DESCRIPTION (provided by applicant): The objective of the proposed research is to test hypotheses related to understanding how bottle-feeding influences mothers' infant feeding practices and young infants' short-term feeding behaviors. The proposed research aims to elucidate potential strategies for optimizing feeding during infancy, which is one of the earliest opportunities for primary prevention of the negative health outcomes associated with undesirable intake and weight gain patterns, such as obesity and type II diabetes. Previous researchers have proposed that bottle-feeding mothers feed in response to the amount of milk or formula in the bottle, rather than in response to infant hunger and fullness cues, leading to overfeeding, excessive weight gain, and heightened risk for obesity. Although plausible, the evidence underlying this hypothesis is observational, at best, and we are currently lacking experimental data that allow us to fully understand the impact of bottle usage on mothers' feeding practices and infant consumption. The first specific aim of this research is to test the hypothesis that infants will consume less formula when fed from opaque, weighted bottles (OWBs; which remove visual and weight clues related to the amount of formula in the bottle) compared to when fed from conventional clear bottles (CCBs). The second specific aim of this research is to test the hypothesis that mothers will use more responsive feeding practices when using OWBs compared to when using CCBs when feeding their infants. We propose a within-subject design to test our hypotheses. Mother-infant dyads will visit our laboratory on three separate occasions for feeding observations. All visits will occur at the same time of day and visit days will be separated by one day. The first visit will be an acclimation visit, where we wil video-record mothers while they feed their infants their typical formula from a CCB. During the second and third visits, we will video- record mothers as they feed their infants their typical formula from a CCB or OWB; bottle type will be counterbalanced across these two visit days. Mothers will be instructed to feed their infant as they normally would at home. Bottles will be weighed pre- and post-feeding to assess infant intake. Video-records will be later coded using the Parent-Child Interaction Feeding Scale from the Nursing Child Assessment. We hypothesize that during the OWB condition, infants will consume less formula and mothers will show greater sensitivity to infant cues when compared to the CCB condition. The proposed research will provide important preliminary data for larger-scale intervention efforts. Findings from this study could provide evidence for a novel approach to promoting responsive feeding practices in bottle-feeding mothers: modification of the feeding context to facilitate bottle-feeding mothers' ability o attend to satiation cues displayed by their infants.

PUBLIC HEALTH RELEVANCE: A significant proportion of U.S. infants are bottle-fed: 50% of U.S. infants are exclusively formula-fed by 3 months of age; ~40% of breast-fed infants receive supplemental formula; and almost 70% of breast-fed infants receive expressed breast milk from a bottle on a regular basis. Given previous correlational and observational data suggesting the act of bottle-feeding places infants at higher risk for poor intake regulation, overconsumption, and overweight, strategies are needed to understand and reduce risk for infants whose mothers chose to bottle-feed. The objective of the proposed research is to describe mothers' feeding practices during typical bottle-feeding conditions and examine whether removal of visual and weight cues related to the amount of liquid in the bottle will improve mothers' abilities to feed i response to infant hunger and satiation cues, rather than in response to the amount of liquid left in the bottle.