Opaque Bottle Study
Condition: Opaque Bottles; Conventional, Clear Bottles
Study type: Interventional

Summary: 
      The proposed research aimed to conduct an intervention study assessing the effect of feeding
      mode (clear versus opaque bottle) on the quality and outcome of infant feeding interactions.
    

Detailed description: 
      The overall objective of the proposed pilot/feasibility study was to evaluate a home- and
      family-based intervention to increase bottle-feeding mothers' responsiveness to infant
      satiety cues and moderate bottle-feeding infants' rates of weight gain over a 12-week period.
      Specifically, the investigators propose to provide mothers with opaque, weighted bottles
      (instead of conventional, clear bottles) with which to feed their infants; based on
      preliminary studies, it is hypothesized that removal of mothers' abilities to assess the
      amount the infant consumes during feeding will facilitate abilities to feed in response to
      infant satiation cues.

      For the proposed research, predominantly bottle-feeding mothers with <6-month-old infants
      were randomized to use opaque bottles (intervention or opaque group) or to use clear bottles
      (control or clear group). The investigators conducted home-based assessments at the beginning
      and end of the 12-week study period during which mothers were video-recorded feeding their
      infants using clear or opaque bottles. Two interim assessments will be conducted (after 2 and
      6 weeks) to assess feeding adequacy and fidelity to the intervention. During feeding
      observations, infant intake were assessed via bottle weight. Video-records were later coded
      for maternal responsiveness to infant cues using the Nursing Child Assessment Parent-Child
      Interaction Feeding Scale (NCAFS). It was hypothesized that mothers in the opaque group will
      feed their infants less and show greater increases in their levels of responsiveness to
      infant cues compared to mothers in the clear group. Infants' weight and length were measured
      at the beginning and end of the 12-week study; weight-for-length z-scores (WLZ) were
      calculated using the World Health Organization (WHO) Growth Standards. It was hypothesized
      that WLZ change would be significantly lower for infants in the opaque compared to the clear
      group. The feasibility of the intervention was also explored by collecting and analyzing
      objective and subjective data related to the extent to which mothers use and like the
      bottles, and whether characteristics of mothers or infants moderate intervention effects. The
      proposed feasibility study is a critical step toward understanding mothers' acceptance and
      use of opaque bottles compared to conventional, clear bottles, and the potential for opaque
      bottles to improve the outcome of feeding interactions in home-based settings.
    

Intervention name(s): Clear Bottle; Opaque Bottle
Intervention type(s): Other; Other
Intervention description(s): These mothers received usual care from their pediatric providers and each mother was given 12 conventional, clear bottles of various sizes (4-12 ounces) that were compatible with a variety of different nipples manufactured by leading bottle companies. Mothers were also given handouts about proper formula preparation and paced bottle-feeding, which included messages about feeding in response to infant cues.; These mothers received everything provided to the clear group, but instead received 12 opaque bottles of various sizes (4-12 ounces). These bottles were stainless steel and compatible with a variety of different nipples manufactured by a leading bottle company. Mothers in the intervention group also received an additional handout that contained safety tips for their opaque bottles (e.g., never microwave your bottle).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: All participants were randomly assigned to either the opaque bottle group or the clear bottle group. Mothers were asked to use their assigned bottle type to feed their infant for a full 12-week period. Pre-tests were given before the 12-week period and post-tests occured after the 12-week period. During these tests, we observed each mother using the clear bottle to feed her infant on one visit and the opaque bottle on another visit. The order of these conditions was randomized and counterbalanced.
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: infant feeding; feeding interactions; maternal feeding practices; bottle-feeding; opaque bottles