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Subject:
From:
Morgan Gallagher <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 28 Feb 2008 02:10:48 +0000
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Lact-net rocks.

The following two quotes will, I reckon, be very valuable to some of 
you, so I'm putting them out now, as they are just so wonderful, and 
some of you may need them! :-)

On the subject of how to make an assessment of a weight chart, I refer 
you to Dr Mercedes de Onis, Coordinator, of Growth Assessment and 
Surveillance, WHO: 
http://www.who.int/nutrition/media_page/speakers_dr_deonis/en/index.html

""The assessment of growth implies looking not at a single measurement 
point but at the overall trajectory of growth to determine whether a 
child is tracking along the curve or is crossing centiles towards the 
lower centiles. Infants born with low birthweight will be expected to 
track along the lower centiles of the WHO standard since exclusive 
breastfeeding does not alter the fact that they were small for age in 
the first place. By looking at a single point, a baby in this category 
will indeed be considered low weight-for-age; but before deciding that 
exclusive breastfeeding is inadequate, most health professionals will 
consider the baby’s birthweight, growth trend, any problems with 
lactation, and infections that might explain the apparent growth 
failure." (WHO Child Growth PDF, page 204, Mercedes de Onis & Adelheid 
Onyango)

As this quote clearly refers to the argument to supplement for a baby 
prior to six months, I then contacted Dr de Onis at WHO, and asked for a 
quote that may be relevant to a toddler, on, for instance, the 15th 
percentile.

I received this:

"The internationally accepted cut-off for underweight (by a single-point evaluation) is equivalent to the 3rd centile.  Therefore, a child whose growth is tracking on the 15th centile cannot be considered to be underweight."   Adelheid Onyango, Department of Nutrition, WHO

The second quote, which is precisely what we require at this moment, is, I think a gem! And I'm sure many of you will be happy to have such a quote identifying the 3rd percentile in a _single point evaluation_ in such a way.

This info was also passed on by Adelheid Onyango:

"We have developed a training course that is available on the web (http://www.who.int/childgrowth/training/en/) to support the implementation of the WHO child growth standards. There is detailed information on the interpreting growth indicators in a module by the same title (http://www.who.int/childgrowth/training/Interpreting.pdf). Section 3 deals with growth trends." 

I also received a 'still in progress' handout from Diane Weissinger, which I'll post separately, as she is wishing feedback on it as a 'rough copy', and my experience of lact-net is such things are easier in separate posts.

You rock, Lact-net.  :-)

Morgan Gallagher

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