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Breastfeeding and Infant Growth: Biology or Bias?

Infants following World Health Organization (WHO) recommendations for prolonged and exclusive breastfeeding appear to show a fall-off in weight and length in the first year of life compared with the existing WHO/Centers for Disease Control and Prevention (CDC) reference,1 which is based on predominantly formula-fed infants. Previous studies are fairly consistent in showing a downward trajectory in z scores beginning at 2 or 3 months until 12 months, with considerable but not complete catch-up by the age of 24 months.2–11 The data for length-for-age z scores generally follow the same pattern, although the magnitude of the z score deficit for length is lower.2–11 Based on this evidence, WHO is currently developing a new international infant growth reference based on infants who follow WHO feeding recommendations

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