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Subject:
From:
Kathy Dettwyler <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 29 Apr 2000 10:12:55 -0500
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Magda makes a number of excellent points in her post about growth charts.
As those who have heard me speak on this topic at conferences know, I think
many people misuse the current growth charts, and I think many people will
misuse any future growth charts that come out -- I don't think the problem
will be solved by having new growth charts.  The problem is not with the
charts themselves, it is with how they are used.

I do think that is has become "accepted wisdom" that you shouldn't expect
breastfed children to grow as fast as the current charts, based on studies
of children who breastfed on a schedule and slept alone and through the
night at an early age.  I think that the *faltering* reported from the
DARLING studies is because those babies weren't being fed often enough.

I don't think we should enshrine the idea that breastfed babies are not
supposed to grow similarly to the current charts, based on what information
we currently have.

I think that we should expect "properly" breastfed and co-sleeping children
to grow just fine, and not to falter relative to the current charts.

And I think that if people understand how growth charts were constructed,
how wide is the variation in how individual children actually grow (both
compared to other children and across time), and how properly to use the
charts as *one* tool to assess the nutritional adequacy of a child's diet,
then it wouldn't matter whether you used the NCHS charts or the future WHO
charts, or ones you found in Dr. Spock from the 1940s, and it wouldn't
matter if the children whose growth went into the charts were bottle-fed or
breastfed or mixed fed, etc.

Kathy Dettwyler

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