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• W74955796 abstract "Infants whose growth falls below WHO reference charts may be unnecessarily put at risk by efforts to boost weight gain. current World Health Organization (WHO) references on normal growth for infants are faulty, causing undue alarm among health care workers when infants fail to keep pace with growth-for-age expectations. Breast-fed infants in particular fall behind in the growth schedule, which may lead health care professionals to recommend the premature introduction of supplementary foods--a potentially serious mistake in developing countries, where poor food and water sanitation often leads to fatal infections. Those are the conclusions of the WHO Subcommittee on Infant Growth, chaired by Cutberto Garza, director of the Division of Nutritional Sciences. terminology used by WHO is part of the problem. Although WHO uses the term reference for its normal-growth criteria, most people interpret it as a standard. A 'reference' is a tool providing a common basis for purposes of comparison, Garza notes. The term 'standard' embodies a concept of norm or target. That is, it imparts a value judgment. Traditionally, reference data have been justified on the basis of being reflective of a large, readily identifiable country or population where nutrition, health, and environmental conditions are favorable to children's reaching their genetic growth potential, such as a representative sample of all healthy infants in the United States born in a certain set of years. Little thought, however, has been given to whether a reference reflects the growth that should occur or how variable 'normal' growth is. Both the average growth and the variability in growth are critical, because they affect clinical and public health decisions. existing WHO references for infants are based on the Fels Longitudinal Study, conducted in Yellow Springs, Ohio, from 1929 to 1975. There are several significant limitations in these reference data, Garza observes. First, the sample was limited to North American infants, so the data do not represent the world's children. Second, measurements were taken every three months rather than every month, which is not ideal for characterizing the shape of the growth curve, particularly during the first six months of life. Last, most of the infants were bottle fed; of the breast-fed infants, very few were breast-fed for more than three months. When growth is evaluated on the basis of the Fels measurements and references, exclusively breast-fed infants begin to falter by the third month. Yet the infants may well be growing normally. …" @default.
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• W74955796 date "1994-09-22" @default.
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• W74955796 title "Infant growth charts need revision" @default.
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