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Subject:
From:
Susan Burger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 1 Dec 2010 08:13:15 -0500
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Dear all:

I read at least two posts asking questions about growth charts.

The 50th centile is NOT a magic number that all children should achieve.  The WHO charts represent the normal healthy RANGE of breastfed infants.  There will be healthy infants at the 100th centile and there will be healthy infants at the 1st centile.  Because there are fewer infants at the top and the bottom ranges, it is appropriate to monitor to make sure that they are not there from over or undereating, but if they are otherwise healthy and track at that level, then they should be left alone.  You cannot pick A centile and say THAT centile is good for all babies.  Babies are different and should be allowed to grow along their own curve.  I'm only five feet tall and my husband is only five feet four inches. It would have been unreasonable to expect or try to force feed our son into a 50th centile curve.  At the same time, parents who are at the 100th centile, may actually have a baby that is not doing well at the 50th centile, if their baby inherits their body type.  

In terms of shifting up or down the charts, weight will tend to wobble more than length.  If a baby has a cold, the baby may not grow as rapidly for a little while and then will grow better after they recover.  Or if a baby learns to crawl, the baby may be so excited and active that they may not grow as rapidly during that period and then will grow more rapidly after they master crawling.  As babies get older, weight is increasingly influenced by length.  A baby that is at the 50th centile for weight, but at the 1st centile for length, may actually be overweight (depending on how old they are).  

Growth is not just a reflection of intake (which is influenced by absorption) and growth, energy expenditure is very important too.  So, I always ask about the baby's activity level if there is a shift in the weight curve.  

Once babies get past the first three months, I also ask about length gain as well.  If a downward shift in the weight really is a reflection of poor nutrition, you usually see that the length gain slowed down.  If the length gain is on the high end, I stop worrying and just keep an eye on that baby. Usually the long lean ones are very active, more so than their peers.  An active baby is burning up calories at a much more rapid rate.  If a baby is not eating enough calories for their own body, the first thing that happens is their activity levels slow down to preserve growth.  

I know many cultures love fat babies, but with the childhood obesity rates hitting ENDEMIC proportions (which means the disease is not just a brief epidemic, but a chronic lingering problem) in the US and the UK, I think a health ACTIVE vigorous, but lean baby who is growing exceptionally well in length would be something to be celebrated.  

Best regards, Susan

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