DOWN SYNDROME
PCHR insert
for babies born
with Down syndrome
(Third Edition, June 2011)
© Down Syndrome Medical Interest Group (2011)
The Children’s Centre, City Hospital Campus,
Hucknall Road, Nottingham NG5 1PB
Tel: 0115 8831158 Fax: 0115 8831146
Email: [email protected]
http://www.dsmig.org.uk
Down Syndrome
Medical
Interest
Group
All rights are reserved. No part of this
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retrieval system, or transmitted in any
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photocopying, recording or otherwise
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addressed to the publishers
Printed and Supplied by:
Harlow Printing Limited
Maxwell Street ● South Shields
Tyne & Wear ● N33 4PU
Tel: 0191 455 4286
Email: [email protected]
1
INTRODUCTION
DOWN SYNDROME
The following pages are extra pages for your baby’s Personal Child Health Record Book
(PCHR) which is issued to all new babies in the UK. These extra pages have been produced
by the UK Down Syndrome Medical Interest Group (DSMIG UK). They are for babies who
are born with Down syndrome. They give additional information which will help you
maintain the health and well being of your child. They include special growth charts for boys
and girls with Down syndrome.
Babies and young children with Down syndrome have just the same needs as any child. You
should take your baby for routine child health checks and immunisations in the usual way.
(see main PCHR).
It is not possible in this small booklet to cover all topics relevant to your child’s health and
well being. Your local healthcare team, or one of the agencies listed at the end of this insert
will be able to provide more information. You will also find more detailed information written
specifically for parents in the Department for Education Early Support materials. Information
on how to access this can be found under “Early Support”, in the Sources of Help and Advice
section on page 14. A wide range of information for healthcare professionals can be found
on the DSMIG website. (www.dsmig.org.uk)
2
Down syndrome insert © DSMIG 2011
DOWN SYNDROME – CHILD DEVELOPMENT
There is no such thing as a typical child with Down syndrome. Children with the syndrome
are as different from each other as are all children. However, by and large, their development
is slower than that of most children. The charts which follow give the usual developmental
progress of children with the syndrome. By understanding what is usual for a child with
Down syndrome you will be able to recognise any additional problems at an early stage.
Down syndrome insert © DSMIG 2011
DOWN SYNDROME
Many parents like to record developmental ‘firsts’ on the pages provided in the main PCHR.
You may also like to use the Early Support Programme Developmental Journal for Babies
and Children with Down Syndrome. Information on how to access this can be found under
“Early Support”, in the Sources of Help and Advice section on page 14. You can download
this publication or order it free of charge.
3
DOWN SYNDROME – DEVELOPMENTAL MILESTONES
Finding out about moving
DOWN SYNDROME
Activity
Children with Down syndrome
Typical Children
Average age
Range
Average age
Range
Holds head steady
when sitting
5 months
3-5 months
3 months
1-4 months
Rolls over
8 months
4-12 months
5 months
2-10 months
Sits alone
9 months
6-16 months
7 months
5-9 months
Stands alone
18 months
12-38 months
11 months
9-16 months
Walks alone
23 months
13-48 months
12 months
9-17 months
Adapted with permission from Cunningham. Down Syndrome: An Introduction for Parents and Carers (3rd Edition). 2006. Souvenir Press
4
Down syndrome insert © DSMIG 2011
DOWN SYNDROME – DEVELOPMENTAL MILESTONES
Finding out about hands
Follows objects
with eyes
Reaches out and
grasps objects
Passes objects
hand to hand
Builds a tower of
2 cubes
Copies a circle
Children with Down syndrome
Typical Children
Average age
Range
Average age
Range
3 months
1.5-6 months
1.5 months
1-3 months
6 months
4-11 months
4 months
2-6 months
8 months
6-12 months
5.5 months
4-8 months
30 months
14-32 months
15 months
10-19 months
48 months
36-60 months+
30 months
24-40 months
DOWN SYNDROME
Activity
