Nutritional status of breastfed infants in rural Zambia: comparison of theNational Center for Health Statistics growth reference versus the WHO 12-month breastfed pooled data set

Cross-sectional data for breastfed infants in rural Zambia were used to eva luate the effect of applying two different data sets as a reference, i.e. t he WHO 12-month breastfed pooled data set and the National Center for Healt h Statistics (NCHS) growth reference in terms of prevalence of malnutrition (stunting, underweight, and wasting). A total of 518 infants who were atte nding mother-and-child health clinics were included. Age, weight and length were recorded. Anthropometric Z-scores were calculated in two ways: by app lying the NCHS growth reference and by using the WHO breastfed data set. An thropometric Z-scores calculated using the breastfed data set were lower du ring the first 6-7 months of life com pared with those calculated by applyi ng the NCHS growth reference. This resulted in a higher proportion of child ren aged 0-6 months being classified as stunted and underweight using the b reastfed data set versus the NCHS growth reference. After the age of 7 mont hs, similar prevalences of stunting or underweight were observed. Relativel y few infants were classified as wasted. In order to adequately assess the prevalence of stunting and underweight in breastfed infants, it is recommen ded that a new growth reference be developed, as has been initialed by WHO.