Dear all:

The main benefit I'm finding with WHO growth charts is when other health care practitioners don't use the US charts properly.  I had a mother in my group who was told to supplement with formula because her four month old declined in weight from the 50th to the 25th percentile.  Her baby fed very frequently during the day because, on her own she started sleeping longer at night and also because she is a typical four month old socially aware baby --- looking around and actively engaged in her environment.

The WHO has recently provided far more detail for the charts and I was able to chart her far more precisely.  

Here's the pattern that I suspected. 

Birth weight was around the 50th centile (birth weight is NOT predictive of later weight and length)
Her weight continued steadily from the 2nd month between the 25th and the 50th centile on the WHO curves.

Birth length was around the 25th centile and INCREASED up to the 50th centile around 2 months of age.

So, her increase in length gain translates into a drop in the weight for length from the 50th centile to the 25th centile.  This was incorrectly interpreted as cause for alarm, even though the baby is now 4 months old and has been steadily, happily growing in EXACTLY THE SAME PATTERN for two months.

The mother was recently (and in my humble opinion) arbitrarily put on a plan to offer 8 ounces of formula per day, with no instructions for feeding frequency or pumping.

You can guess what I thought of that plan, but by charting the patterns for the mother she can see that there really is no problem with her daughter.  She is long and lean and active and bright and happily breastfeeding.  I basically said to offer the breast as frequently as her daughter wants.

Wish I could put the color charts up on Lactnet because it is such a classic error.


Best, Susan Burger

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