Adapted with permission from Cunningham. Down Syndrome: An Introduction for Parents and Carers (3rd Edition). 2006. Souvenir Press
Down syndrome insert © DSMIG 2011
5
DOWN SYNDROME – DEVELOPMENTAL MILESTONES
Finding out about words
DOWN SYNDROME
Activity
Responds to
sounds
Babbles “Da-da”
and “Ma-ma”
Responds to
simple instructions
First words spoken
with meaning
2-word phrases
Children with Down syndrome
Typical Children
Average age
Range
Average age
Range
1 month
0.5-1.5 months
0 month
0-1 month
7 months
4-8 months
4 months
2-6 months
16 months
12-24 months
10 months
6-14 months
18 months
13-36 months
14 months
10-23 months
30 months
18-60 months+
20 months
15-30 months
Adapted with permission from Cunningham. Down Syndrome: An Introduction for Parents and Carers (3rd Edition). 2006. Souvenir Press
6
Down syndrome insert © DSMIG 2011
DOWN SYNDROME – DEVELOPMENTAL MILESTONES
Finding out about people
Children with Down syndrome
Typical Children
Average age
Range
Average age
Range
2 months
1.5-4 months
1 months
1-2 months
11 months
9-16 months
8 months
5-13 months
20 months
12-30 months
12 months
9-17 months
Dry by day
36 months
18-50 months+
24 months
14-36 months
Bowel control
36 months
20-60 months+
24 months
16-48 months
Smiles when
talked to
Plays pat-a-cake or
peek-a-boo
Drinks from an
ordinary cup
DOWN SYNDROME
Activity
Adapted with permission from Cunningham. Down Syndrome: An Introduction for Parents and Carers (3rd Edition). 2006. Souvenir Press
Down syndrome insert © DSMIG 2011
7
DOWN SYNDROME - HEALTH PROBLEMS
DOWN SYNDROME
Children with Down syndrome do not on the whole have health problems which are different from those
which can affect any child. Some have very good health whilst some seem to have more than their fair share
of illness. Because some problems occur more often among those with the syndrome all should have some
extra health checks (see next section) so that if there is a problem it can be identified and treated as quickly as
possible.
Heart problems
About half of all children with Down syndrome are born with some sort of heart problem but less than one in
five have a serious problem. It is important however to identify any serious problems in the first 2 months
because early treatment may be needed. If the checks we recommend are carried out nearly all serious problems
can be identified before a child is six weeks old. If these checks are done and your child is given a clean bill of
health then he/she is very unlikely to develop a heart problem during childhood.
Vision and hearing problems
Children with Down syndrome are particularly likely to develop hearing problems and long or short sight. It is
very important to identify these early on because they can easily be treated. If not treated they can affect your
child’s developmental progress.
Thyroid problems
The thyroid gland is more often underactive in children with Down syndrome than in other children. If this
happens your child’s development will slow down unless treatment is given. Treatment is simple and effective.
Regular blood tests need to be done to see if this sort of problem is developing.
Constipation
Constipation is a common problem in children with Down syndrome. In most cases it is not due to any
underlying bowel problem and can be managed as it would be in any child. If it has been a problem since
birth, is severe and persists despite simple measures, then other causes such as Hirschsprung’s disease or an
under active thyroid should be considered and discussed with your Doctor or health visitor.
8
Down syndrome insert © DSMIG 2011
Breathing
Children with Down syndrome may be more susceptible to respiratory infections for a variety of reasons
including reduced immunity, feeding difficulties, gastro-oesophageal reflux and heart or airway problems.
Treatment will focus on tackling these causes, often in combination. Some children also develop irregular
breathing and poor quality sleep due to sleep related breathing difficulties. This may need to be checked with
sleep studies.
DOWN SYNDROME
Teeth
Teeth do not necessarily come at the same time or in the same order as other children. As with all children
dental hygiene is important and children should visit their dentist regularly.
