The new "breast from birth" growth charts. An updated version of the paper given at the Primary Care Conference and Exhibition, May 2003.

The Child Growth Foundation has published the first weight reference charts specifically designed for the breast-fed infant. Based on a sample of 120 long-term British breast-fed babies, the charts demonstrate the particular growth pattern of breast-fed babies. This differs from formula-fed infants in that breast-fed babies initially gain weight more rapidly, but from two to three months of age their weight gain decreases and they begin to move downwards across centiles. At present breast-fed babies are measured against the standard British 1990 weight reference chart rather than one that reflects the pattern of the long-term breast-fed baby. The author, Tam Fry from the Child Growth Foundation, argues that the new charts will prevent mothers and health professionals from becoming anxious and changing the infant from breast to formula milk when growth begins to slow down. He also suggests that the charts could be used as the reference for all British babies, whatever the means of feeding.

Screening at school entry: vision, hearing and growth.

Tam Fry of the Child Growth Foundation criticises the new recommendations for screening at school entry in the 2003 edition of Health for all Children. He argues that proposals to reduce preschool surveillance make the school entry screening even more important for detecting deviations from the normal, especially in vision, hearing and growth. This surveillance needs to be rigorously performed, yet a shortage of school nurses and optometrists makes this less likely to happen. The author argues that even though there may be insufficient evidence for retaining current preschool screening programmes, there is also insufficient evidence to show that severely curtailing them will not cause harm.