One of the reasons women struggle with breastfeeding is that their chart-obsessed doctor keeps telling them that their exclusively breastfed baby is underweight, or not gaining, and that they should supplement with formula.
The problem is doctors are using the CDC's chart for children under 2 -- which is based off of the gain of American formula-fed infants, since the US has abysmal breastfeeding rates. Because babies are meant to grow on breast milk, it doesn't make sense to use formula-fed babies as the health standard -- especially when they're more at risk for being overweight.
The CDC has admitted their charts are leading to unnecessary concerns about weight gain and should no longer be used. So what's the new standard?
On the basis of input from this expert panel, CDC recommends that clinicians in the United States use the 2006 WHO international growth charts, rather than the CDC growth charts, for children aged <24 months (available at https://www.cdc.gov/growthcharts).
The WHO charts base growth off breastfed babies, so that will now become the recommended standard -- meaning everything should be based off of breastfed infants. They have found that when using the WHO's charts, far more breastfed babies are considered in a healthy weight range, but more formula-fed babies are indicated as at risk for obesity -- not surprising, considering formula is shown to increase the risk.
The panel also recognized that AAP has stated the breastfed infant "is the reference or normative model against which all alternative feeding methods must be measured with regard to growth, health, development, and all other short- and long-term outcomes."
Another point that this would address is that it's normal for breastfed babies to slow down in growth between 3 to 18 months, whereas formula-fed babies have a tendency to continue on a level weight gain ... which explains why a lot of women's doctors tell them their 3- to 6-month-old breastfed babies "aren't gaining enough weight."
They hope that by reverting to the WHO's charts, breastfeeding moms will be more confident that their babies are gaining weight properly, and that real problems with excess weight can be caught a lot sooner.
One final thing discussed in their new recommendations is that the growth charts are intended to be used as a reference, not a necessity. Children with optimal diets with no medical problems will not necessarily stick to these charts. A deviation from percentiles should be a cause of further investigation, NOT a reason to start changing the baby's diet immediately.
So, yay! Yet another step in the right direction. Hopefully this can help doctors understand what a breastfed baby's first two years should really look like, and moms won't hear as often that their baby isn't gaining enough.
Though I'm sure my fantastic pediatrician knows this information (she's really on top of current information, which is part of the reason I love her), I'm taking this info from the CDC and a copy of the WHO's growth charts with me next month.
Did your doctor ever concern you with the growth of your baby against the growth chart?
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