Blood disorders
Children with Down syndrome should have their blood count checked at birth as many children will have
differences in the make up of their blood, and a few may need treatment.
Neck problems
You may hear mention of children with Down syndrome having neck problems. This is very rare and does not
require routine screening. However if there are symptoms suggestive of a problem, these may need
investigation and treatment. Possible warning signs are pain behind the ear or in the neck, or holding the head
and neck in an odd position.
Other conditions
It is not possible in this small booklet to cover all the conditions which may occur more frequently in children
with Down syndrome. Those discussed above are some of the most common. Any concerns you may have
about your child’s health should be discussed with your local health professionals. But remember, although a
few children seem to have more than their fair share of health problems others enjoy good health.
Down syndrome insert © DSMIG 2011
9
FEEDING
Many babies with Down syndrome feed just as well as other babies but there are also quite a few who have
difficulties, particularly in the first few weeks.
DOWN SYNDROME
The most common problems are:
- your baby falls asleep soon after starting feeding so doesn’t take enough.
- your baby may have a weak suck.
- that the coordination of sucking, breathing and swallowing has not yet matured so your baby gets tired
and distressed and again he/she ends up not getting enough milk.
These problems usually get better after the first few weeks but can be very worrying for parents at the time.
If your baby does have these problems you can help by feeding little and often until feeding settles down to
normal. You may even need to wake your baby up at night to feed.
If you had decided to breast feed your baby before he/she was born don’t change your mind just because
he/she has Down syndrome. Most mothers who want to, do breast feed their babies successfully although
efficient breast feeding may take longer to establish. Breast feeding support groups such as La Leche League
and the National Childbirth Trust provide useful information, some of it specifically about feeding babies with
Down syndrome.
If your baby has the early feeding problems mentioned above you may find it helpful to express breast milk for
a time and use this to feed your baby. You can then go back to breast feeding as soon as your baby is mature
enough to cope. Similarly, if you are advised to give up breast feeding because of poor weight gain it may be
worth expressing for a few weeks in case changing to formula makes no difference to weight gain. Your health
visitor or breast feeding expert will be able to advise you about these issues.
A few children with Down syndrome have difficulties with feeding at later stages of development - for instance
when moving on to solids. If this happens your Health Visitor will be able to advise and you may need more
specialist help from a Speech & Language Therapist.
Remember though, many babies and children with Down syndrome feed just as well as other children.
10
Down syndrome insert © DSMIG 2011
DOWN SYNDROME - IMMUNISATIONS AND CHILD HEALTH CHECKS
Immunisations
Children with Down syndrome may be particularly susceptible to infections therefore it is very important they
have the same immunisations as everyone else (see immunisation section in the main PCHR). For some children,
particularly those with heart problems, additional immunisations may be recommended, for instance to protect
against seasonal flu and bronchiolitis.You can discuss this with your GP, Paediatrician, Health Visitor or Practice
Nurse.
DOWN SYNDROME
Child health checks
You will find information about routine child health checks in the main part of your PCHR. Your child should
be included in just the same way as other children in your area. It is also advisable for children with Down
syndrome to have a few extra tests or checks.
The next page tells you in the first column what sort of extra health checks (thyroid, eyes, hearing, growth,
heart, breathing, blood) are needed. The other four columns tell you at what age these should be carried out.
Details are given about the actual tests or procedures advised. Your GP or Health Visitor will be able to explain
these to you.
Different areas organise their child health services in different ways so the schedule will not always be followed
precisely. However if you think that your child has missed out on one of these checks take this book along to
your GP or Health Visitor or Paediatrician and ask if you can have the checks carried out.
Down syndrome insert © DSMIG 2011
11
DOWN SYNDROME - SUGGESTED SCHEDULE OF HEALTH CHECKS
The following are suggested ages for health checks. Check at any other time if there are parental or
other concerns.
