Use of the Who Growth Standards in the United States

In April of 2006, the World Health Organization (WHO) released a new international growth standard for young children birth to 5 years of age. The CDC 2000 growth reference, currently in use in the United States, describes growth of U.S. children from birth to 20 years of age. The CDC and WHO growth charts differ in their overall approach to describing growth, in that the CDC charts are designed to be a growth reference (growth in a particular place and time) whereas the WHO charts are designed to be a growth standard (physiological growth under optimal environmental conditions). In June 2006, the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the American Academy of Pediatrics (AAP) convened an expert panel to discuss the potential use of the WHO growth charts in clinical settings in the United States. The panel discussed the use of growth charts in clinical settings, considerations of using a U.S. reference or an internationally derived standard, differences between breast and formula fed infants, and practical implications of using the WHO charts. Care was taken to consider the longitudinal portion of the WHO standards (birth to 2 years) separately from the cross-sectional portion (2-5 years). This talk will discuss current deliberations on whether and how the WHO standards should be applied in the U.S.