Susan comments on the population of US babies who participated in the data
collection that formed the basis for the new WHO growth charts for optimally
fed babies.

Davis, California, was chosen as the US data collection site because it is a
community with high breastfeeding rates and high levels of health and
education in general.  All the places around the world were chosen with this
in mind.  They didn't want to be looking at babies in the community who were
drastically different from the community at large.  But they didn't want to
look at a cross-section of everyone.  They wanted babies who were not
suffering from poverty, lack of health care services, parental illiteracy,
exposure to tobacco smoke, and more.  This was purposeful sampling for a
reason, to answer the question, how do babies grow when they have the very
best conditions we can give them?  

I don't know how the protocol was in the other places, but in Oslo the
mothers who were recruited were given extraordinary support for
breastfeeding.  Among the people doing the data collection were five of the
seven candidates who certified as IBCLCs when I did, and they certified as
the project was winding down.  The experience that they got working with the
growth study was key to their being able to take the exam, even though all
of them came to the project with at least a professional background working
with breastfeeding and half of them were long-standing peer counselors with
the breastfeeding support organization besides.  All but one had personal
experience breastfeeding, and the one exception was childless.  These were
the people who provided on call service around the clock to the mothers in
the study, who were in their homes regularly weighing and measuring babies
according to very specific guidelines set out in the protocol, and who made
sure that no baby was weaned unnecessarily due to breastfeeding
difficulties.  There may have been people in Oslo at the time who were using
Ezzo or Ezzo-like techniques with their babies, but such practices would
have been discovered and counseled against if a mother were participating in
the study.

The most significant finding in the growth study was that babies in all
parts of the world, when fed optimally, grow the same.  They aren't the same
size, but they grow the same way. 

The most significant effect the study had in Norway was that there is
greater awareness in and around Oslo about what it takes to breastfeed
exclusively for six months, than there is where I live, just a few hundred
km away.

Rachel Myr
Kristiansand, Norway

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