Implications of adopting the WHO 2006 Child Growth Standard in the UK: two prospective cohort studies

• Published in: Archives of disease in childhood Vol. 93; no. 7; pp. 566 - 569
• Main Authors: Wright, C, Lakshman, R, Emmett, P, Ong, K K
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.07.2008; BMJ; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Age; Aging - physiology; Anthropometry - methods; Babies; Biological and medical sciences; Birth Weight; Body mass index; Body Weight; Breastfeeding & lactation; Child Health; Child, Preschool; Children & youth; Childrens health; Cohort Studies; General aspects; Growth; Humans; Infant; Infant, Newborn; Infants; Longitudinal studies; Medical sciences; Miscellaneous; Obesity - diagnosis; Original; Physical growth; Physiology; Prevention and actions; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Reference Values; Studies; Thinness - diagnosis; United Kingdom; Weight control; Weight Gain; World Health Organization; Young Children; United Kingdom; Europe; United Kingdom > UK; England; Human; Pediatrics; 2006; Growth; Follow up study; Cohort study; Standard; Somatic growth; Child; Standards; Public health; WHO
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.2007.126854

Background:The WHO 2006 Child Growth Standard is based on data from international optimally nourished breastfed infants from birth to age 5 years.Objective:To assess the potential effect of its use on weight and growth monitoring of UK children.Participants:Full-term members of two population-based UK birth cohorts: the Children in Focus sub-cohort of the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 1335) and the Gateshead Millennium Baby Study (GMS; n = 923).Design:Growth data from birth to 5 years were converted into z-scores relative to the WHO 2006 standard.Results:Compared with the WHO standard, both UK cohorts had higher birth weights (mean z-scores: GMS, 0.17; ALSPAC, 0.34) and ALSPAC had higher birth lengths. After birth, length showed a good fit at all ages. By 2–4 months, both cohorts were similar in weight to the WHO median (mean WHO weight z-score at 4 months: GMS, 0.01; ALSPAC, −0.07), but thereafter the UK cohorts were heavier (mean WHO weight z-score at 12 months: GMS, 0.57; ALSPAC, 0.65). At age 12 months, the risk of being classified as underweight (weight <2nd centile) was considerably lower according to the WHO standard than by the UK 1990 Growth Reference (RR = 0.15, 95% CI = 0.07 to 0.32), and the risk of being classified as obese at 4–5 years (body mass index >98th centile) was slightly increased (RR = 1.35, 95% CI = 1.02 to 1.78).Conclusions:Adoption of the WHO 2006 Growth Charts would set a markedly lower standard of weight gain beyond the age of 4 months for UK infants and could support efforts to avoid future childhood obesity. However, the WHO standard is not representative of size at birth in the UK.