Nigel Hawkes, Health Editor
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Thousands of women are inadvertently overfeeding their babies because ministers and health advisers have delayed the introduction of new child growth charts.
The charts, produced by the World Health Organisation (WHO), have been available for more than a year, but the Government has made no decision on when to introduce them, Tam Fry, of the Child Growth Foundation, said.
The new charts are based exclusively on breast-fed babies, who grow more slowly in the first year of life. The charts currently in use classify many breast-fed babies as underweight, encouraging their mothers to take to bottle-feed-ing. This helped to create overweight children and to fuel the obesity epidemic, Mr Fry said.
“Ministers keep on saying breast is best but they’ve done nothing about it,” Mr Fry said. “It wouldn’t cost them a brass farthing – the charts are free. We’ve had two committees . . . who have spent a year not making up their minds. Finally they resorted to a public consultation. Now that has finished and still the Department of Health has no idea when a decision will be made.”
Health experts and nutrition-ists welcomed the charts, which are based on a study of 8,500 breast-fed babies in Brazil, Gha-na, India, Norway, Oman and the US between 1997 and 2003.
The difference between these and the existing charts, which were based on Britain’s experience before 1990 and were weighted towards bottle-fed babies, is striking. Breast-fed babies have a growth spurt in the early weeks and are ahead of the growth chart at 12 weeks. But then they start to put on weight more slowly so that at 52 weeks the average breast-fed baby is about half a kilogram – more than 1lb – lighter than the chart indicates.
“Introducing these charts will shift a quarter of the babies from below the average weight at one year to above the average weight,” Mr Fry said. “It means that many fewer babies will be referred for ‘failure to thrive’ and lots of women will go on breast-feed-ing longer, because they won’t be discouraged.”
The evidence is that breast-fed babies are less likely to become overweight infants, so a rise in breast-feeding is likely to have an impact on obesity.
A joint expert group from the Scientific Advisory Committee on Nutrition and the Royal College of Paediatrics and Child Health was set up by the department to give advice. It concluded that the WHO study “provides a hitherto unsurpassed foundation for a growth standard being based on healthy children living in conditions that favoured the achievement of full genetic potential”.
The variations between countries in the study were insignificant, so the charts would be representative of babies in Britain.
Last month Bert Koletzko, a researcher from the University of Munich, told a conference in Budapest that the old growth charts “have skewed infant nutrition towards overfeeding for decades”.
Peter Aggett, of the University of Lancaster, a member of the expert group that reviewed the WHO charts, said that mothers who were told about the new charts were relieved because they were often pressured by health visitors to feed their babies more.
A spokeswoman for the Department of Health said: “The expert group hopes to issue recommendations to UK health departments by the end of June.”
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I'm currently being advised by health visitors to top up my 8 month old baby with formula. She is 14lb7oz (4lb10 at birth). She is bonny, healthy, active and so happy, but she has only put on 7oz in 4 weeks and they are not happy with that amount. She eats 3 solid meals a day and has 4 breast feeds. They want me to just breast feed am and pm then give her formula in the day. I hate that growth chart, dread having her weighed and I feel like i'm failing as a new mum. Having read this article I'm tempted to not give her the formula - but if she doesn't put on the weight what will they say when i next go to have her weighed??
Claire Chatterton, Evesham, Worcestershire, United Kingdom
My baby is 5 months old and weighs only 10lb 14oz (6lb 13oz at birth), I am so glad I found this article because every time I take my daughter to be weighed, the Health Visitors suggest giving her a 'bottle' or trying to increase her feeds. I've exclusively breast fed her from brith, and her weight gain has been so slow, teetering on the bottom line on the graph, so her weight has kind of become an obsession for me because of the pressure I get from the Health Visitors. These new charts are well overdue because people think my baby is tiny for her age, but she is the most contented baby I have ever seen, never had a cold, she's hitting all the developmental targets on time and is generally a really happy baby. As they say 'breast is best' but with all this pressure to have a chubby baby, I can see why many mothers move onto formula. But I've come this far and I'm not switching!!
Andrea, HULL,
I was told by a midwife at a Breast feeding support group to top up my daughter with formula when she was 4 months old. The reason being that she had dropped 2 centiles on the dreaded graph. She did not take into account that my daughter weighed in at a hefty 10lbs 4oz. If she had of continued to gain weight according to the graph she would have been enormous and I would have been told off for allowing my child to become so big. Luckily she was my 4th child and I had breast fed the others who were healthy, inteligent teenagers, so I took no notice and walked away never to return. It is young and first time mothers who I feel sorry for as they do not have the experience or know what to expect. I think that many are bullied by medical staff who do not seem to understand the concept of breast feeding in the first place. To top up with formula actually causes a decrease in the amount of milk produced by the mother. I am still feeding my daughter who is 4 and tall for her age !
