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Your comments: Summer 2006

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We would also like to know about your encounters with numbers, whether mystifying, strange or even beautiful.

And we hope you will join us in keeping a watchful eye on the way numbers are used and reported.

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Baby growth charts

I think changing to these charts even if only for breastfed babies would be a real step forward.

As the mother of a three-month-old, exclusively breast fed I have been perpetually told she is "small" (between the bottom 2 centiles) but this would make her to be far 'larger' and normal for a breast fed baby. Bring them on and stop the worry for breast feeding mothers.
Jo Parry-James, UK

Of course breast feeding is better for babies, and this is a great way of getting the message through.

However, it is absolutely essential that the support systems are put in place for breastfeeding women. Health professionals need to be educated about problems with breastfeeding and how to overcome them.

Breastfeeding isn't always easy. My daughter and I found it incredibly easy, I couldn't believe my luck, until she was about 10 weeks old and started to get extremely agitated every time she fed, and was hungry the rest of the time, she dropped down to 25th centile (which on the new charts would have been 50th!!) which I found a big worry as she was born at 75th centile.

In the end she was feeding less than every hour for about three minutes at a time. When I approached my health visitor she asked me if I wanted to talk about it and could be of no more help except to recommend a breastfeeding support group about 45 minutes journey away.

At the time the feeding had got so bad that the idea of spending 45 minutes getting anywhere was unthinkable, and there was no other help at hand. I eventually gave up breastfeeding my daughter at three-and a-half months, but wish I had been able to get support to help me to continue.
Susie, England

My daughter, born two years ago, weighed 8.12oz at birth. I was breast feeding, what I thought was "happily". However the "professionals" didn't think that my daughter was gaining weight fast enough and my health visitor insisted that I had an appointment with a consultant at my local hospital.

Formula was recommended as a supplement. I continued to breastfeed my daughter for four months. However, the bottle/formula soon took over as my daughter didn't have to work so hard to get the milk.

It is clear from my daughter's three friends who were and continue to be breastfed that their growth chart would be considerably different as they are all much lighter than my daughter.

I welcome the introduction of the WHO charts but feel that the "professionals" need greater training in breastfeeding and the encouragement of new mums at a time that is an emotional rollercoaster and can be stressful without the complication of "professionals" making their demands. Had I realised that the charts were created based on formula fed babies I would have challenged the advice that I was being given.
Jane Banks, UK

It is good that they are planning to encourage breastfeeding, but with both my babies, now aged one and two, there was a concern over weight loss in the first week or so.

Concern over weight is what caused all the anxiety, and I had one midwife threatening to re-hospitalise Katie because she lost 11% from her birth weight in the first week!

She was healthy and there would have been no need to do that. Let's get some calm common sense here and stop this obsession the weight charts!
Lesley Mansfield, Berkshire, England

I feel very strongly that my two children, who are slim and healthy 12 and 15-year-olds have benefited very definitely from being breastfed for between four and six months each.

In addition, we cook real food and use very little processed food, although the odd pizza and burger might slip in - and I look at what they eat. It is too easy to say to the children "what would you like for tea?" - parents should control the meals and if you make little fuss children do try new things.

I followed Dr Spock's rule which is not to make a fuss when they are learning to eat different foods, but to let them try what they want until they find what they like.

Don't keep crisps and sweets in the house except on weekends if at all - it means they have to go out and get sweets if they want them. Result: two kids who eat everything and love brussels sprouts and cabbage!
Sue Berry, UK

I am entirely in favour of using growth charts for babies that relate to breastfed weight gain.

Fourteen years ago I was the only breast-feeding, cloth-nappy using woman at my inner London health centre.

Everything from leaflets detailing "How to budget for your baby" through to welcome packs for new mothers was geared to formula feeding and disposable nappies.

As a result I was constantly interrogated by the health care staff because my baby wasn't "normal". Nor was he. Nor is he still; at nearly six feet tall, never having had even a minor illness, let alone a serious one, and not being prone to asthma, eczema or any of the other prevalent health conditions in his cohort.

Normal and normative are not the same thing - but normative values can help people make better decisions. It is foolish to calculate a baby's healthy weight based on an artificial food that costs a huge amount, often causes allergies, and deprives the child of his or her best chance to obtain a strong immune system.

Breast is best, for charts and babies.
Kay Sexton, UK

How interesting that now babies are going to be measured using stats based on breastfeeding it is seen to be discriminatory. For years babies being breastfed have been thought by many health professionals to be underweight and have been forced to have formula milk supplements as a result.
Addy Henderson, England

Having listened to your piece about the birth weight charts, I have looked at them on the website.

