Since 1977, pediatricians and other health professionals have used standardized growth charts to help parents keep track of their children's growth.
The original National Center for Health Statistics (NCHS) growth charts were replaced with growth charts from the Centers for Disease Control and Prevention (CDC) in 2000. The revised CDC growth charts included eight charts each for boys and girls, including charts to follow a child's height, weight, head circumference, body mass index and various ages.
WHO Growth Charts
The World Health Organization (WHO) released its own set of revised growth charts in 2006. Unlike the CDC versions, a growth reference, the WHO charts are a real growth standard - they describe the growth of healthy children in optimal conditions, measuring children who were being breastfed in many different countries (Brazil, Ghana, India, Norway, Oman, United States).
One issue with the CDC growth charts was long thought to be that they simply described how children grew at a particular time and place, most of whom were fed formula, instead of representing how children should grow.
The real problem occurred when you tried to observe the growth of an exclusively breastfed infant on the CDC growth charts, as it would often seem like they were not gaining weight well enough. They were often gaining weight just fine, though; their pattern of weight was just different from an infant drinking formula. This pattern of weight gain for breastfeeding babies--faster weight gain than formula babies in the first few months, but then slower weight gain for the rest of the first year--is easier to see on the WHO growth charts.
It is now recommended that the WHO growth charts be used for infants and toddlers who are less than 2 years old. The CDC growth charts can still be used for older children.
The WHO growth charts can be used for all children, no matter their ethnicity or socioeconomic class or whether they are breastfeeding or drinking formula.
WHO Growth Charts for Girls
WHO growth charts are available from the World Health Organization and from the CDC:
WHO Growth Charts for Boys
Separate WHO growth charts for boys are also available:
WHO Growth Charts vs. CDC Growth Charts
If your pediatrician thinks that your exclusively breastfeeding infant isn't gaining weight well enough, make sure they are using the WHO growth charts to monitor your child's growth.
Does it really matter?
Consider a baby who is growing at the 25th percentile on the WHO growth charts. She would be about 12 pounds at 3 months, 14 1/2 pounds at 6 months, 16 1/4 pounds at 9 months and 18 pounds at a year.
In contrast, on the CDC growth charts, she would have started at the 50th percentile at 3 months, moved down to the 25th percentile at 6 months, down again to the 10th percentile at 9 months and ended up just below the 10th percentile at a year.
Crossing percentiles, some health professionals may have thought something was wrong with the way she was growing, even though it was likely a normal pattern for a breastfeeding baby.
Sources:
MMWR: Use of the WHO and CDC Growth Charts for Children Aged 0-59 Months in the U.S. MMWR. September 10, 2010 / 59(rr09);1-15.
World Health Organization. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: World Health Organization, 2006.
