Hi Gayle and Lactnet-- Take a look at the baby, not just the numbers. Also bear in mind that babies of moms with OAMER will gain wt more rapidly in the first weeks. Now that the problems with OAMER are resolved, thanks to your support and mom's diligence, baby's rate of gain may now have leveled out to what would have been "normal" for her in the absence of OAMER. Whenever there is a concern about growth rates not lining up with charts, I like to take a look at the big picture. Breastfed babies are expected to double birthweight by 4-6 months, and triple by 1 year. Is your baby likely to meet this criterion? IF so, point it out to ped and mom that things are probably OK. Has baby's overall gain been close to one oz a day? Also be sure and take into account initial wt loss. If baby lost a lot of wt initially, start calculating the 1 oz a day from the lowest wt, not the birth weight. good luck! Martha Johnson RN IBCLC Eugene OR -----Original Message----- From: Gayle Prehn [mailto:[log in to unmask]] Sent: Friday, August 09, 2002 4:58 AM Subject: WHO growth chart Hi, I am a new member of the list since April. I took my test last month and hope to be joining the honored ranks of the certified. I am requesting your help in interpreting the WHO growth charts as found in the appendix of Lawrence, 1999. I am working with a mom who is very upset because her pediatrician says that her 4 mo girl is not gaining well because she has fallen from the 90th to 75th percentile since the 2 mo visit. Initially we had serious problems with oversupply and OAMER for this little one. Mom had previously nursed twins. Got that one solved and things were going great, and now mom very upset. I have tried to plot the baby on the WHO charts but not sure if that is how they should be interpreted. On those charts, her weight to length has her dropping two standard deviations since 2 months. No matter which chart I use, weight by age, length by age, she is dropping, though some it is only one SD. I looked at the chart on month to month intervals, but difficult to gage as I have weights for birth, 9 days, 2mo and 4mo. Do you expect a baby to stay within one standard deviation if all is going well? I was hoping to use information from charts based on breastfed children to get the doctor of mom's back, but if anything this looks worse as I am interpreting it. Doc says to increase feedings and add cereal. Mom is reluctant to add cereal because has had major food allergy problems with the twins since they weaned, and I agree with her. She has tried to add a feeding and baby refuses to nurse. Baby was sleeping 10 hours at night. Mom woke her for feeding which baby did but then would sleep more and nurse less during the day. I have mom doing breast compression throughout feeding to increase fat content. So my requests from you wise ones, 1) advise on how to use and interpret the WHO growth charts and 2)any advise for this mom. Thanks in advance. Gayle Prehn, RN Romeoville, IL *********************************************** 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(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html *********************************************** 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(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html