Re:  New Growth Charts Dispel the Myth That One Size Fits All
By HOWARD MARKEL

Dead Editor,
     Problems with how growth charts are used by pediatricians won't be
solved by new charts.  Babies are weighed on scales that are seldom or never
calibrated.  There often is no protocol for whether the baby is naked or
clothed, has just eaten or not, has just pooped/peed or not, etc.
Measurements of length/height in pediatricians' offices are even less
accurate.
     Research showing that breastfed children grow more slowly has been
based on children who mostly were fed on an infrequent schedule (only every
2-4 hours) and who slept apart from their parents and were sleeping through
the night at an early age.  Research shows that infrequent breastfeeding
leads to less milk and lower-fat milk and that solitary sleep leads to less
frequent nursing and less total time nursing.  Sleeping through the night at
an early age (before 2-3 years) leads to less nursing at night as well.
Thus, breastfed children with poor growth may be a result of not being
breastfed often enough.
     Research also shows that, regardless of ethnic/national background,
where children have good diets and few diseases, they grow pretty much like
the old US standards.  It isn't accurate to say that "Asian children are
often smaller than Caucasian children" and imply that it is due to
population genetic differences.  Children may be smaller in Asia, due to
poor diets and disease.  But there's no reason not to worry about a
Chinese-American child with poor growth simply because he is Chinese.  The
range of variation for genetic potential among Chinese populations is the
same as for Caucasian populations.
     New international growth charts based on the WHO infant feeding
recommendations (exclusive breastfeeding until about 6 months, and continued
breastfeeding for a minimum of 2 years), will be available in 2003.  Let's
wait for them, and in the meantime, measure the kids more accurately.

Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University [on leave 2001-2002]
(302) 831-8691/work in Delaware
(302) 738-5631/home


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