> Can anyone point me toward some resources explaining how to use the new > WHO growth charts. This is the information that is still to come. In my opinion, this could be the most interesting and valuable part of the charts -- if it challenges people worldwide to change practice and deepen understanding of the appropriate use of growth monitoring. On a very > simplistic level, how much will these charts change our usual guidelines > on ounces-per- week-in-the-early-weeks, and for the later months? I don't know what the usual practice is in the USA, but here in the UK, where every mother is issued with our own country-specific charts (weight, height, head circumference) which are used when routine and other measures are done, and the weight both written down in ounces / grams (sometimes both) AND plotted on the charts, there is much much less emphasis on the 'ounces per week' that was current when I had my children. If you look at the chart, you notice that the rate at which growth is changing changes (otherwise it growth 'curves' would be a straight line) -- so every week or two, the average number or range of ounces one can expect a baby to gain, also changes. And, in any case, a week is too short a timescale. I know of no chart where the data is based on babies weighed so often -- they are usually weighed once a fortnight at most, sometimes once a month (or, the data is cross-sectional) -- so the two weights taken two weeks apart are connected by a smooth line, which is an ASSUMPTION as to how the growth of an individual occurs [or, at least an assumption adopted for the sake of chart production] during the fortnight. The curves are smoothed. The most interesting part of ounces per week is that (here in the UK) a range was quoted for what was expected, but never a cut-off of 'if it is less /more than this amount, you must act in such and such a way'. The lower limit -- was that a danger limit? Never clear. And anyway, dnager of what? A danger to health or a danger of being underweight? The point of the chart is to make the curve visible and to show if the SHAPE is roughly 'right', to take the focus away from absolute numbers of ounces. Don't American babies each get issued with their own chart? (mind you I have just been sent the chart from the Republic of Ireland, which is thumbnail size -- no way you could plot on it!!). An interesting read on the point of growth monitoring (which really only deals with weight) is: Panpanich R & Garner P (1999). Growth Monitoring in Children (Cochrane Review), Issue 4 ed. John Wiley & Sons, Ltd, Chichester. One interesting feature of the WHO chart is that, unlike our UK chart or many others I have seen, it depicts the initial weight loss/regain. This used to be shown in books from the first half of the 20th century (which just had one centile line in them!!!), but, due to fortnightly weighing dissappeared from later charts. I doubt this helps you much, but there have been no other replies, so I thought I would chime in. I think the basic issue is that we should all be clamouring for better initial training in weight monitoring of ALL babies, and the sue of whatever materials WHO issue. Of course, I know that the UK hardly likes to use international WHO documents and policies, considering it (I think) somehow infra dig. I bet this holds to the nth degree in the USA, but one can live in hope -- and each of us might try to take responsibility for reminding the heirarchy in our country of the usefulness of this mammoth piece fo work from WHO (once it is fully available). Magda Sachs *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html