If they had been available a year ago, even as a handy second reference I may still be breastfeeding my child now. She was born on the 91st centile line and at 10 weeks was on the 25th. I panicked that I was not providing her with enough nutrition and swapped over to bottle feeding, I don't think I would have panicked as much if I had seen a chart that was specifically drawn up for breastfed babies.

On a second note, surely the point of the chart is to aim at where you should be. Bottle milk formula is developed constantly to ever more closely match breast milk, so why are bottle-fed babies still so much heavier? Is this to do with the formula itself or the way mothers feed their babies the formula?
Anna Gardiner, UK (England)

There are always likely to be concerns from some families regarding the weight, height etc...of their baby, however the WHO seems to be naive in their recommendations, charts will not affect the actions of the majority of parents.

I work with children who have eating and drinking difficulties and following the last WHO recommendations regarding breastfeeding (or formula) only to six months we have received an increase in referrals for children who will not wean and become hypersensitive to changes in texture.

The theory is fine, however the practice often needs to be very different for some children, and there is not enough information given to healthcare professionals, by the WHO, about those who do not fit into the comfortable, developing without-a-hitch group of children, it seems to be left to others to sort out.
Elizabeth Purt, UK

Charts are only a guide and should be based on healthy ideal, not what happens - we don't do this with target adult weights.

I breastfed and charts showed my kids below average - yet they looked really healthy. No-one in my family breastfed, so I had to have confidence in myself and see charts in perspective. It's hard enough to promote breastfeeding - other mums could lose confidence which is a big thing when starting out with b/feeding, especially if older relatives disapprove/distrust it.

Problem with anything that shows breastfeeding as the norm/ideal - all the guilt trip stuff around it means bottle feeders might get upset. This guilt is the problem, not the facts/truth of medical research.
Karen McKay, UK

Given that breastmilk is the ideal milk for a baby, I think it makes sense to swap the "old" charts for the new WHO ones, based on breastfed infants.

What's wrong with basing the charts on the ideal? Body Mass Index charts for adults are based on an ideal - a BMI of 25 is likely to be associated with better health than one of 35. Weight charts for adults aren't based on the general populations, where many are overweight.

One reason frequently given by women for giving up breastfeeding is that their babies are "not gaining enough weight" according to the current charts, and they therefore suspect their milk is insufficient. In fact, their babies are probably gaining weight perfectly healthily for breastfed babies, and this would be shown on the new WHO charts.

I agree that information supplied by health professionals is critical - many women switch (unhappily) from breast to formula feeding on the advice of health professionals because of apparently inadequate weight gain based on the old charts.
Gill Ball, UK

I am a GP and caught this item while going out on a home visit and it was music to my ears.

Let us hope that the WHO charts will be adopted so that we will at last be assessing children to "gold standard criteria" which means the growth range of healthy breast fed babies rather than the current charts which include babies fed on artificial milk who tend to get heavier than they should be.

We must educate our mothers far more about the benefits of breast feeding in order to improve uptake of breast feeding which is pitifully low in the UK - and we are supposed to be a first world country!
Dr Elizabeth Foster, UK

I think that you have made an assumption in your programme that the formula babies are just as healthy, but weighing more, the WHO charts were based on babies receiving an optimal diet. We know that adult obesity starts with big babies, therefore it may be in fact that formula milk makes babies fat, which makes for fat adults, or to put it another way, perhaps these charts show that formula milk is not so good for babies.
Lisa Northover, UK

How interesting that your contributors want to avoid worrying formula-feeding parents that their children are too heavy when exactly the opposite problem has occurred for years, with breastfeeding mothers driven by health professionals to add supplementary feeds because their babies are not growing quickly enough.

That pressure is a significant factor behind the appalling statistic that only 20% of women continue to breastfeed for six months or more. You yourselves fall into the trap of putting inverted commas around ideal in the phrase 'this "ideal" sample of babies'.

Do you know better than the WHO on this? Have you too succumbed to the propaganda of the formula companies?

Given the obesity epidemic sweeping the world, does it not seem sensible to compare babies against a group where the mother is giving her baby the best possible start in life, rather than just taking the 'average' baby, including all those who are fed sub-optimally? Tam Fry appears to be suggesting that parents should not be concerned that their babies are putting on weight too quickly on formula. Surely that is precisely the point of the WHO's work: to highlight to parents the dangers of overfeeding their children.
Emily Booth, UK

As a midwife and infant feeding specialist I have been looking forward to the new WHO growth charts for some time.

What is now needed is for Health Visitors to be re-educated to understand the normal growth for breastfed babies and the research behind the introduction of complementary foods at around six months of age and the continuation of breastfeeding into the second year of life.
Sarah Hunt, England

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