The Motherwear Breastfeeding Blog

CDC recommends use of WHO growth charts based on breastfed babies!

This is huge news.

The CDC just announced that it is now recommending that health care providers use the 2006 WHO growth charts for children up to 24 months instead of the 2000 CDC charts.  Here is the announcement, dated today.  The U.K. health system adopted these charts last year.

Not sure what the WHO growth charts are?  Here's the scoop, from a post I wrote in 2007:

Until recently the growth charts used by pediatricians were based on a sample of all formula-fed, all Caucasian babies born between 1929 and 1975 in Ohio.  These babies also often started solid foods before four months.  I recently learned that these charts were used around the world to chart babies' growth.  More recently, in 2000, the CDC released a chart using a mixed sample of breastfed and formula-fed infants.  It yielded similar problems (explained below).

Research from the early 1990's demonstrated that breastfed and formula-fed babies have different growth patterns.  The most significant differences are that breastfed babies grow faster than formula-fed babies in the first few months, and then "lean out" compared to formula-fed babies between 3 and 12 months.  

So, if you try to chart a breastfed baby's growth using the formula-fed charts, you might see a baby who is falling off of the curve after the first 2 months.  This sometimes resulted in recommendations that mothers supplement with formula.  It also meant that formula-fed babies who were experiencing excessive weight gain in later months - and at risk of later overweight and obesity - were viewed as normal and no interventions were recommended. 

The new WHO charts use a sample of nearly 9,000 babies who were exclusively or nearly exclusively breastfed for the first six months.  The study methodology is described in detail here.  To me, the most interesting finding is that, when factors like malnutrition, socio-economic status, and maternal smoking are controlled for, growth of children around the world is quite similar.

The WHO is clear that these charts are not intended to apply just to breastfed babies.  They can serve as an important early warning to doctors if a formula-fed baby is experiencing excessive weight gain - a particular concern because formula-fed babies are at risk for overweight and obesity.  The WHO states, "Arguably, the current obesity epidemic in many developed countries would have been detectable earlier if a prescriptive international standard had been available 20 years ago."

With the CDC's endorsement, I think we can expect providers to finally start using these charts.  And you can now discuss the use of these chart with your pediatrician with the backing of the CDC. This is a huge step forward.

Here are links to the WHO charts:

• Chart for girls, birth to two years, showing percentiles (pdf)
• Chart for boys, birth to two years, showing percentiles (pdf)
• A calculator for converting pounds to kilos, which you'll need to use the charts.  Remember to first convert ounces to fractions of a pound - i.e. 6 lbs 8 oz = 6.5 lbs.
• Other charts, including height for age and body mass index for age
• Frequently asked questions about the new charts (particularly helpful if your pediatrician has questions)
• A video on the development of the new growth charts
• Software your pediatrician can use to implement the new charts

A few expressions I could live without

"When is she going to start real food?"  Breastmilk is real food.

"I didn't have any milk yet, just colostrum."  Colostrum is milk.  It just doesn't look like cow's milk.

"Is she a good baby?"  This baby?  No, she robs banks.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Motherwear's fall line is here!

 
Motherwear's fall line is out this week, and I'm sharing some of my favorite items below. 

Shown are the Floret Top, the Sydney dress, the Tatoo Tee, Northwest Tunic, and the Whimsy Floral Top. 

I also like (and own) the Yogini Tee, now in a new color.

 

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Eating on the run

One skill I never mastered with my son - actually never really attempted to learn - was nursing in a sling while walking around. 

Now, I do have the excuse that the sling options seven years ago were pretty limited.  We had a Dr. Sears Nojo sling (which was a no-go for us), a Bjorn, and later an Ergo.  There wasn't too much more than that available then, at least as far as I knew at the time.

But now, oh my.  There really isn't any excuse anymore considering the plethora of options.  And we have indulged in many of them: a ring sling, mei tai, wrap, soft structured carrier are all sitting in a carrier basket in our living room, and we use them all the time.

Not only that, but Meg, our region's babywearing expert, has been shadowing me at a breastfeeding group I run (note to moms in my area - this is huge bonus of coming to the group), and does free weekly sling clinics at a local store.  So I'm going to give it the old college try. 

I thought I'd post this video of Kate, the owner of a the local store where Meg works, teaching how to nurse in a ring sling in two positions - a cradle carry and hip carry.  A few years ago I also posted a video of Meg teaching how to nurse in a pouch sling.

How about you?  Can you feed your baby on the run?

 

Neither rain, nor sleet, nor gloom of night...

We've been on Cape Cod for the last week with family.  But with Hurricane Earl headed toward the Cape, we decided to leave a little early.  

My son was very disappointed at the idea of missing the sight of trees falling on cars.  We got back late last night.

As you can imagine, it can be hard to get off of the Cape if everyone else is leaving too, and I really didn't want to get stuck on the road in a huge backup with a crying 3 month old. 

But what I would worry about more than that is how to feed a baby during a big evacuation.  Where to buy formula, clean water, and how to heat it if you're stuck on the highway?  Fortunately I didn't have to give that a second thought.

The experience reminded me of a story a friend (I'm forgetting who - if you're reading this, please feel free to identify yourself!) who was breastfeeding and who was caught in a power outage.  Her neighbor ran over to make sure that she and the baby were alright, presumably concerned that the baby couldn't be fed without electricity. 

Fortunately for us, no batteries are required.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Summertime nursing

Summer is fast fading...  Here we are nursing at the beach, blueberry picking, at Tanglewood, and in the backyard.

    

About last night

There's a new morning ritual in my house.  At breakfast we all try to reconstruct where everyone slept the night before.

The night usually starts off with everyone in their assigned sleep spaces:  Husband and me in the bed, baby in the co-sleeper, 7 year old on the bottom bunk of his bunk bed in his room.

Then, in the middle of the night, something like this happens:

Midnight:  Baby wakes to nurse, stays in the bed.

1:00 am:  I can't sleep, move to the top bunk of my son's bed.

2:00 am:  Baby needs to nurse again, I move back to our bed.

2:30 am:  Seven year old moves to our bed.  We are now four in a queen size bed.*

3:00 am:  I move to the bottom bunk of my son's bed.

3:30 am:  Son moves to bottom bunk of his bed, to sleep with me.

5:00 am:  Baby needs to nurse again.  I move back to our bed, then go back to top bunk of son's bed.

7:00 am:  Everybody wakes up.  I can't put together a complete sentence until at least noon.

One night I woke up partially sleeping in the co-sleeper.  I repeat: I slept in the co-sleeper.

Fortunately this is not what it looks like every night.  But it 's not at all what it was like when my son was a baby. I have the distinct feeling of being pursued all all night.

Note that my husband is the only one who stays put.  But he also does all the nighttime diaper changes and trips to the potty with my son, bless him. 

Sound familiar to anyone?

* Yes, I am aware that having siblings in the bed with a baby this age is not considered safe co-sleeping.  Our son stays on the opposite side of one of us from the baby.