The impact of reducing the frequency of night feeding on infant BMI

INTRODUCTION: Teaching caregivers to respond to normal infant night awakenings in ways other than feeding is a common obesity prevention effort. Models can simulate caregiver feeding behavior while controlling for variables that are difficult to manipulate or measure in real life. METHODS: We developed a virtual infant model representing an infant with an embedded metabolism and his/her daily sleep, awakenings and feeds from their caregiver each day, as the infant aged from 6–12 months (recommended age to introduce solids). We then simulated different night feeding interventions and their impact on infant’s body mass index (BMI). RESULTS: Reducing the likelihood of feeding during normal night wakings from 79% to 50% to 10% lowered infant BMI from the 84(th), to the 75th to the 62(nd) percentile by 12 months, respectively, among caregivers who didn’t adaptively feed (e.g., adjust portion sizes of solid foods with infant growth). Among caregivers who adaptively feed, all scenarios resulted in relatively stable BMI percentiles, and progressively reducing feeding probability by 10% each month showed the least fluctuations. CONCLUSIONS: Reducing night feeding has the potential to impact infant BMI, (e.g., 10% lower probability can reduce BMI by 20 percentile points) especially among caregivers who don’t adaptively feed.