World Health Organization International Growth Standards/Growth Charts

1
World Health Organization International Growth
Standards/Growth Charts

• Seven Minute Overview

2
World Health Organization Growth Standards/
Growth Charts

• For this presentation we will
• Introduce the WHO growth chart
• Discuss recommendations and adoption of the WHO
  International Growth Standards
• Compare and contrast infant growth charts (CDC
  versus WHO)
• Discuss strategies to reinforce consistent
  messages that help parents understand how their
  infant or child is growing and make referrals for
  growth concerns

3
Worldwide Recommendation

• Use the WHO growth standards charts to monitor
  growth for
• (infants and children 0-24 months of age)

4
Overview of the WIC Program

• In California, services are provided
• Via 84 local agencies
• By 3,600 local staff
• To 1.48 million people per month
• To almost 60 percent of all infants born in the
  State

5
Rationale for Change
To base growth assessments on

• A growth standard not a point on a reference
  chart.
• The growth of healthy children living in optimal
  environments.
• Breastfeeding until 12 months of age

6
WHO International Study Revealed
When provided optimal conditions Children grow
the same on average. It does not matter where
they live.
Brazil
Ghana
India
Norway
Oman
USA
7
WHO Standards Reflect Breastfeeding as the Norm

• In general, breastfed infants grow more
• quickly the first 3 months
• slowly 3-12 months
• than formula-fed infants

8
Comparison of Infant Growth Charts
CDC Growth Category References WHO Growth Standards
Underweight 5th Percentile lt 2nd Percentile
Height weight 95 Percentile for length gt98th Percentile
Short Stature 10th Percentile 2nd Percentile
9
Impact of Using WHO Standards

• For age 0-24 months
• 2nd versus lt5th percentile
• Fewer diagnosed as underweight

• 98th versus gt95th percentile
• Fewer diagnosed as high weight

10
Consistent Messages
11
Understanding Infant Growth
Under- weight
Healthy weight
High Weight-for Length
At risk of underweight

2
5
98
50
12
Understanding Child Growth
99
13
References and Tools

• Centers for Disease Control and Prevention
  http//www.cdc.gov/nccdphp/dnpao/growthcharts/who/
  index.htm
• www.cdc.gov/mmwr
• World Health Organization website
• http//www.who.int/childgrowth/training/en/
• WIC WHO Growth Charts webpage
• www.cdph.ca.gov/programs/wicworks