Growth Charts – WHO Child Growth Standards

2010 October 5
by Daniel Lakeland

Growth Charts – WHO Child Growth Standards.

Why does the CDC recommend the use of WHO growth charts for infants under 2 years even though the CDC has their own charts? The answer is that the WHO growth charts are based on a well designed study where infants were followed longitudinally with high frequency data collection and large sample sizes. Not only that, but the infants in question were predominantly breastfed and given an “optimal growth environment” that is, I assume, neither intentionally fed extra calories (a frequent practice among poor uneducated people in the US who worry about their babies not gaining enough weight according to reports that I have read) nor in an environment where malnutrition was common.

They make the claim that rather than reflecting how some random babies just happened to grow within some uncontrolled environment, the WHO charts reflect how babies grow when given a good healthy environment.

Now we have to ask, why is it that pediatricians still seem to predominantly look at weight-for-age and length-for-age, when it seems obvious both from a modeling perspective and from my general reading in this area, that weight-for length is the appropriate statistic since it tells you whether babies are obese or malnurished compared to their skeletal develoment.

I suppose really we should look also at length-for-age since that could help detect stunted growth due to some kind of growth hormone problem or whatever, but weight-for-age certainly seems to be problematic.

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