"Anti-Colic" Bottle: Is There an Interest?

Critical Review of a Randomized Clinical Trial from JAMA Network Open, March 2026

A crying infant during feeding, a bloated belly, repeated regurgitations, and exhausted parents often purchase the "anti-colic" bottle recommended by their circle or spotted on Instagram.

The term is ubiquitous in baby product aisles, used by brands as different as MAM, Tommee Tippee, Philips Avent, or Dr. Brown's (the latter highly favored on social media).

Yet, behind this marketing label lie technically heterogeneous mechanisms, and until now, very little robust clinical evidence exists to distinguish between them.

In this context, a multicenter randomized clinical trial published in JAMA Network Open in March 2026 provides concrete data on the issue. Here is a critical review.

Types of Bottles

Before diving into the results, it is useful to clarify terminology, which manufacturers often deliberately blur.

• The standard bottle with a nipple vent is the historical and most widespread design. A small hole or microvalve is integrated into the nipple. During feeding, air enters through this opening to compensate for the vacuum created in the bottle as milk is drawn out.

Disadvantage: this air passes through the milk before reaching the upper space, generating bubbles and potentially increasing the aeration of ingested milk.

Many bottles marketed as "anti-colic" belong to this category, despite the lack of specific evidence.

• The base-vented bottle operates on a different system: a valve (usually silicone) is placed at the base of the bottle. Air enters from the bottom without passing through the milk, minimizing bubble formation and theoretically reducing aerophagia. This system requires the infant to generate sufficient intra-bottle pressure to activate the valve, a point that will be important in interpreting the results.

Example: MAM Anti-Colique – the detachable base integrates a bottom-ventilation valve.

Another brand: Thyseed – the brand used in the study, which includes one of the study's authors.

• The internal tube bottle (such as Dr. Brown's Original) uses an internal channel system that directs air directly to the bottom without contact with the milk. This is a third distinct family, sometimes included in comparisons but absent from this trial.

In summary: the term "anti-colic" does not denote a precise technology. It is used interchangeably by manufacturers for all these designs, making comparisons between brands and communication with families particularly difficult without a clear technical framework.

The Liu et al. (2026) Trial on Anti-Colic Bottles

The study directly compares two systems: nipple vent vs. base vent, in 1,055 infants aged 0 to 90 days, across 5 Chinese maternity hospitals, over a 14-day period. Infants had to receive at least 3 bottles per day, with expressed breast milk or commercial formula. The primary outcome was the prevalence of mild gastrointestinal discomfort (IGL), assessed using the validated IGSQ questionnaire (score > 23 out of 65).

Results:

No Significant Overall Difference

Across the entire cohort, both bottle types yielded comparable results: 35.5% IGL at Day 14 in the base-vent group versus 37.9% in the nipple-vent group (RR 0.94; 95% CI 0.80–1.10; p = 0.44). Sensitivity analyses and subgroups of preterm or small-for-gestational-age infants confirmed the absence of an overall effect.

Practical implication: there is no solid scientific argument to systematically recommend a base-vented bottle to reduce an infant's general digestive discomfort. Manufacturers' universal claims are not supported.

A Significant Result for the 2-to-3-Month Age Group

Among infants aged 61 to 90 days, the base-vented bottle was associated with a 55% reduction in IGL prevalence (21.1% vs. 47.1%; RR 0.45; 95% CI 0.26–0.77; interaction p = 0.009). This effect was absent in infants under 60 days.

The hypothesis is as follows: the bottom valve requires sufficient negative intra-bottle pressure to activate. Newborns and young infants, whose sucking abilities are still immature, do not generate this reliably, negating the theoretical advantage of the device. From around 2 months of age, sucking becomes more efficient, allowing the mechanism to function fully.

Reduction of Crying During and After Feeding

This secondary post-hoc criterion may be the most useful for daily practice: 32.2% of feeding-related crying in the base-vent group versus 40.8% in the nipple-vent group (RR 0.79; p = 0.003). The effect was even more pronounced in infants receiving 6 or more bottles per day (RR 0.63). Proposed mechanisms include stabilization of milk flow, reduction of negative intra-oral pressure and its transmission to the middle ear via the Eustachian tube, as well as less aeration of milk.

Biases in This Study

Structural Conflict of Interest

This is the most critical point to note. One co-author, Hao Wang, is CEO and founder of Thyseed, the manufacturer of the base-vented bottles used in the study, and holds numerous patents on these very devices. The study was funded by "unrestricted" funding from Thyseed, within a joint R&D laboratory with Peking University.

Open-Label Trial

Blinding of participants and recruiters was impossible, as the two bottle types were visually distinct. Results rely on parental reports, which may be influenced by prior expectations, especially in a domain heavily invested in marketing. This risk of information bias is acknowledged by the authors.

Underrepresentation of 2-to-3-Month Infants

Only 11.7% of infants were older than 60 days – precisely the age group where the benefit was observed. The trial was therefore structurally underpowered to confirm this effect, which partly explains the attenuation of the overall result. A trial specifically designed for this age window would be needed to validate this signal.

Short Follow-Up and Limited Exposure

14 days of follow-up, and more than 63% of infants received fewer than 6 bottles per day. The cumulative effects of longer or more intensive exposure remain unknown.

Post-Hoc Analyses

All positive results (age effect, crying) are post-hoc analyses, not prespecified in the protocol. They generate hypotheses but do not validate them.

Major Bias According to Lactasource: No Data on Feeding Method

In clinical practice, it is established that "paced bottle feeding" or the "horizontal bottle" method can limit regurgitation and digestive discomfort, yet this is not mentioned in the article, as the study does not document the bottle administration technique. Paced bottle feeding, which aims precisely to reduce flow, promote self-regulation, and limit aerophagia, acts on the same mechanisms invoked to explain the benefits of the base-vented bottle. The absence of control for this variable makes it difficult to attribute observed effects solely to the bottle design.

Key Takeaways for Practice

There is insufficient evidence to universally recommend one type of "anti-colic" bottle over another based on overall gastrointestinal comfort.

In infants over 2 months receiving many bottles, the base-vented bottle may reduce feeding-related crying and digestive discomfort, but this requires confirmation.

The term "anti-colic" is a marketing category, not a clinical one. It covers heterogeneous mechanisms and should not be used as such when advising families.

Any communication of this trial to families must include disclosure of the manufacturer's conflict of interest.

Rather than focusing on anti-colic bottles, it appears more pertinent to discuss feeding methods with parents.

Référence:

Liu Y, Ding Y, Yu H, et al. Feeding Bottles With Different Venting Methods and Gastrointestinal Discomfort in Infants: A Randomized Clinical Trial. JAMA Netw Open. 2026;9(3):e263749. doi:10.1001/jamanetworkopen.2026.3749