30th Conference Lactation Counselling October 8, 2011

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Presentation transcript:

30th Conference Lactation Counselling October 8, 2011 Growth of Czech infants breastfed in the 1st year (Growth charts of breastfed infants) Riedlová J.1, Vignerová J.2, Paulová M.2 3rd Faculty of Medicine, Charles University, Prague1 National Institute of Public Health, Prague2 Grant IGA MZ ČR NS9974-4/2008-11

Growth chart Length/ height Weight Weight/height Head circumference Body mass index (BMI) Boys/girls The part of the health and vaccination record Programme GrowthCZ

The possible course of growth related to percentile curves Even growth Arrest of growth Acceleration of growth

Evaluation of weight in the percentile chart Percentile range Evaluation 97 < obese 90 – 97 overweight 75 – 90 robust 25 – 75 adequate weight 10 – 25 slim 3 – 10 low weight < 3 thin

Goal of the survey (2008-11) Compare national growth charts with WHO standards Compare the growth of Czech excl. breastfed infants with Czech growth references Compare the growth of Czech excl. breastfed infants with WHO standards Elaboration of guidelines for evaluation of growth of a breasfed child in collaboration with paediatric associations

Material and Methods Czech infants breastfed at least 4 months Absence of health problems Birth in term, singleton Birth weight more than 2500 g Mother – nonsmoker before and after birth Mother – al least secondary school Socioeconomic conditions does not constrain growth (conditions in accordance with the WHO sample) Measurements at preventive examinations in 18 months Interview with mother + informed consent Records of all measurements from birth – length, weight, head circumference from Health and Vaccination Record of a child

Study design Data collection from 43 pediatricians from March 2009 to May 2010, overall 1775 questionnaires Selection of infants according to WHO criteria  960 infants, 471 boys and 489 girls (11 measurements from every child, i.e. overall 10727 measurements) Percentile charts for particular parameters elaborated Percentile charts of Czech breastfed infants compared with: WHO standards Czech reference data from the Nation-wide Anthropological Surveys: 2001 - length and head circumference 1991 – weight and weight/length

Comparison of Czech reference charts and WHO standards Czech growth charts for infants and children up to 5 years have a different course compared to WHO growth standards

Results I. - Czech children are taller

Results II. - More infants below 3rd percentile according to WHO standards

Results III. Higher risk of preliminary introduction of supplements and complementary foods

Comparison of Czech reference charts and charts of Czech breastfed infants

Conclusion The growth of a breastfed infant is specific. Considering specific growth of a breastfed child (esp. development of weight) it is possible to use current Czech reference charts. Neither Czech reference charts nor WHO growth standards can be used without individual interpretation in accordance with the clinical examination.