Birth - 6 weeks
Thyroid blood
tests
DOWN SYNDROME
Eye checks
Hearing
checks
Growth
monitoring
Heart checks
Breathing
checks
Blood checks
Special checks
under 2 years
Preschool checks
School age
Newborn routine
heel prick - blood spot
test
From age 1 year thyroid function should be discussed annually using results
of either
● Annual fingerprick TSH test OR
● 2 yearly thyroid blood tests, including thyroid antibodies
Newborn routine check
Age 18-24 months:
Age 4 years:
Repeat vision test every
including congenital
Formal eye and vision
Formal eye and vision
2 years, or more
cataract check
examination including
examination including
frequently if
check for squint, and
check for squint.
recommended by
refraction for long or
Refraction and
optometrist or
or short sight
assessment of near and
ophthalmologist
distant vision and visual
acuity
Visual behaviour to be monitored at every review particularly in first year
Universal newborn
Full audiological review
Annual audiological
2 yearly audiological
hearing screen
by 10 months including
review as before
review or more frequently
hearing test and
if recommended
impedance check
Length, weight and head circumference should be
Height and weight should be checked and plotted
checked frequently and plotted on Down syndrome
on Down syndrome growth charts at least annually
growth charts
while growing.
(BMI checked if concern regarding overweight)
By age 6 weeks, formal
At all ages low threshold for reviewing heart status if
From adolescence
heart assessment including signs or symptoms develop
onwards as part of routine
Echocardiogram
health checks listen to
heart for signs of acquired
heart disease
Enquire at every review for uneven breathing during sleep and poor quality sleep.
Low threshold for further testing using sleep studies
Newborn blood test to
check for abnormal blood
film
If blood film is abnormal in first 6 weeks, follow up or
repeat blood testing may be necessary until age 5
Detailed recommendations for Medical Surveillance Essentials for children with Down syndrome can be found at www.dsmig.org.uk
12
Down syndrome insert © DSMIG 2011
DOWN SYNDROME - RECORD OF HEALTH CHECKS
Please ask you Doctor and /or Health Visitor to write down the result of thyroid, eye, hearing, growth, heart,
breathing and blood checks on this page.
Age
Type of Test
By whom or
where
Result (please enter actual figures where possible)
DOWN SYNDROME
Date
Down syndrome insert © DSMIG 2011
13
SOURCES OF HELP AND ADVICE
(In case of difficulty contacting the organisations listed below, please check the Links page at www.dsmig.org.uk for updated information).
DOWN SYNDROME
Down Syndrome Association (DSA)
Langdon Down Centre, 2a Langdon Park,
Teddington TW11 9PS.
Tel: 0845 230 0372 (Mon – Fri 10am – 4pm)
Fax: 0845 230 0373
Email: [email protected]
http://www.downs-syndrome.org.uk
(Regional offices in Wales and
Northern Ireland)
Down Syndrome Scotland
158/160 Balgreen Road,
Edinburgh EH11 3AU.
Tel: 0131 313 4225 Fax: 0131 313 4285
Email: [email protected]
http://www.dsscotland.org.uk
Down Syndrome Ireland
Citylink Business Park, Old Naas Road,
Dublin 12.
Tel: (00353) 1 426 6500
Fax:(00353) 1 426 6501
Email: [email protected]
http://www.downsyndrome.ie
Down Heart Group
Advice and support for families with children
with heart problems.
PO Box 4260, Dunstable, Beds. LU6 2ZT.
Tel: 0844 288 4800 Fax: 0844 288 4808
Email: [email protected]
http://www.dhg.org.uk
Down Syndrome Education
International (DSE)
Advancing the development of children with
Down syndrome worldwide.
The Sarah Duffen Centre,
Belmont Street, Southsea. PO5 1NA.
