The 2009 UK-WHO charts for children aged 0–4 years were developed by the Royal College of Paediatrics and Child Health (RCPCH)1,2, using WHO growth standards (Box 1)2. This article discusses how growth might affect long-term health, summarises key features of the 2009 charts, and reports on current experiences with these charts in everyday practice (obtained from informal interviews with seven Healthcare Professionals who are working with the charts).Box 1: The new UK-WHO charts – background information
A study was undertaken by the World Health Organization in Brazil, Ghana, India, Oman, Norway and the USA, to identify optimum growth patterns. There were very strict inclusion criteria. For at least the first 4 months, infants were predominantly breast fed (cool, boiled water was the only alternative), mothers could not smoke cigarettes during pregnancy or lactation and could not be separated from their infants. The families studied came from a wide spectrum of socio-economic, genetic and cultural backgrounds.
These data were used by the Royal College of Paediatrics and Child Health (RCPCH) as the basis for the new UK-WHO Growth Charts.
The new charts reflect optimum growth and development, not typical growth and development, and show a slower pattern of growth, particularly from 4 months.
In practical terms, this means the old 0.4th centile is equivalent to the 2nd centile. A baby classified as of ‘average’ weight and length (i.e. on the 50th centile) on the previous chart will now be classified as on the 70th centile. Potentially, up to 20% more children could be classified as overweight or obese, although none of the Healthcare Professionals interviewed for this article had observed this, to date.