The most common charts in use today are known variously as the
WHO/CDC/NCHS/Ross Labs growth charts.  They were developed in the 1970s by
the National Center for Health Statistics, part of the Centers for Disease
Control.  They were based on two data sets, one from the Fels Research
Institute in Yellow Springs, Ohio, based on a small sample of mostly
middle-class, mostly white children who lived in Ohio in the 1930s-1950s.
The second data set was the NHANES surveys of the 1970s and 1980s.  NHANES
is National Health and Nutrition Examination Survey, which used a broader
range of children in terms of SES and ethnicity and geographic origin within
the US.  These charts have recently been updated and 'corrected'.  In all
cases, some of the children in the sample were breastfed, in various
manners, and some were bottle-fed.  Some started out breastfed, but switched
to bottle-feeding during the study.  Most all started solids early.  The
formula-feeders were getting formula of the times, not the kind available in
2001.

In the late 1970s, these charts were pubblished for use by researchers
world-wide, because comparisons of growth found that, wherever children were
adequately nourished and didn't have to cope with too many diseases (i.e.,
they had immunizations, antibiotics, clean water, good sewage treatment)
they grew pretty much like the US children -- only a few isolated
populations have genetically slow growth and short adult stature.  The short
stature you see in adults in places like Guatemala, Mexico, and Viet Nam, is
due to childhood environmental stresses, including malnutrition, disease,
and emotional stress.

The World Health Organization adopted the CDC/NCHS standards for use
throughout the world.  Probably the UK continued to use the
Tanner-Whitehouse standards, because James Mourilyan Tanner was an
Englishman, and was the pioneer of modern studies of children's growth.
He's one of my heroes.

Ross Labs kindly offered to print up the WHO/CDC/NCHS charts for use in
doctor's offices, and printed them in pink for girls and blue for boys, even
though the original intent was NOT to use these growth charts for individual
children, but only for averages of groups of children.

The WHO printed up their own versions of these growth charts for different
regions of the world.  The charts were identical to the US/Ross Labs charts,
but they were labelled "Growth Charts for Use in Africa" and "Growth Charts
for Use in Asia," etc.  I remember one very frustrating conversation with a
Malian nutrition/health administrator who was furious at me for using "U.S."
charts to plot Malian children's growth, and insisted I use the "WHO Growth
Charts for Use in Africa."  No matter how many times, or in how many ways, I
explained that these were the very same charts, he refused to listen.

You'll find lots of discussion of growth charts in the archives.

Kathy Dettwyler



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