Tel: 023 92 85 5330 Fax: 023 92 85 5320
Email: [email protected]
http://www.dseinternational.org/en/gb/
14
Down Syndrome Medical Interest
Group (DSMIG)
A network of doctors and nurses with a
specialist interest in Down syndrome.
Information Service,
The Children’s Centre,
City Hospital Campus,
Hucknall Road,
Nottingham NG5 1PB.
Tel: 0115 8831158 Fax: 0115 8831146
Email: [email protected]
http://www.dsmig.org.uk
Contact a Family
209-211 City Road
London EC1V 1JN
Tel: 020 7608 8700 Fax: 020 7608 8701
Helpline 0808 808 3555 for parents and
families (Mon-Fri 9.30 am– 5.00pm)
Email: [email protected]
http://www.cafamily.org.uk
(Local and regional offices, family workers
and volunteer parent representatives
throughout the UK.)
Early Support
Free information resources for families in
England, who have a disabled child under 5
years of age. There are two publications
about Down syndrome, specifically,
• Information for Parents: Down
Syndrome
• Developmental Journal for Babies and
Children with Down Syndrome
These can be located by entering “Down
Syndrome” in the search box at:
http://publications.education.gov.uk/.
Both publications can be downloaded.
Alternatively if you register with the website,
http://www.education.gov.uk/publications.
or telephone 0845 60 222 60, they can be
ordered free of charge.
MENCAP
Supporting people with a learning disability
and their families and carers. Offices in Wales
and Northern Ireland.
123 Golden Lane, London EC1Y 0RT.
Helpline: 0808 808 1111
Tel: 020 7454 0454 Fax: 020 7608 3254
Email: [email protected]
http://www.mencap.org.uk
ENABLE Scotland
Support for people with learning disabilities
in Scotland.
2nd Floor, 146 Argyle Street,
Glasgow G2 8BL.
Tel: 0141 226 4541 Fax: 0141 204 4398
Email: [email protected]
http://www.enable.org.uk
Local services:
There may be a local group of the DSA in
your area. DSA head office will provide
information.
Child health care is provided in most areas
through the community paediatric services
and child development centres (CDCs). Your
GP and/or health visitor will be able to tell
you how to get in touch.
Your local social services department will also
be able to give information about local
provision. You will find their number in the
phone book.
For information about obtaining further
copies of this insert contact:
Harlow Printing Limited,
Maxwell Street, South Shields,
Tyne & Wear NE33 4PU.
Tel: 0191 455 4286 Fax: 0191 427 0195
Email: [email protected]
http://www.harlowprinting.co.uk
Down syndrome insert © DSMIG 2011
9.5
6
7
8
9
10
1
8.5
2
3
12
13
14
15
16
17
3
18
19
20
21
4
22
23
24
25
5
9.5
th
99.6
Age in weeks/ months
Weight (kg)
0–6 months
9
11
2
9
4
98th
8
8.5
8
91st
7.5
7.5
75th
7
6.5
Some degree of weight
loss is common after birth,
see instructions.
Weight (kg)
6
e
w
5.5
h
.6t
99
5
h
98t
99.6th
98th
4.5
t
91s
4
50th
6.5
25th
6
5.5
9th
5
2nd
4.5
0.4th
4
75th
91st
75th
t
h
ig
7
50th
3.5
3.5
25th
50th
3
9th
2nd
2.5
2.5
0.4th
2nd
0.4th
3
9th
25th
2
2
1.5
1.5
Age in weeks/ months
1
1
0
1
2
3
4
2
5
6
7
8
3
9
10
11
12
13
4
14
15
16
17
1
5
18
19
20
21
22
23
24
25
DOWN SYNDROME GROWTH CHARTS
5
Boys Down
syndrome
5
Boys Down
syndrome
72
6
7
8
9
10
1
68
2
3
12
13
14
15
16
17
3
18
19
20
21
4
22
23
24
25
5
72
th
99.6
Age in weeks/ months
Length (cm)
0–6 months
70
11
2
70
98th
4
68
91st
66
75th
64
64
50th
62
58
6th
99.
