Using the new UK-WHO growth charts

Wright, Charlotte; Williams, Alexander; Elliman, David; Bedford, Helen; Birks, Eileen; Butler, Gary; Sachs, Magda; Moy, Robert; Cole, Tim J.

doi:10.1136/bmj.c1140

Cited by 101 publications

(87 citation statements)

References 18 publications

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“…For instance, examinations of growth patterns among British children were conducted by the Expert Group on Growth Standards of the Scientific Advisory Group on Nutrition and Royal College of Paediatrics and Child Health (25,26). First, the WHO standards were adopted from 2 weeks to 24 months with the use of the United Kingdom 1990 growth references after the age of 2 years (25).…”

Section: Discussionmentioning

confidence: 99%

Growth of Czech Breastfed Infants in Comparison with the World Health Organization Standards

Vignerová¹,

Shriver²,

Paulová³

et al. 2015

Cent Eur J Public Health

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SUMMARYGrowth references are important for paediatric health monitoring. It is critical to understand differences in growth interpretation and potential consequences when using available growth references. This study compares the growth of Czech breastfed children with the current WHO growth standards 2006 and the Czech references 1991, 2001.A total of 960 infant/parent pairs in the Czech Republic were recruited through paediatric practices. Anthropometric data were collected during infants' first 12 months of life and parent questionnaires were gathered during a preventive visit at 18 months.Czech breastfed infants were longer with a greater head circumference at all percentiles compared to the WHO standards and were similar to the national references. The percentile weight-for-age and weight-for-length values of infants (≤ 6 months) were lower, and higher (6-12 months) compared to the WHO standards. The infant growth in the sample differed from both the WHO standards as well as the national references.Our findings indicate that the growth of Czech breastfed children differs from the current national references. These discrepancies were smaller compared to the WHO standards. The results of the study were used for new growth assessment guidelines to optimize feeding recommendations for Czech infants. The adoption of the WHO standards in the Czech Republic is not recommended.

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Section: Discussionmentioning

confidence: 99%

Growth of Czech Breastfed Infants in Comparison with the World Health Organization Standards

Vignerová¹,

Shriver²,

Paulová³

et al. 2015

Cent Eur J Public Health

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“…However, when UK children are compared with the new WHO growth standard, the prevalence of downward centile shifting is much lower, apart from the period immediately after birth (17) . Owing to this mismatch at birth, only the postnatal WHO standard (from age of 2 weeks) was actually implemented in the UK, (18) but the prevalence of weight faltering from birth when compared with the UK-WHO standard has not yet been described.…”

Section: Failure To Thrive/weight Falteringmentioning

confidence: 99%

Child undernutrition in affluent societies: what are we talking about?

Wright

García

2012

Proc. Nutr. Soc.

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In this paper we set out to explore the prevalence of child undernutrition found in community studies in affluent societies, but a preliminary literature review revealed that, in the absence of a gold standard method of diagnosis, the prevalence largely depends on the measure, threshold and the growth reference used, as well as age. We thus go on to explore describe the common clinical 'syndromes' of child undernutrition: wasting, stunting and failure to thrive (weight faltering) and how we have used data from two population-based cohort studies, this paper to explore how much these different 'syndromes' overlap and the extent to which they reflect true undernutrition. This analysis revealed that when more than one definition is applied to the same children, a majority are below the lower threshold for only one measure. However, those with both weight faltering and low BMI in infancy, go on in later childhood to show growth and body composition patterns suggestive of previous undernutrition. In older children there is even less overlap and most children with either wasting or low fat seem to be simply growing at one extreme of the normal range. We conclude that in affluent societies the diagnosis of undernutrition is only robust when it relies on a combination of both, that is decline in weight or BMI centile and wasting. Undernutrition is an intrinsic hazard in pre-school children in all cultures because infants have such high-nutrient requirements due to high rates of morbidity, requirements for growth, relatively inefficient metabolism and dependence on adults for all food. Worldwide, undernutrition has been clearly linked to a substantial increased risk of mortality and morbidity (1) as well as long-term stunting (2) and probably also has metabolic effects stretching into adulthood (3,4) . Thus undernutrition in childhood is clearly an important risk factor. However, what is less clear is how common it actually is in more affluent societies and what causes it in those settings. Systematic review of the prevalence of undernutrition in affluent societiesWe undertook a systematic review of the literature on the recent prevalence of undernutrition in developed societies, searching Medline, Ovid and/or Web of Knowledge for studies published between 2000 and 2011. Countries listed as having a very high human development index as defined by the UN (5) were considered as 'developed or affluent societies'. Studies were included if published in English and if they included prevalence rates and data collection methodology.

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“…Their results show that at birth, UK children were longer and heavier than the WHO standard and the WHO growth charts would set a lower standard for weight gain for UK infants [10]. Subsequently, new charts UK growth charts were created for children aged 0-4 years old to describe the optimal pattern of growth for UK children [9]. The comparable differences observed in across the mentioned studies challenged whether a universal growth standard is applicable across all populations.…”

Section: Discussionmentioning

confidence: 99%

“…The WHO child growth charts were updated with new international growth standard statistical distribution in 2006 for the growth of healthy children living under optimal conditions [9]. The use of both WHO and CDC growth charts are intended for all children regardless of socioeconomic status and ethnicity, however there are studies to suggest that they may not be suitable for all populations [10,11].…”

Section: Discussionmentioning

confidence: 99%

Norm of Physical Measurement of Typical Developing Chinese Children in Hong Kong

2015

J Syndr

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Introduction: A pilot study to establish a norm of physical measurement for typically developing (TD) Chinese children in Hong Kong. Methods:To establish a norm of physical measurements for typical developing Chinese children, kindergarten and nurseries across Hong Kong were recruited between 2009 to 2011. Height, weight, head circumference, ear length, outer and inner canthi, interpupillary distance, philtrum, hand and foot length were measured using standard procedures in children of typical development at preschool and kindergarten age.Results: A norm of physical measurements was established from recruitment of 658 TD children aged 1 to 7 years old (mean age of 4.19 years).Discussion: Based on the results from this study we have successfully shown the continuing establishment of a norm of body physical measurements for Chinese children in Hong Kong. This norm is a valuable tool for future quantification and the detection of deviations in children with a wide range of developmental and genetic disorders. With the use of validated quantitative measures, this would aid paediatricians with the identification of dysmorphology and differentiating what is within or outside of normal range.

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Using the new UK-WHO growth charts

Cited by 101 publications

References 18 publications

Growth of Czech Breastfed Infants in Comparison with the World Health Organization Standards

Growth of Czech Breastfed Infants in Comparison with the World Health Organization Standards

Child undernutrition in affluent societies: what are we talking about?

Norm of Physical Measurement of Typical Developing Chinese Children in Hong Kong

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