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The New WHO Growth Reference in the First 6 Months of Life and Breastfeeding

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Handbook of Growth and Growth Monitoring in Health and Disease

Abstract

The regular monitoring of growth ranks with immunisation as the most frequently used paediatric intervention. The new WHO growth reference (WHO, 2006) was developed to replace the growth reference in widespread use around the world, the CDC 2000 growth reference. The old reference was thought not to reflect optimal growth rates, as the sample used contained a high proportion of formula-fed infants. It was thought that a new growth reference would be lighter than the existing one. When the new WHO 2006 growth reference was developed it was heavier than the existing reference for the first 6 months of life. After 6 months the weight-for-age curve is lighter than existing references as was expected. However, if the new WHO 2006 growth reference is used under the age of 6 months an increased proportion of infants will be classified as underweight. This may lead to the early introduction of complementary foods and even the cessation of breastfeeding. Before a new growth reference is introduced it should be the subject of a randomised controlled trial to ensure that such an important monitoring toll does not have an unexpected impact on breastfeeding. Until the situation can be resolved the WHO 2006 growth reference should not be used under 6 months of life.

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References

  • Binns C. Assessment of growth and nutritional status. J Food Nutr. 1985;42:119–26.

    Google Scholar 

  • Binns C, Davidson G. Infant feeding guidelines for health workers. Dietary guidelines for children in Australia. Canberra: National Health and Medical Research Council; 2003.

    Google Scholar 

  • Binns CW, Scott JA. Breastfeeding: reasons for starting, reasons for stopping and problems along the way. Breastfeed Rev. 2002;10:13–9.

    Google Scholar 

  • Cattaneo A. Breastfeeding: innovative solutions. First World Conference on Public Health Nutrition, Barcelona; 2006.

    Google Scholar 

  • Cattaneo A, Guoth-Gumberger M. The new WHO Child Growth Standards: possible effects on exclusive breastfeeding in the first six months. Breastfeed Rev. 2008;16:9–12.

    PubMed  Google Scholar 

  • Center for Disease Control and Prevention. CDC growth charts: percentile data files with LMS values. 2000a. http://www.cdc.gov/growthcharts/percentile_data_files.htm. Accessed 1 Oct 2009.

  • Center for Disease Control and Prevention. CDC growth charts: United States. Advance Data (NCHS). 2000b;315:1–28.

    Google Scholar 

  • de Onis M, Garza C, Habicht JP. Time for a new growth reference. Pediatrics 1997;100:E8.

    Article  PubMed  Google Scholar 

  • de Onis M, Garza C, Onyango A, Borghi E. Comparison of the WHO child growth standards and the CDC 2000 growth charts. J Nutr. 2007;137:144–8.

    PubMed  Google Scholar 

  • de Onis M, Garza C, Victora CG, Onyango AW, Frongillo EA, Martines J. The WHO multicentre growth reference study: planning, study design, and methodology. Food Nutr Bull. 2004;25:S15–26.

    PubMed  Google Scholar 

  • de Onis M, Onyango A. WHO child growth standards. Lancet 2008;371:204.

    Article  PubMed  Google Scholar 

  • de Onis M, Onyango AW, Borghi E, Garza C, Yang H. Comparison of the World Health Organization (WHO) child growth standards and the national center for health statistics/WHO international growth reference: implications for child health programmes. Public Health Nutr. 2006;9:942–7.

    PubMed  Google Scholar 

  • Dettwyler K, Fishman C. Infant feeding practices and growth. Ann Rev Anthropol. 1992;21:171–204.

    Article  Google Scholar 

  • Dewey KG. Growth characteristics of breast-fed compared to formula-fed infants. Biol Neonate. 1998;74:94–105.

    Article  PubMed  CAS  Google Scholar 

  • Edwards P, Roberts I. Population adiposity and climate change. Int J Epidemiol. 2009;38(4):P1137–40.

    Google Scholar 

  • Eriksson J, Forsén T, Tuomilehto J, Osmond C, Barker D. Early growth and coronary heart disease in later life: longitudinal study. Br Med J. 2001;322:949–53.

    Article  CAS  Google Scholar 

  • Garn S. Human growth. Annu. Rev. Anthropol. 1980;9:275–92.

    Article  Google Scholar 

  • Hamill PV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM. Physical growth: National Center for Health Statistics percentiles. Am J Clin Nutr. 1979;32:607–29.

    PubMed  CAS  Google Scholar 

  • Harder T, Bergmann R, Kallischnigg G, Plagemann A. Duration of breastfeeding and risk of overweight: a meta-analysis. Am J Epidemiol. 2005;162:397–403.

    Article  PubMed  Google Scholar 

  • Horta BL, Bahl R, Martines JC, Victora CG. Evidence on the long-term effects of breastfeeding: systematic review and meta-analyses. Geneva: WHO; 2007.

