1215 Evaluation of Breastfed Infants with Respect to Who Growth Standard: A Meta-Analysis

Aim: Product development of infant formulas is done by randomized clinical trials, which are often containing an observational breastfeeding group for comparison purposes. These breastfeeding groups are tightly followed up in a clinical trial setting which was also the case when developing the WHO standard. Aim of this meta-analysis was to assess heterogeneity of the breastfed infants of the clinical trials with respect to the WHO standard. Methods: Four studies were included in the metaanalysis, over all 192 infants. Population under investigation was healthy term born breastfed infants. The studies were conducted in Italy, Chile and two in France. Main outcome was length for age z-scores at 4 months of age, because WHO has communicated on length for age z-scores in their Multicentre Growth Reference Study (Brazil, Ghana, India, Norway, Oman and USA). The presented statistics is the random effect total and the 95% confidence interval which can interpret as a mean over all studies considering the heterogeneity of the contributing studies. Results: The random effect total in length for age z-scores of the breastfed infants of the clinical trials was 0.04, [-0.19, 0.26]. For the WHO multicenter growth reference study the random effect total was estimated as -0.0164, [-0.1366, 0.1038]. Conclusion: We attribute the difference in totals and the increased heterogeneity to randomness.