56
h
98t
54
62
h
t
g
n
le
60
Length (cn)
DOWN SYNDROME GROWTH CHARTS
66
25th
60
9th
58
2nd
56
0.4th
54
t
91s
52
52
h
75t
h
50t
50
50
h
25t
48
48
9th
46
46
2nd
44
44
h
0.4t
Age in weeks/ months
42
1
0
1
2
3
4
2
5
6
7
8
3
9
10
11
12
13
4
14
15
16
17
42
5
18
19
20
21
22
23
24
25
48
16
18
22
24
5
26
28
6
30
32
34
7
36
38
8
40
42
9
44
46
10
48
50
11
52
49
99.6th
48
98th
47
91st
46
45
75th
45
44
50th
44
25th
43
9th
42
2nd
41
Age in weeks/ months
Head Circumference (cm)
0–1 year
47
2
46
4
6
8
10
12
d
a
e
h
43
42
41
Head Circumference (cm)
20
4
40
39
0.4th
40
39
th
.6
99
38
38
th
98
37
37
st
91
36
36
th
75
35
35
th
50
34
34
th
25
33
33
h
9t
32
d
2n
32
31
h
4t
0.
31
30
30
Age in weeks/ months
29
1
0
2
4
2
6
8
3
10
12
4
14
16
5
18
20
22
6
24
26
7
28
30
8
32
34
9
36
38
10
40
42
44
11
46
48
50
29
52
DOWN SYNDROME GROWTH CHARTS
14
Boys Down
syndrome
49
16 17
Boys Down
syndrome
24
23
22
Weight (kg)
6 months to 4 years
21
7
8
19 20 21 22 23
11/2
25 26 27 28 29
31 32 33 34 35
21/2
2
37 38 39 40 41
43 44 45 46 47
31/2
3
23
Age in months/ years
22
9 10 11 12 13 14 15
th
99.6
20
19
98th
21
20
19
18
18
91st
17
16
75th
t
h
g
i
e
w
15
14
Weight (kg)
DOWN SYNDROME GROWTH CHARTS
24
th
99.6
13
98th
12
t
91s
11
75th
10
50th
9
25th
50th
15
13
9th
12
2nd
11
0.4th
10
9
8
2nd
7
16
14
25th
9th
8
17
7
0.4th
6
6
5
5
4
4
3
3
Age in months/ years
2
1
1 /2
1
1
6
7
8
9 10 11
13 14 15 16 17
2 /2
2
19 20 21 22 23
2
1
25 26 27 28 29
3 /2
1
3
31 32 33 34 35
37 38 39 40 41
43 44 45 46 47
1
16 17
100
Length/Height (cm)
6 months to 4 years
7
8
9 10 11
96
19 20 21 22 23
11/2
25 26 27 28 29
37 38 39 40 41
43 44 45 46 47
31/2
3
th
99.6
Age in months/ years
98th
13 14 15
1
75th
88
6th
99.