    Google Scholar 

  • James JP. An analysis of the breastfeeding practices of a group of mothers living in Victoria, Australia. Breastfeed Rev. 2004;12:19–27.

    PubMed  Google Scholar 

  • Jeffery AN, Voss LD, Metcalf BS, Alba S, Wilkin TJ. Parents’ awareness of overweight in themselves and their children: cross sectional study within a cohort (EarlyBird 21). Br Med J. 2005;330:23–4.

    Article  CAS  Google Scholar 

  • Kerac M, Egan R, Mayer S, Walsh A, Seal A. New WHO growth standards: roll-out needs more resources. Lancet 2009;374:100–02.

    Article  PubMed  Google Scholar 

  • Khan L, Sobush K, Keener D, Goodman K, Lowry A, Kakietek J, Zaro S. Recommended community strategies and measurements to prevent obesity in the United States. MMWR 2009;58(RR07):1–26.

    PubMed  Google Scholar 

  • Kramer MS, Aboud F, Mironova E, Vanilovich I, Platt RW, Matush L, Igumnov S, Fombonne E, Bogdanovich N, Ducruet T, Collet JP, Chalmers B, Hodnett E, Davidovsky S, Skugarevsky O, Trofimovich O, Kozlova L, Shapiro S. Breastfeeding and child cognitive development: new evidence from a large randomized trial. Arch Gen Psychiatry. 2008;65:578–84.

    Article  PubMed  Google Scholar 

  • Kramer MS, Guo T, Platt RW, Shapiro S, Collet JP, Chalmers B, Hodnett E, Sevkovskaya Z, Dzikovich I, Vanilovich I. Breastfeeding and infant growth: biology or bias? Pediatrics 2002;110:343–7.

    PubMed  Google Scholar 

  • Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol. 2004;554:63–77.

    PubMed  Google Scholar 

  • Kramer MS, Matush L, Vanilovich I, Platt RW, Bogdanovich N, Sevkovskaya Z, Dzikovich I, Shishko G, Collet JP, Martin RM, Smith GD, Gillman MW, Chalmers B, Hodnett E, Shapiro S. A randomized breast-feeding promotion intervention did not reduce child obesity in Belarus. J Nutr. 2009;139:417S–21S.

    PubMed  CAS  Google Scholar 

  • Lee CM, Barzi F, Woodward M, Batty GD, Giles GG, Wong JW, Jamrozik K, Lam TH, Ueshima H, Kim HC, Gu DF, Schooling M, Huxley RR. Adult height and the risks of cardiovascular disease and major causes of death in the Asia-Pacific region: 21 000 deaths in 510 000 men and women. Int J Epidemiol. 2009;38(4):1060–71.

    Google Scholar 

  • Morley D. Woodland M. See how they grow: monitoring child growth for appropriate health care in developing countries. Oxford, NY: Oxford University Press; 1980.

    Google Scholar 

  • NHMRC. Food for health: dietary guidelines for Australian children incorporating the infant feeding guidelines. Canberra: NHMRC; 2003.

    Google Scholar 

  • Oddy W, Scott J, Binns C. The role of infant feeding in overweight young children. In: Flamenbaum R, editor. Childhood obesity and health research. New York, NY: Nova Science Publishers; 2006.

    Google Scholar 

  • Owen CG, Martin RM, Whincup PH, Davey-Smith G, Gillman MW, Cook DG. The effect of breastfeeding on mean body mass index throughout life: a quantitative review of published and unpublished observational evidence. Am J Clin Nutr. 2005a;82(6):1298–307.

    PubMed  CAS  Google Scholar 

  • Owen CG, Martin RM, Whincup PH, Smith GD, Cook DG. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics 2005b;115:1367–77.

    Article  PubMed  Google Scholar 

  • Powles J. Commentary: why diets need to change to avert harm from global warming. Int J Epidemiol. 2009;38(4):1141–2.

    Google Scholar 

  • SACN/RCPCH Expert Group on Growth Standard. Application of the WHO Growth Standards in the UK, London, RCP; 2007.

    Google Scholar 

  • WHO. World Health Organization. A growth chart for international use in maternal and child health care: guidelines for primary health care personnel. Geneva: WHO; 1978.

    Google Scholar 

  • WHO. WHO Child growth standards: Methods and development. Geneva: World Health Organisation; 2006.

    Google Scholar 

  • WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–63.

    Article  Google Scholar 

  • World Health Organization Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet 2000;355:451–5.

    Google Scholar 

  • Ziegler E, Nelson S. The New WHO growth standards: comparison with other growth charts. Ann Nestlé [Engl]. 2007;65:109–15.

    Article  Google Scholar 

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Correspondence to Colin Binns .

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Binns, C., Lee, M.K. (2012). The New WHO Growth Reference in the First 6 Months of Life and Breastfeeding. In: Preedy, V. (eds) Handbook of Growth and Growth Monitoring in Health and Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1795-9_34

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  • DOI: https://doi.org/10.1007/978-1-4419-1795-9_34

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