Recommendations concerning implementation in Poland of WHO Child Growth Standards for children 0-5 years
Rekomendacje dotyczące wykorzystania w Polsce standardów WHO Rozwoju Fizycznego Dzieci w wieku 0-5 lat
Committee of Human Development Polish Academy of Science
Committee of Anthropology Polish Academy of Science
Main Board of the Polish Anthropological Society
Institute of Mother and Child
Institute of Food and Nutrition
World Health Organization in Geneva launched a WHO Multicentre Growth Reference by Study1 carried out in 1997- 2003 six countries: Brazil, Ghana, India, Norway, Oman and USA. The aim of this study was to collect primary growth data that would allow the construction of new growth charts consistant with optimal health practices. Rigorous standardized methods concerning sampling, data collection and procedure for data management were applied. The study population were healthy children aged 0-5 years living under conditions likely to favour achievement of their full genetic growth potential.
Newborns with single term birth and absence of significant morbidity were enrolled at birth. Their mothers did not smoke before and after delivery. Breastfeeding was identified as the biological norm and breastfed child creates the normative model for growth and development.
The results of this multicentre study shows that health of children from around the world grow similarly when their health and care needs are met. It was the basis for development of the WHO Child Growth Standards for children 0-5 years.
It is the tool for assessment of health and nutritional status of infants and young children which can be implemented in different countries, regardless of ethnicity and socioeconomic status. These standards demonstrate “how children should grow” in all countries. Up to now growth references described “how children grew at a particular time and place”.
The WHO Child Growth Standards for children 0-5 years (0-60 months) consist the set of anthropometric sex specific variables, among them: weight-for age, length/height-for-age, body mass index-for-age. For children aged 0-24 months also standards of head circumference and growth velocity standards for weight, length and head circumference were released. The full set of tables and charts is presented on WHO webside (www.who.int/childgrowth/en).
The WHO Child Growth Standards for children 0–5 years were accepted by significant international organization e.g. International Pediatric Association, European Child Obesity Group, European Society for Pediatric Gastoenterology, Hepatology and Nutrition. They were adopted and implemented in more than 100 countries. They are used in systems of preventive surveillance and in clinical medicine in assessment and monitoring young children’s growth, nutrition and health.
Discussion concerning the possibility of implementation of the WHO Child Growth Standards for children 0-5 years in Poland was started during the conference held in Warsaw on 24 June 2009. Participants represented leading in the country centres of anthropology and pediatrics and among of them authors of regional growth references, recognize (by voting) that these standards should be implemented in Poland2. Variable included in these standards were compared with reference indicators for Warsaw children aged 0-5 years. The results of this comparison showed no or very small differences3. On this basis we signed as follows:
1. to recognize that the WHO Child Growth Standards for children 0 – 5 years provide a good tool for assessment and monitoring of growth, nutritional status and health of infants and young children.
2. to recommend these standards for implementation and dissemination in Poland.
Prof. Barbara Woynarowska M.D., PhD – Head of Commission of Indicators of Development, Health and Quality of Life
of Children and Adolescents, Committee of Human Development Polish Academy of Science
Prof. Joachim Cieslik PhD – Deputy President of Committee of Anthropology Polish Academy of Science
Prof. Maria Kaczmarek PhD – President of Main Board of the Polish Anthropological Society
Prof. Krystyna Mikiel-Kostyra M.D., PhD – Head of Department of Protection and Promotion of Children
and Adolescents Health, Institute of Mother and Child
Prof. Jadwiga Charzewska PhD – Head of Department of Nutritional Epidemiology and Dietary Allowances,
Institute of Food and Nutrition
Warsaw, 5 April 2011
1de Onis M., Garza C., Victora C.G., Bhan M.K., Norum K.R. (eds.): WHO Multicentre Growth Reference Study (MGRS): Rationale, Planning and Implementation. Food and Nutrition Bulletin 2004, t. 25 (Suppl), s.1-89.
2de Onis M., Woynarowska B.: Standardy WHO Rozwoju Fizycznego Dzieci w wieku 0-5 lat i mozliwosci ich wykorzystania w Polsce. Med. Wieku Rozwoj., 2010, t. 14, nr, 2, s. 87-94.
3Oblacinska A., Jodkowska M., Mikiel-Kostyra K., Palczewska I.: Ocena rozwoju fizycznego dzieci i młodziezy. Cz. I. Niemowleta i dzieci do 5 lat – normy krajowe czy standardy WHO? Med. Wieku Rozwoj., 2010, t. 14, nr, 2, s. 95-100.