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Feds Seek Spurt in Use of New Growth Charts

Old formulas still used despite update

MONDAY, Jan. 7, 2002 (HealthDayNews) -- Just like ear infections and runny noses, growth charts have long been a common sight in pediatricians' offices, but few parents knew their kids were being compared to a select group of middle-class children from Ohio.

Now, more than a year after new growth charts were introduced, federal officials are stepping up efforts to convince pediatricians to throw out the inaccurate old ones.

The government is "explaining why it's better, why you should switch," says Cynthia Ogden, an epidemiologist with the Centers for Disease Control and Prevention (CDC).

Doctors plot the age and weight of children on a growth chart; they also use head circumference measurements for babies. Doctors can tell if children fall within normal growth ranges, and track them over time.

"If they are gaining weight too rapidly or losing weight, falling off the curve, that would be a big red flag," says Dr. Paul Stricker, a pediatrician who specializes in sports medicine at Scripps Clinic in San Diego.

Growth isn't a simple matter of steady gains in height and weight. Children go through two major growth spurts between the ages of 4 and 6, and again in puberty, Stricker says. In some cases, children may need medical treatment if they grow too slowly or too quickly.

The old growth charts were designed in 1977, and were based on mostly white children from the Midwest who were studied between 1929 and 1975, Ogden says.

Researchers didn't take into account the country's ethnic diversity, and most of the children studied were bottle-fed, not breast-fed. Children grow at different rates, depending on how they are fed, and an estimated 50 percent of all babies are breast-fed at some point.

The new charts, released in 2000, reflect the fact that children have different ethnic and economic backgrounds, Ogden says.

It's not clear how many doctors are using the new charts, but it appears that some have not yet switched, Ogden explains. So the government decided to publish the charts in the January issue of the journal Pediatrics, along with an explanation about how they have changed from the 1977 versions.

Among other things, the new charts include information about body-mass index, a gauge that combines height and weight to determine whether someone is fat. Body-mass index charts are included for children aged 2 to 20. The previous charts included information about obesity, but only for younger children.

What To Do

Learn more about the new growth charts from the CDC.

To learn more about diseases that may affect a child's growth, check out the MAGIC Foundation.

SOURCES: Interviews with Cynthia Ogden, Ph.D., epidemiologist, Centers for Disease Control and Prevention, Hyattsville, Md.; Paul Stricker, M.D., pediatrician, San Diego; January 2002 Pediatrics
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