Volume marker inaccuracies: A cross‐sectional survey of infant feeding bottles

Abstract

A cross-sectional examination of the accuracy of volume markers on infant feeding bottles available for sale in Australia between December 2013 and February 2014 was carried out. Ninety-one bottles representing 28 different brands were examined. Eighty-eight bottles were hard sided. Volumes in these bottles were marked in a combination of milliliters and ounces. Thirty-six (41%) bottles claimed compliance with the European standard EN14350, five (6%) with non-existent Australian standards, and forty-seven (54%) bottles had no standard claim. Nineteen bottles (22%) had at least one measured marking outside the tolerance of EN14350. Bottles claiming compliance with EN14350 were not less likely to have inaccurate markings than those that made no claim. More expensive bottles did not have fewer inaccurate markings. Three bottles were disposable liner systems and had particularly large volume inaccuracies (up to 43% outside the marked volume). Inaccurate volume markers on infant feeding bottles are a previously neglected but potentially important source of error in the reconstitution of infant formula. Over-concentrated and under-concentrated infant formula can cause serious illness or malnutrition. Over-concentrated infant formula may contribute to obesity. Bottles with inaccurate volume markers are unfit for purpose; disposable liner bottles are particularly poor in this regard and should be prohibited from having volume markers on the bottle casing. To avoid individual or public harms, well-enforced standards are needed. Guidance for parents, carers, and health professionals is needed to ensure that infant formula is accurately reconstituted.

Infant formula feeding practices associated with rapid weight gain: A systematic review

“…Interestingly, recent research in Australia has found around 20% of infant bottles have inaccurate measurements, which could lead to over or under concentrated formula (Gribble, Berry, Kerac, & Challinor, 2016). The present review found the consumption of milk with cereals may have positive association with excess weight gain (Almquist-Tangen et al, 2013) but further evidence is required, as not all studies found a positive association (Cartagena et al, 2016).…”

“…The energy density of formula is a theoretically interesting point because parents may make up the formula at a higher density than the manufacturer's recommendations or add cereal (in the belief it may enhance sleep or satiety; Baughcum, Burklow, Deeks, Powers, & Whitaker, ; Lucas et al, ). Interestingly, recent research in Australia has found around 20% of infant bottles have inaccurate measurements, which could lead to over or under concentrated formula (Gribble, Berry, Kerac, & Challinor, ). The present review found the consumption of milk with cereals may have positive association with excess weight gain (Almquist‐Tangen et al, ) but further evidence is required, as not all studies found a positive association (Cartagena et al, ).…”

Unintentional error in formula preparation and its simulated impact on infant weight and adiposity

“…If the entire contents of a bottle prepared with formula powder and water is consumed, the amount of formula powder alone represents the kilocalorie intake; but, indeed, if bottles are not entirely consumed, kilocalorie intake can be varied because of the amount of water added. It has been shown that potential dispensing error of water may be due to inaccurate volume markers on the infant bottle, although we provided measuring cups to all participants. Water dispensing was investigated, but we focused on simulating the effects of formula dispensing error.…”

National survey of infant feeding bottles in Germany: Their characteristics and marketing claims

“…We identified two other studies surveying infant feeding bottles or their marketing claims, including a 2014 survey from Australia on 91 bottles from 28 brands (Gribble et al, 2017) and a study of 197 (Table 2).…”

“…We identified two other studies surveying infant feeding bottles or their marketing claims, including a 2014 survey from Australia on 91 bottles from 28 brands (Gribble et al, 2017 ) and a study of 197 feeding bottles and 77 teats sold in retail outlets in Uruguay (Alcaire et al, 2021 ). Compared to these surveys, our survey identified 41 brands comprising 226 bottles and 221 teats, a substantially larger sample.…”