1. 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/

2. 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

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

4. 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

5. Goal of the survey ( )
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

6. 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

7. 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 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:
length and head circumference
1991 – weight and weight/length

8. 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

9. Results I.
- Czech children are taller

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

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

12. Comparison of Czech reference charts and charts of Czech breastfed infants

16. 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.