Academic journal article Human Ecology Forum
Cornell Nutritionists Help Establish New International Growth References
Millions of healthy infants may be assessed as growing too slowly because of inadequate international child growth standards, according to nutritionists from Cornell University and the World Health Organization (WHO). As a result, many infants are taken off breast milk and given solid foods before they need them, with potentially life-threatening consequences.
In fact, child growth standards - the set of height and weight guidelines health workers use to assess whether growth is occurring at satisfactory rates for good health - are inadequate for many young children, not just infants, Cornell experts say.
"Although current growth references for young children have served many useful purposes, we have come to recognize that they have a number of serious drawbacks and are not suitable for healthy, breast-fed infants around the world whose caregivers follow health recommendations," says Cutberto Garza, chair of the WHO Working Group on Infant Growth. Garza is director of the Division of Nutritional Sciences and associate director of the Food and Nutrition Programme for Human and Social Development at United Nations University. Garza also is a member of the WHO Expert Committee established to reevaluate the use of growth standards for different ages.
"We now know that health workers using the current references too easily make faulty decisions regarding the adequate growth of breast-fed infants and thus mistakenly advise mothers to supplement unnecessarily or to stop breast-feeding altogether. Given the health and nutritional benefits of breast-feeding, which include helping to prevent severe infectious and potentially fatal diseases, this potential misinterpretation of the growth pattern can have dire results," he says.
For more than five years, two WHO Working Groups on Infant Growth, under Garza's direction, have been analyzing and assessing the current growth references, which were established by the National Center for Health Statistics (NCHS) and recommended by the WHO since the late 1970s. Those growth curves were based on two sets of data, both using samples of American children.
"We found early on that infants who live under favorable conditions and are fed according to the WHO feeding recommendations often grow more slowly than the patterns reflected in the NCHS-WHO international reference," Garza says. …