Someone wrote:
Pearl asks,  Is there really a breastfeeding growth chart, and is so how =
can I get a
copy.

YES. The WHO working group on Infant Growth recently published "An =
Evaluation of Infant Growth" with new charts. It's published by the =
Nutrition Unit, World Health Organization, 1211 Geneva 27, Switzerland.


Me talking now:  I hate to disappoint everyone, but the "breastfeeding
growth charts" published in the WHO publication "An Evaluation of Infant
Growth" are NOT, repeat NOT, to be used to evaluate breastfeeding babies'
growth.  They represent the currently available studies of breastfed babies,
and have many many drawbacks and limitations which are *clearly stated* in
the publication.  The publication states:

"Growth curves based on the 12-month breast-fed pooled data set [the one in
the publication] should be used in RESEARCH SETTINGS [their emphasis] to
assess the growth of exclusively and partially breast-fed infants and of
infants fed artificially from birth."    They go on to say "Available data
are insufficient to allow the development of a new reference."  NOTE: They
tell you that these are NOT new references, and are not to be used as such.

The main drawbacks listed for the currently available data set, on which
these growth charts are based, are that they come from a very small sample
size, of all Caucasian mothers, and have very little variation -- the
population was too homogeneous and the sample size MUCH TOO SMALL to develop
meaningful percentile scores.  In addition, I would add that researchers
need to study the effects of frequency of breastfeeding on infant growth, as
more frequent feeding leads to greater quantity and higher fat content of
milk, both of which might mean greater growth; they also need to study the
effects of night nursing, as children nursed often at night might grow very
differently from children nursed only during the day.  They also need to
study the effects of various quality and quantities of solids, as some
babies "on solids" eat only a little, sporadically, while others eat large
amounts of solids three times a day, once they start.  The WHO report notes
the quality of solids issue, but not the amount/consistency of getting that
amount issue.

The research community is still *very far* from developing a meaningful
growth standard for breastfed babies in healthy environments.  Please,
please, don't use the WHO charts in this publication to evaluate breastfed
babies' growth.  It would be inappropriate, and meaningless.




Katherine A. Dettwyler, Ph.D.
Texas A&M University