Regarding the WHO growth chart.

I don't have the who growth chart here with me so can't comment on that specifically but I should ask did the baby drop percentiles on weight only and stay in the percentiles 90th for height and head circumference?  If the baby's physicalis normal and development is normal I would not worry about this baby at all.  Babies often change percentiles during the first year of life.  Big babies often drop percentiles first weight then some times height less so when they are adjusting to the genetic growth channel they were supposed to grow in.  The babies size at birth is dependent on many factors including mom's prenatal nutrition, mom's height and other prenatal factors.  The second half of the first year babies adjust their growth to reflect their genetic growth channel.  The growth curve is a compilation of many different babies but is not reflective of each specific baby.  The breast fed baby of course has a different growth curve which reflects faster weight growth in the first couple of months of life and slower weight growth in the remainder of the first year of life.

There is an interesting article in the journal Pediatrics this month about breast fed babies growth.  You may want to refer the pediatrician to this article to start him or her thinking about growth curves more clearly.

Kramer,M.S. et al,Breastfeeding and Infant Growth. Pediatrics 2002;110: 343-348.


Penny Soppas, MD