OBJECTIVE: To assess the association between raised BMI and bottle-feeding practices in infancy.

METHODS: A case control study among different schools of Karachi from all socioeconomic status was conducted from 2019 to 2021 using multistage sampling technique. Sample size of n=636 was recruited with cases and controls in 1:2 ratio. Matching was performed for age, gender and socioeconomic status among cases and controls. School going adolescents between 10-15 years of age of either gender having BMI greater than or equal to 85^th percentile were taken as cases whereas those have less than this criteria were enrolled as controls. Exclusion criteria included those with medical illnesses, absenteeism on the data collection day, lack of EPI vaccine and failure of informed consent from parents and children. Trained data collectors recorded data from school health cards and made measurements. Data was analyzed on SPSS version 21.

RESULTS: The total sample size was n=636. Among cases n=108 (49%) and in controls n=247 (59%) had history of breast feeding. Mean BMI for cases was 25+/-3.2 and controls was 17.6+/-2.1. When logistic regression was performed the odds of being overweight and obese were 1.5 times more likely with presence of bottle feeding. The odds of being overweight are 1.1 times more likely with presence of bottle feeding. The odds of being obese are 2.5 times more likely with presence of bottle feeding (95% CI 1.4-4.3, P- value 0.002).

CONCLUSION: Bottle feeding was associated with raised BMI in terms of overweight and obesity.

Keywords: Adolescents, Breastfeeding, Bottle-feeding, BMI, Overweight, Obesity, School going,