LLLI Center for Breastfeeding Information

Journal Abstract and Review of the Month for June 2006

"The WHO Child Growth Standards"

Author:World Health Organization, 2006

"Acta Pædiatrica Supplement to the WHO Child Growth Standards"

Acta Pædiatrica 45; 2006 (4): 1-106, Suppl. 450

Guest Editors: Mercedes de Onis, et al.

Abstract:

The World Heath Organization has completed its redrawing of the charts that establish "normal" growth patterns in children aged 0-5 years. This reassessment of the standards that have been used for decades corrects many of the errors that have long been apparent to those in the breastfeeding community.Of primary significance is that these new standards are based on "the way children should grow" instead of the way they actually grow. For the first time, the feeding of human milk is defined as the normative standard and those children who are fed breastmilk are regarded as the standard by which children fed artificial baby milk are measured instead of the other way around.

The WHO website abounds with information about the process that resulted in these standards. More than 8,000 exclusively breastfed children from 6 countries around the globe (Brazil, Ghana, India, Norway, Oman and the United States) were weighed and measured with much greater frequency than in previous studies. This means that the new standards are reflective of a wider range of ethnic, socio-economic, and cultural groups than the old standards, which were based solely on upper middle-class white Americans, and that they are more finely tuned to babies’ incremental growth over time.Additionally, the WHO defines 6 benchmarks of physical development that should be used along with the growth charts to determine healthy overall development of any particular child. The WHO was surprised to find that exclusively breastfed children the world over are remarkably similar in their growth patterns, underscoring the value of species-specific milk for the human child and pointing to variances in growth as being more likely determined by differences in environment than by genetics.

Using the actual charts will take education and practice. One drawback to the new standards for American users is that all measurements are given in metric units [see the link below to access a website that can convert metric to English system units]. Another challenge is the new layering system that essentially divides the charts into ranges from +3 to -3 with 0 as the previous 50% mark. These differences from the previous layout of the charts may require users to rethink the vocabulary they use to discuss growth issues.

With these new standards, the WHO has set the bar for health in children at a much higher level and had redefined the baseline for that health as being the infant who is exclusively breastfed for at least 6 months, with complementary foods being given around the middle of the first year and breastfeeding continuing for as long as mother and child desire. This has been La Leche League's stance for half a century and it is exciting to know that this will become the standard to which every baby can grow!

This paper is categorized by the following keywords:

Advantages
Growth
Growth of breastfed babies

The World Health Organization has dedicated a portion of its website to the new child growth standards. Instructions for use, related articles, and information on training health care professionals can be found at
http://www.who.int/childgrowth/en

Additionally, Acta Pædiatrica, an international journal of pediatrics, has published a supplement that provides more in-depth information on the new growth standards and their development. It can be accessed using Adobe Acrobat at http://www.who.int/childgrowth/standards/Acta_95_S450.pdf

To download a free copy of Adobe Acrobat, go to
http://www.adobe.com/ and click on "Get Adobe Reader".

A convenient website for converting English system (pounds and inches) to their metric equivalents (kilograms and centimeters) can be found at

http://www.onlineconversion.com/weight_common.htm

Additional information on the optimal growth of breastfed infants, the benefits of breastfeeding, and the introduction of complementary foods can be found on the LLLI website at
http://www.lalecheleague.org/Release/growth.html
http://www.lalecheleague.org/llleaderweb/LV/LVJunJul02p51.html
http://www.lalecheleague.org/llleaderweb/LV/LVDec99Jan00p130.html