Let us not get too hung up on growth charts, like the pediatricians
have done. Remember what they are for. Growth along a given
percentile is another sign of good health, just like a happy, smiling
baby, good skin colour, absence of heart murmur and the rest. If the
baby or child is crossing percentiles, it is an indication that this
child needs special attention--he might have developed some sort of
illness, he might have a hormone deficiency, he might not be getting
enough love, he might not be getting enough calories. A good history
(including feeding history), a physical examination (which includes
observation of the baby breastfeeding) and a look at the pattern of
growth, will usually make the diagnosis fairly obvious. Thus, growth
charts, even if they are not made specifically for the breastfed baby
(indeed, not even made for the formula feeding baby of today), ***if
they are used properly***, are useful. The problem arises when we
forget history, physical examination and observation of breastfeeding
and only look at the growth chart as if it were some sort of message
from heaven.
Jack Newman, MD, FRCPC
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