84
h
98t
t
91s
80
h
75t
h
50t
76
104
100
91st
92
Height (cm)
31 32 33 34 35
21/2
2
g
n
e
l
t
h
g
i
e
h
/
h
t
50th
25th
96
92
88
9th
2nd
0.4th
84
80
76
h
25t
72
72
9th
2nd
68
68
h
0.4t
64
64
60
60
56
56
52
52
Age in months/ years
48
1 /2
1
1
6
7
8
9 10 11
13 14 15 16 17
21/2
2
19 20 21 22 23
25 26 27 28 29
31 32 33 34 35
48
31/2
3
37 38 39 40 41
43 44 45 46 47
DOWN SYNDROME GROWTH CHARTS
104
Boys Down
syndrome
100
95
7
8
9
10
11
12
13
14
15
16
17
Age in years
h
99.6t
Weight (kg)
4-18 years
5
100
95
90
6
98th
85
85
80
80
91st
75
70
75
70
75th
65
60
50
45
40
th
98
35
st
91
30
h
75t
50th
t
h
g
i
e
w
55
99
.6
th
Weight (kg)
DOWN SYNDROME GROWTH CHARTS
90
Boys Down
syndrome
h
25t
9th
2nd
h
0.4t
7
8
40
15
Age in years
6
45
20
10
5
50
25
9th
2nd
0.4th
15
55
30
25th
20
60
35
h
50t
25
65
9
10
11
10
12
13
14
15
16
17
18
170
7
8
9
10
11
5
16
17
99.6th
175
98th
170
75th
150
145
140
h
h
.6t
99
135
Hiehgt (cm)
15
6
155
th
98
130
st
91
125
t
h
g
i
e
155
9th
2nd
0.4th
145
140
130
125
120
115
9th
110
d
2n
105
150
135
th
25
110
160
25th
th
50
115
165
50th
th
75
120
DOWNSINSERT
14
91st
160
June 11
13
Height (cm)
4-18 years
165
Manufacture 1
12
Age in years
105
th
0.4
100
100
95
95
90
90
85
85
Age in years
80
4
5
6
7
8
9
10
11
12
13
14
15
16
17
80
18
DOWN SYNDROME GROWTH CHARTS
Boys Down
syndrome
175
5
Girls Down
syndrome
7
8
9
10
1
8.5
2
13
12
14
15
16
17
3
18
19
20
21
4
22
23
24
25
5
9.5
Age in weeks/ months
Weight (kg)
0–6 months
9
11
2
th
99.6
3
4
9
8.5
98th
8
7.5
8
7.5
91st
7
7
75th
Some degree of weight
loss is common after birth,
see instructions.
6.5
Weight (kg)
6
6.5
t
h
eig
5.5
h
99.6th
98t
4.5
t
91s
98th
4
6
25th
w
6th
99.
5
50th
5.5
9th
5
2nd
4.5
0.4th
4
75th
91st
75th
50th
50th
3.5
3
2nd
2.5
2.5
0.4th
2nd
0.4th
3
9th
25th
9th
3.5
25th
2
2
1.5
1.5
Age in weeks/ months
1
1
0
1
2
3
4
2
5
6
7
8
3
9
10
11
12
13
4
14
15
16
17
1
5
18
19
20
21
22
23
24
25
DOWN SYNDROME GROWTH CHARTS
9.5
6
5
Girls Down
syndrome
70
6
7
8
9
10
1
66
2
3
12
13
14
15
16
17
3
Length (cm)
0–6 months
68
11
2
18
19
20
21
4
22
23
24
25
5
70
th
99.6
Age in weeks/ months
68
98th
4
66
91st
64
75th
62
62
50th
h
t
ng
60
58
56
h
98t
54
91st
52
60
25th
le
th
99.6
Length (cn)
DOWN SYNDROME GROWTH CHARTS
64
58
9th
2nd
56
0.4th
54
52
h
75t
50th
50
50
25th
48
48
9th
46
46
2nd
0.4th
44
44
42
42
Age in weeks/ months
40
1
0
1
2
3
4
2
5
6
7
8
3
9
10
11
12
13
4
14
15
16
17
40
5
18
19
20
21
22
23
24
25
14
47
Girls Down
syndrome
46
Head Circumference (cm)
0–1 year
45
2
4
6
18
16
20
4
8
10
22
24
5
26
28
6
30
32
34
7
36
38
8
40
42
9
44
46
10
48
50
47
98th
46
Age in weeks/ months
91st
12
45
75th
44
52
11 99.6th
44
43
d
a
e
h
42
41
40
Head Circumference (cm)
43
39
38
42
9th
41
2nd
40
0.4th
39
th
.6
38
th
37
st
36
99
37
25th
98
36
91
th
75
35
35
h
0t
5
34
34
h
5t
2
33
33
h
9t
32
32
d
2n
31
31
h
4t
0.