Tania, Runcorn, Cheshire
About time too. I was bullied beyond believe by my Health Visitor to give a formula top up or start weaning at 4 months because my son had started to gain less weight after 3 months per week than before. He was in excellent health & very happy, alert & slept well. I stood up to them & ignored their advice, sadly other monthers I know introduced formula top ups & then before they knew it where completly on formula. My son looks the picture of health, he is now 8 months, eats very well, is still breastfed & will be till he choices otherwise. We where stopped in a restuarant last week by 2 paedeatricians who wanted to pass comment on how helthy my son looked! Cant get better than that. I am pleased I went with my opinion & stood up to the bullies, it just upsets me when other mothers are bullied into decisions they are not happy with.
Ann, Southampton, England
These WHO charts are long overdue. I'm a breastfeeding counsellor and see many women give up on breastfeeding because they mistakenly think that they are unable to produce enough milk.
The vast majority of women are able to breastfeed exclusively for the first six months if they are given the correct information and adequate emotional and physical support.
It is ironic that once out of infanthood there is a problem with obesity while babies are forcefed artificial formula made from milk desiged for a different species.
barbara, Ilkley,
The whole idea of following a graph is ridiculous quite frankly - after all the babies haven't read them!
Follow the baby, not the book. If your baby is happy, alert, has plenty of wet and dirty nappies, you don't have much to worry about regardless of whether they're a skinny minnie or a chunky monkey. Babies have a pretty good way of telling you what they need and your body provides accordingly. Try telling my son breastmilk isn't good enough!
And Mr Dikstr - I, for one, think it is wonderful that your wife is feeding your 4 year old. If only more mothers fed for longer, we'd have less prejudice for a start.
J Nunn, Glasgow, Scotland
I agree with Keith, babies who are allowed to feed on demand will take as much as is required to reach their genetically pre-destined weight. My 3 children were all breast-fed. Maria (now 14 and a perfect weight) was breast-fed exclusively only for 3 months, as was the recommendation in those days. Danny and Anita were breast-fed exclusively for 6 months. They both weighed exactly 10.7 kilos at their 6 month check-up. (All 3 of mine were chubby breast-fed babies!) So not all breast-fed babies are smaller, even though this is the norm. Genetics does play a part.
Lynne, Valencia, Spain
I don't think you will ever see a "Chubby Baby" that's fed on breast milk, and lets face it "Breast is Best" if you can manage it!
Target weights for Babies, should not put pressure, on a Woman that's "Breast Feeding" as long as "Baby is Healthy" and "Mummy is Happy" that's all that matters!
Charles Linskaill, Edinburgh, UK
There seems to be a misunderstanding. The article does not suggest that mothers should exclusively breastfeed. Nor have we done so. Formula milk, normal milk and solids were all introduced in our toddler's diet along the way. But she prefers her mother's milk above all.
About half a year ago there was an article in the Timesonline about mothers in the UK who breastfeed for up to 6 or 8 years, or am I mistaken?
Sitz Dikstr, Sneek, Netherlands
If breastfeeding mothers were misled, then I wish I was misled earlier! These officials who preach that breastfeeding is good for the baby have probably never breastfed exclusively. I found that many friends and even health professionals lied about breastfeeding often stating that they breastfed; I later realised that admitting to breastfeeding meant that they probably did it once a week! I breastfed exclusively and I feel my baby suffered for it. She lost a lot of weight as she would have nothing but breast milk. Whilst I was happy to oblige, it broke my heart to see her lose so much weight. When I sought to introduce solids at 6 month, she refused most foods and even refused formula milk too! I feel my baby lost out on been introduced to food. I am told that there are benefits to breastfeeding but I did not see it and still do not see it. When I have my next baby, I will most certainly be misled and will offer my baby formula milk at the earliest opportunity.
Annie, Cambridge, UK
A case of mother knows best and nanny state got it wrong. But as a mother who did (not for 4 years I hasten to add, which no ofence Mr Dikstr I personally find distasteful) feed both my children myself and feel vindicated for not worrying that they were not putting on weight the way the charts suggested. However I would like to point out that parents today are damed for what they do, dammed for what they do not do and are quite fed up with being blamed for all of societies ills and I for one am so guilt ridden that I feel I can take no more, so take this new guilt and.....!
Catriona Straine-Urquhart, Edinburgh, UK
The whole concept of feeding by graph is ridiculous.
Babies will take as much milk from their mother as they need - they're not reticent in making their requirements known, after all. Identifying a baby as over- or under-weight is a facile process that can only lead to overriding a baby's instinctive judgment. Force-feeding or withholding milk based on a chart of perceived norms isn't healthy.
Keith, Wirral, Merseyside
This is unbelievably good news.
My wife has been breastfeeding for 4 years. And ever since our lovely baby daughter was one year we have been nagged because her weight was below average.
But she looks perfectly healthy to us.
Her friends however, who are on supposedly normal weight, look rather "bulky" to us.
Also, our toddler never has even the slightest cold, while all other children in the village have all sorts of minor illnesses allt he time. The good effect of the antibodies in mother's milk?
Sitz Dikstr, Sneek, Netherlands