Will introducing the new World Health Organization growth reference to Australia reduce breastfeeding rates: why not a randomised controlled trial first?

Aim: The aim is to review the implications of the introduction of new World Health Organisation (WHO) growth reference into Australia, and in particular its potential effects on breastfeeding rates in the first six months of life.

Methods: A review of the velocity and trajectory of growth in the new WHO Growth Reference compared to the growth references most commonly used in Australia.

Results: The World Health Organisation has recommended the universal use of its new growth reference. However, in the first 6 months of life, the critical period for the maintenance of breastfeeding, the new WHO reference is heavier than the reference previously used in Australia. This may mean that more infants will be classified as having poor growth. It is likely that these infants will be given additional feeds or even may cease being breastfed. Maintenance of breastfeeding is important for minimising short-, medium- and long-term risks.

Conclusions: Before the introduction of a new growth reference is contemplated, a randomised controlled trial should be conducted to be sure that there will be no adverse effect on breastfeeding.