Weight monitoring of breastfed babies in the UK – centile charts, scales and weighing frequency

Abstract

Weighing infants during their first 6 months is an important focus of growth monitoring and a common activity of child health care services worldwide. In these same months, health workers provide support for breastfeeding and promote continued exclusive breastfeeding. The literature on the practice of weighing breastfed babies is reviewed, as it applies to the United Kingdom. The shape of the growth curves for breastfed babies differs from that of formula-fed infants and also from centile charts previously in use. The World Health Organization commitment to the production of a new growth reference has generated discussion of the implications of charts in use. The country-specific charts in use in the UK are examined and the data used to construct them discussed with reference to clinical use for breastfed infants. Recent UK discussions on charts, as well as on the frequency of routine weighing for babies in the community are considered, and the available evidence on the accuracy of weighing in practice is noted. The choices made in constructing different charts; the physical condition of scales and their use in practice have implications for plotted growth. This paper aims to present a wide range of evidence available in this area in order to encourage debate on practice. A companion paper will discuss issues of interpretation, conveying information to parents, and interventions.

A meta‐ethnographic synthesis of women's experience of breastfeeding

“…2000; Kelleher 2006) and/or repeatedly checking and rechecking, detaching and reattaching the baby in their effort to achieve that picture perfect ‘latch’. In addition, the focus on the science of breastfeeding, results in an obsession with weighing babies to seek confirmation that optimum growth is being achieved (Dykes & Williams 1999; Sachs et al. 2005).…”

Untitled

“…This chart (the UK90) includes data from babies who were breastfed initially, as well as some who were not, and some for whom no feeding data were provided. Some of the data are longitudinal and some cross-sectional and all were initially collected for other purposes [23,24]. This chart is likely to represent optimum breastfed baby growth less well than the new WHO chart, but not to present as poor a fit as the previous international chart.…”

Untitled

“…Midwives appeared to see offering to weigh the baby as a key way of supporting, whereas B f N supporters were quite wary of weighing. The wariness on the part of the B f N supporters to weighing may reflect a more in depth knowledge of the challenges that weighing may create to breastfeeding women, as recently summarised by Sachs et al [43,44]. B f N supporters also placed more emphasis upon responding to baby cues rather than using more instrumental approaches such as the measurement of external parameters to ascertain well-being and growth.…”