When is a baby too fat? New guidelines lower the bar (statesman.com)

Parents are notoriously obsessive over how their babies stack up on the growth charts pediatricians use. Now, new guidelines from the World Health Organization are prompting a debate over how big a healthy baby should be.

WHO, the United Nations' health agency, is urging every country to adopt its growth charts, which aim to show how children ideally grow in their first five years of life. The guidelines also include for the first time measurements for body mass index, or BMI, for babies younger than 2 — a weight and height calculation used to determine whether people are overweight or underweight. (Currently, BMI doesn't appear on U.S. growth charts before age 2.)

But the charts — and particularly the new BMI standards — are raising concerns that worries about obesity will be pushed into infancy, a time when adequate nutrition is crucial for brain development and other important growth. Pediatricians and health officials in the U.S. say they aren't sure whether the WHO guidelines should be adopted in this country.

One reason is that the WHO growth curves are based on babies who were breast-fed for at least a year, while the American charts are based on children who were primarily formula-fed after the first few weeks. Formula-fed children tend to be bigger than breast-fed children in late infancy. Another difference: The WHO charts are based on children from affluent, educated families in six countries. The U.S. charts are based on a broader sample of U.S. children.



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