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Baby health and safety
You are looking at: Home : Baby health and safety

Growth charts based on breastfed babies

Every new baby has a chart against which his progress is measured, and now these have changed to encourage more mums to breastfeed

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Posted: 22 May 2009
by Laura Lee Davies

Breastfeeding and steady baby weight gain.
Babies who are breastfed put on weight at a slower, more healthy rate.

At birth, all babies are given a health record book in which there are many different pages to help keep track of immunisations, weight changes and other developmental and health landmarks. In the early months of your baby’s life, this book is very important to you, as gauging your child’s growth is a key indicator that he is well and that he is drinking enough milk.

In the past the charts, which show average growth for all babies, have been plotted according to average measurements of babies fed predominantly on formula milk. However, this is now changing so that in the future the charts will show average figures for breast-fed babies.

Why do the charts need to change?

Growth charts are used for all babies, whether they are breastfed or formula fed, and formula-fed babies put on weight more quickly than breastfed ones, making the old charts’ average weight measurements heavier. This means that often breastfed babies on the old charts looked as though they weren’t thriving as well as formula-fed children.

The World Health Organisation (WHO), through extensive research over many years, advises that the best possible start to life is for babies to be breastfed for the first six months. The Organisation were therefore concerned that the old growth charts would make parents opt for formula feeding to push their babies up to or above the average.

Expert Tip

The new UK-WHO growth charts will help healthcare professionals and parents to identify early signs of overweight or obesity and provide support.

Dr Sheila Shribman, Department of Health

Instead, WHO wants parents to understand the risks from longer term obesity which increase for formula-fed babies. Research shows that breast-fed babies tend to gain weight at a healthier pace and are less likely to become obese in later life. So the new charts are based on the weight of breast-fed babies to bring these averages down.

How the change will work

The new charts will encourage breastfeeding as the most regular way to feed a new baby and will be included in Personal Child Health Record books, which parents of every newborn are given. Tracking weight from birth up to four years, they will help parents spot the early risk of obesity and provide important reassurance about the slower weight gain of breast-fed babies.
 
The new charts include easy-to-follow instructions plus a chart specifically for premature babies. As babies can lose and gain weight at different rates in the first two weeks, it is recommended that they are not measured during this time. The charts also help make more reliable predictions of a child's adult height.

The NHS have made a video explaining the new charts, which you can see online by clicking here.

How growth charts are used


  • You are encouraged to keep in regular contact with your local health visitor, who can see from weighing sessions, how your baby is growing.
  • Remember to take your Personal Child Health Records book along with you every time you visit the baby clinic or your GP.
  • It is not always easy to see if your baby is getting enough milk during a feed, especially with breastfeeding or with babies who are a little bit sick after a feed (this is called ‘possetting’), so a growth chart is a good way to gauge if your child is thriving.
  • It is important for all parents to remember that a child is always measured on the growth chart according to his or her own progress. That is, if your child is large or small, there is a line he or she should follow upwards. It is not a question of bouncing up to a higher growth line if your child is naturally smaller than another mum’s baby.

Mum’s story

"Growth charts reassured me"

“My son was doing well on breastmilk but I was ill and needed an operation when he was six weeks old. While we were in hospital together he also picked up a cold, and I was so disappointed to see that by seven weeks his weight hadn’t gone up. But given that we’d been through a tough week, we stuck at breastfeeding, and he started putting on weight again. He’s a healthy toddler now, but having those little dots plotted regularly on his growth chart through the first year really reassured me.”

Beth, 34, mum to Frankie, 2



breastfeed, growth, development, milk, newborn, weight, growth chart, weight gain
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So what do you think?

Brian Steele

My wife and I have been saying this for ages.  We know a  number of people who were forced to bottle feed their babies because their breastfeeding had left them "underweight".

In our experience of four babies, all of which required a few initial days in hospital for my wife, they plaster maternity units with "breast is best" propaganda, but the midwives are so busy that they cannot spare the time to help people.  The fourth time, we were victims of a new "voluntary" blood sugar protocol that left us ordered to give our baby supplementary bottles.  When we remonstrated with them, they relented and said we could put him on a drip instead.  Eventually found out the blood sugar readings were wrong anyway.

Also overheard a paediatrician saying to a mother: "Don't tell the midwives I said this, but I reckon you should just bottle feed your baby.  It would save a lot of trouble."

What can you do?

About 3 years ago
audrey1234
i never worried about my children being 'underweight' as i know they were feeding enough, and too many children are too fat nowadays anyway. About 3 years ago
alison greene
I am breastfeeding my 4th and unfortunately my old health visitor (who was fab and used to say ignore the growth charts as you are a good breastfeeder) has left. The new health visitor seems obsessed with the baby graphs and doesn't like the fact I am also still allowing my toddler to have some feeds as well.
How can I tell if the growth charts in the book I have are the old stylee ones or the ones for breast fed babies. There was a bit of a threat yesterday when she said if the weight didn't start going on faster by the next vacs "we will have to do something". I assume she means add bottle feeds. But all my babies were like this and my latest is putting on weight and seems healthy and happy.
About 2 years ago
audrey1234
Alison, it is your baby, and surely they can't make you add bottle feeds.  Just go above her head if she is presurrising (sp) you too much.  My first child was always underweight, and she is now 9 years old, and still very underweight (on the 9th centile).  I got her assessed by the school nurse.  I think she is just going to be skinny. (unlike me) About 2 years ago
Jeanette Sayer

The charts are so silly. They should be used as a guide but for some reason some H.V.'s place too much importance on them. We can see how our babies are developing and know from their feeding and general being if they are thriving. I understand less experienced parents (and we were all there at some point) might need extra help but the charts just seem to breed anxiety (so and so has dipped or so and so is on the wrong centile). I don't have enough fingers to count the amount of times I have had to reassure friends and my sister because their babies (mostly breastfed) weren't following the expected development as set out on the charts. A chart in the red books for breastfed babies is well over due, I agree with Brian and his wife that women are getting mixed messages "breast is best" but the support network is not there and the charts add insult to injury. There should be two charts for reference so both breast feeding and bottle feeding parents can follow the guides but we should remember that all babies are individuals and they will not always stick to a chart.

Unfortunately it seems that midwives and H.v.'s don't have the time or resources to support breast feeding. I remember really struggling with my son and I was in great pain. The visiting h.v. wasn't much use and she recommended I go to a support group at my local sure start centre. The problem I had was struggling to feed a newborn and looking after a toddler with no family or friends around in the daytime. Coordinating a trip out at an allocated time just wasn't going to happen!. I soldiered on, sought advice from websites and my trusted guide books, stayed in a lot! and with the support of my husband and a lot of patience I managed to feed him well and I continued to feed him sucessfully until his first birthday. I couldn't establish breastfeeding with my daughter and I expressed for 6 weeks as I felt so strongly that I wanted to feed myself. After all I had just spent the last 9 months being bombarded with  breast feeding "propaganda", if only the support was there I might have been able to feed properly, I was inexperienced and riddled with guilt. I spent the first month of my daughter's life worrying about doing the right thing and doing my best for her that I lost sight of the fact that she was healthy and developing normally and all the problems I had were to do with what I felt were my own shortcomings.

I am so thankful for these kind of discussions because hopefully we can help and reassure each other. It's so unfortunate that paid health care professionals can not always do the same. There are some really good Midwives and health visitors out there but there is a serious lack of funding and resources in the NHS and most new parents are not able to get the help that they need. It's sad to hear that some women feel bullied into breast feeding in the first place and some feel bullied into changing to formula. I think personal choice and support is key. If only we could have that.

About 2 years ago
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