Dear all:

 I have to heartily second Rachel Myr's comments about babies "growing the same".  There is a 
vast amount of research on this topic, most notably by Reynaldo Martorell.   Even before the new 
growth charts, we knew that the amount of genetic variation among infants (including pygmies) in 
growth from birth to age five is remarkably similar when they are well nourished.  The assumption 
that some populations are genetically short is a false one. Many of these populations have 
suffered widespread malnutrition.  In segments of those populations that are well noursihed or 
who move to other countries where their nutritional status improves, they grow similarly.  There is 
genetic variation among individuals within their populations so that some infants will grow along 
the 1st percentile and that is their normal rate of growth just as other individuals will grow along 
the 99th percentile and that is their normal rate of growth.

The reason why I mentioned the narrowing of the growth curves to healthy babies who were not 
failling to thrive and the potential culturally-based exclusion of infants who might have gained at 
an even faster rate in a completely ad libitum breastfeeding environment is that many lactation 
consultants are working as clinicians rather than in public health.  So, we may very well see those 
children who are above or below the 1st or 99th percentile.,  While we should certainly evaluate 
why these children are at the extreme ends to rule out any problems and probably will catch some 
problems, we may be the ones who also detect the exceptions that may actually be healthy and 
normal despite being off the charts at one end or the other.

Perhaps I may have even missed some points that Kathy Dettwyler mentioned when the research 
was being conducted for the growth charts.  I am now thinking about the African style of nursing 
about 20 times a day.  There may well be some infants who would grow at an even faster and 
healthy rate on the African nursing style plan.

My training taught me that it is the growth trajectory that is more important than the particular 
curve and that plateaus and dips are a warning signal.   

Best regards, Susan Burger

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