I think this is my first time ever replying to a Lactnet post - after years of reading. Hope I'm doing it right!
 
So, how will exclusively breastfed babies who are even further off these charts (in terms of being big) be looked at? I am concerned by the statement that "gaining weight more rapidly than is indicated on the WHO charts might signal early signs of overweight." It was always my understanding that, for the most part, exclusively breastfed babies grow at their own rate and that being "big" wasn't a concern. For example, both of my girls tripled their birth weight around 6 months. I never had any problems with their Pediatrician, she just joked that I must "make cream" and "have enough milk to feed a village". My girls were off the regular growth charts... I'm sure they'd be even more off the WHO Charts... Are Pediatricians going to start telling mothers to breastfeed less if they have heavier babies? (I have no idea how I could have created skinnier babies - I nursed them when they wanted to be nursed... and they are growing up to be very slim children. I know of many other mothers with similar experiences. I'm sure you all do too.) I have heard several references on the news recently to "babies who are at the top end of the growth chart being at a higher risk of overweight", but I never hear a distinction between formula fed babies and breastfed babies. Will this distinction be made? 
 
Theresa Hoch
LLLL, Rome, GA
 
> Date: Thu, 9 Sep 2010 14:29:57 -0400
> From: Dawn Kersula <[log in to unmask]>
> Subject: CDC recommends use of WHO charts for US infants
> 
> Just looked at my MMWR -- this is a big WAHOOO!!
> Dawn Kersula in Vermont
> 
> 
> https://mail.google.com/mail/?hl=en&shva=1#inbox/12af7457ec5cdc45
> 
> In 2006, CDC, the National Institutes of Health, and the American Academy of
> Pediatrics convened an expert panel to review scientific evidence and
> discuss the potential use of the new 2006 World Health Organization (WHO)
> growth charts in clinical settings in the United States. On the basis of
> input from this expert panel, CDC recommends that clinicians in the United
> States use the 2006 WHO international growth charts, rather than the CDC
> growth charts, for children aged <24 months (available at
> http://www.cdc.gov/growthcharts). The CDC growth charts should continue to
> be used for the assessment of growth in persons aged 2–19 years. The
> recommendation to use the 2006 WHO international growth charts for children
> aged <24 months is based on several considerations, including the
> recognition that breastfeeding is the recommended standard for infant
> feeding. In the WHO charts, the healthy breastfed infant is intended to be
> the standard against which all other infants are compared; 100% of the
> reference population of infants were breastfed for 12 months and were
> predominantly breastfed for at least 4 months. When using the WHO growth
> charts to screen for possible abnormal or unhealthy growth, use of the 2.3rd
> and 97.7th percentiles (or ±2 standard deviations) are recommended, rather
> than the 5th and 95th percentiles. Clinicians should be aware that fewer
> U.S. children will be identified as underweight using the WHO charts, slower
> growth among breastfed infants during ages 3–18 months is normal, and
> gaining weight more rapidly than is indicated on the WHO charts might signal
> early signs of overweight.
> 
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