A CDC employee, who preferred not to be named, said the WHO standards will likely not be adopted in the U.S. because they're based on countries where breastfeeding is the norm. Even though the CDC encourages breastfeeding, there has been no effort to use breastfed babies for its charts. Instead, for its latest update, the CDC used data from "five nationally-representative studies" conducted between 1963 and 1994.
Researchers used no controls to maximize the numbers of breastfed babies included in the study, reports a study published in the American Society of Nutrition in January 2007. In fact, a large portion of the data was taken from the Pediatric Nutrition Surveillance System, a project started in 1972 to track children in low-income households using publicly funded health and nutrition programs — a far cry from the WHO study's standards.
So, why would that matter? Well, because breastfed babies often have a different growth curve than formula-fed babies. A healthy breastfed baby can begin to thin out by six to nine months and become quite lean by nine to twelve months. By the CDC standard, such children sometimes appear underweight.
Posing just this issue to the CDC in the September 2002 issue of Pediatrics, the Official Journal of the American Academy of Pediatrics, Dr. Mary Bender of Norwich, Vt. said:
"Unless practitioners use anticipatory guidance to warn parents about this predictable phenomena (and until the World Health Organization charts are available), they will spend the six-month visit, rather than congratulating parents on having exclusively nursed their infants, trying to reassure away their apparent growth faltering (or worse — beginning a failure to thrive investigation and supplementing with formula)."
Reached recently by phone, Bender said she continues to lack faith in the CDC guidelines: "These growth charts do not reflect how babies grow," she said frankly.
Michele Crasa saw her son Nicholas shoot to the top of the height charts around his first birthday.
"These growth charts do not reflect how babies grow."
He was at the 90th percentile for length while his weight was dipping. She said the words "failure to thrive" from her pediatrician threw her into a frenzy. She was pushing Nicholas to eat so hard that the toddler began to become resistant. Each time Crasa put food on the tray of his highchair, Nicholas would refuse. Each time he refused, she'd pull out one of his favorites, because she was desperate to make him eat.
When she returned to the pediatrician for his fifteen-month appointment, his weight was climbing back up the charts. But the doctor had a new criticism for Crasa.
"She called me a deli mom," Crasa said with a sigh. "She said when he doesn't want something I shouldn't give in and make him whatever he wants. It's like I can't win with her."
And parents want to win. They want to do the very best for their kids. So they get obsessive over the charts, as if they were test grades.
"So often, parents get attached to 'My kids is at the 10th percentile, and oh, I wish they were at the 90th,'" Bender said. Bender recalls a parent who was 5'3" worrying because her child's height was on the shorter end of the spectrum.
"I'd tell parents, 'This chart has absolutely nothing to do with the health of your baby,'" she said. "The charts are just not based on the optimal way to feed babies. Considering the issues in this country with obesity in children, what are we trying to do here?"
©2008 Jeanne Sager and Babble
About the Author
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Jeanne Sager is a freelance writer and photographer living in upstate New York with her husband and daughter, Jillian. She maintains a blog of her award-winning columns at jeannesager.blogspot.com. |
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