title: Anthropometric indices and exclusive breastfeeding in the first six months of life: a comparison with reference standards NCHS, 1977 and WHO, 2006.
abstract: BACKGROUND
  There is a gap in knowledge on the growth of children exclusively breastfed during the fifth and sixth months of life. This study aimed to assess the growth of infants who were exclusively breastfed for the first 6 months of life and compare the distributions of anthropometric measures based on the National Center for Health Statistics (NCHS, 1977) and World Health Organization (WHO, 2006) curves.
  
  
  METHODS
  Cross-sectional study that measured the weight and length of 360 healthy and exclusively breastfed infants who were enrolled in a primary care program in Belem, Brazil from October 2006 to December 2008. The children were evenly grouped into age groups from 1 to 6 months of age.
  
  
  RESULTS
  The mean weights were higher than the NCHS, 1977 mean weight for all of the studied groups regardless of gender and showed greater similarity to the WHO, 2006 mean weight, especially when standard deviations were considered. Regarding length, although the average length at birth was smaller, females had higher averages in the second and sixth months compared with the reference curves (p < 0.05).
  
  
  CONCLUSIONS
  Exclusive breastfeeding in the first 6 months of life provides adequate physical growth, resulting in height and weight gain curves that are similar to or greater than the NCHS, 1977 and WHO, 2006 curves. The greater mean weight at the fifth and sixth months of life suggests that the second-quarter growth curves of children who are exclusively breastfed are greater than those of children who receive other types of food.
authors.affiliation: Discipline of Pediatrics Specialties, Department of Pediatrics, Escola Paulista de Medicina/Universidade Federal de São Paulo (UNIFESP/EPM), Sao Paulo, SP Brazil.
authors.forename: Rosa de Fátima da Silva Vieira
authors.initials: Rde F
authors.lastname: Marques
authors.affiliation: Discipline of Nutrology, Department of Pediatrics, Escola Paulista de Medicina/Universidade Federal de São Paulo (UNIFESP/EPM), Sao Paulo, SP Brazil.
authors.forename: José Augusto de Aguiar Carrazedo
authors.initials: JA
authors.lastname: Taddei
authors.affiliation: Discipline of Nutrology, Department of Pediatrics, Escola Paulista de Medicina/Universidade Federal de São Paulo (UNIFESP/EPM), Sao Paulo, SP Brazil ; Department of Health Sciences, Universidade de Santo Amaro (UNISA), Sao Paulo, SP Brazil.
authors.forename: Tulio
authors.initials: T
authors.lastname: Konstantyner
authors.affiliation: Discipline of Nutrology, Department of Pediatrics, Escola Paulista de Medicina/Universidade Federal de São Paulo (UNIFESP/EPM), Sao Paulo, SP Brazil.
authors.forename: Fábio Ancona
authors.initials: FA
authors.lastname: Lopez
authors.affiliation: Hospital do Servidor Público Municipal (HSPM), Sao Paulo, SP Brazil.
authors.forename: Affonso Celso Vieira
authors.initials: AC
authors.lastname: Marques
authors.affiliation: Universidade Federal do Pará (UFPA), Belém, Brazil.
authors.forename: Consuelo Silva
authors.initials: CS
authors.lastname: de Oliveira
authors.affiliation: Discipline of Pediatrics Specialties, Department of Pediatrics, Escola Paulista de Medicina/Universidade Federal de São Paulo (UNIFESP/EPM), Sao Paulo, SP Brazil.
authors.forename: Josefina Aparecida Pellegrini
authors.initials: JA
authors.lastname: Braga
keywords: Breastfeeding; Growth; Growth charts; Infant; Infant nutrition