

This is noteworthy because previous research has shown that children who use a bottle beyond age 2 have much higher rates of obesity, iron deficiency and cavities.

"We can change a child's health trajectory with a five-minute intervention," Jonathon Maguire, a researcher at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, said in an interview.

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The American Academy of Pediatrics recommends children be weaned from the bottle by age 15 months.

However, almost 40 per cent of children are still bottle-fed at age 2, 16 per cent at age 3 and eight per cent at age 4.

"A lot of parents simply don't know when to wean their children from the bottle, nor do they know the health consequences of not doing so," Dr. Maguire said. "We have to do a much better job of teaching them."

In a new study, published in Monday's edition of the medical journal Pediatrics, Dr. Maguire and colleagues from the Hospital for Sick Children showed that counselling can have a dramatic impact.

The team found that five minutes of nutrition counselling during the well-baby visit at nine months paid big dividends.

The study shows that the rate of bottle-feeding of children whose parents received the counselling was 60 per cent lower at age 2 than among children whose parents did not get the talk.

The research involved 251 children. At their nine-month well-baby visit, half the parents received the traditional intervention, which involves principally nutrition advice like beginning solid foods, avoiding foods that can trigger allergies (nuts, honey, shellfish) and limiting intake of fruit juice.

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The other half of the study participants received that information plus specific information about the risks of prolonged bottle use, including iron deficiency anemia (and the link to poor educational outcomes later in life), dental problems and obesity. They were also told to limit the child's milk intake to 16 ounces daily and given a sippy cup.

The researchers found that children whose parents received the extra counselling started using the sippy cup three months earlier - at nine months instead of 12 months of age on average. They were also weaned entirely from the bottle four months earlier - at 12 months instead of 16 months on average. And they were far less likely to still be using a bottle at age 2 - 15 per cent versus 40 per cent.

"We know that bottle use declines with age but this is a way of speeding up the process," Dr. Maguire said. "Once the child reaches age 2, it gets a lot more difficult to take the bottle away."

The team that produced the study is known as the Toronto Area Research Group for Kids (TARGet Kids!), a network of pediatric researchers who have set out to produce practical, evidence-based advice to parents on common child-rearing questions such as how and when to wean a child from the bottle.

"It can be very difficult to answer these type of questions," Dr. Maguire said. "But we have to do a much better job of co-ordinating our efforts so we can answer the questions of parents."

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About the Author
Public health reporter

André Picard is a health reporter and columnist at The Globe and Mail, where he has been a staff writer since 1987. He is also the author of three bestselling books.André has received much acclaim for his writing. More

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