30
30
Age in weeks/ months
29
1
0
2
4
2
6
8
3
10
12
4
14
16
5
18
20
22
6
24
26
7
28
30
8
32
34
9
36
38
10
40
42
44
29
11
46
48
50
52
DOWN SYNDROME GROWTH CHARTS
50th
16 17
Girls Down
syndrome
24
23
1 /2
22
Weight (kg)
6 months to 4 years
21
7
8
19 20 21 22 23
1
25 26 27 28 29
31 32 33 34 35
2 /2
1
2
37 38 39 40 41
43 44 45 46 47
23
Age in months/ years
th
9.6
9
h
98t
19
20
19
18
91st
17
18
17
75th
16
15
t
h
g
i
e
w
th
99.6
14
Weight (kg)
22
21
9 10 11 12 13 14 15
20
DOWN SYNDROME GROWTH CHARTS
24
3 /2
1
3
13
98th
12
t
91s
11
75th
50th
16
15
14
25th
13
9th
12
2nd
11
0.4th
10
50th
10
9
25th
9
8
9th
8
2nd
7
7
0.4th
6
6
5
5
4
4
3
3
Age in months/ years
2
1 /2
1
1
1
6
7
8
9 10 11
13 14 15 16 17
19 20 21 22 23
2
21/2
2
25 26 27 28 29
31/2
3
31 32 33 34 35
37 38 39 40 41
1
43 44 45 46 47
16 17
104
Girls Down
syndrome
100
Length/Height (cm)
6 months to 4 years
7
8
9 10 11
96
19 20 21 22 23
1 /2
1
25 26 27 28 29
31 32 33 34 35
2 /2
1
2
37 38 39 40 41
43 44 45 46 47
3 /2
1
3
104
th
99.6
Age in months/ years
98th
13 14 15
91st
1
100
96
92
88
th
84
.6
99
8th
9
Height (cm)
80
t
91s
h
75t
76
h
50t
g
n
le
t
h
g
i
e
h
/
h
t
50th
25th
88
9th
84
2nd
0.4th
80
76
h
25t
72
92
72
9th
2nd
68
68
h
0.4t
64
64
60
60
56
56
52
52
Age in months/ years
48
1 /2
1
1
6
7
8
9 10 11
13 14 15 16 17
21/2
2
19 20 21 22 23
25 26 27 28 29
31 32 33 34 35
48
31/2
3
37 38 39 40 41
43 44 45 46 47
DOWN SYNDROME GROWTH CHARTS
75th
100
95
90
Girls Down
syndrome
7
8
9
10
11
12
13
14
15
16
17
h
99.6t
Age in years
Weight (kg)
4-18 years
5
100
95
90
6
85
85
80
80
91st
75
70
75
70
75th
65
60
Weight (kg)
DOWN SYNDROME GROWTH CHARTS
98th
50
th
6
9.
9
45
th
98
40
st
35
60
t
h
g
i
e
w
55
91
50th
55
25th
50
45
9th
40
2nd
35
0.4th
h
75t
30
65
30
h
50t
25
25
25th
9th
2nd
0.4th
20
20
15
15
Age in years
10
5
6
7
8
9
10
11
10
12
13
14
15
16
17
18
165
160
Height (cm)
4-18 years
155
5
7
8
9
10
11
12
13
14
15
16
17
Age in years
99.6th
98th
6
t
h
g
i
e
h
150
145
140
th
.6
135
99
th
98
130
t
165
160
91st
155
75th
150
50th
145
25th
140
9th
2nd
0.4th
135
130
s
91
Hiehgt (cm)
125
th
125
th
120
75
120
50
th
25
115
115
9th
110
th
June 11
DOWNSINSERT
105
Manufacture 1
110
d
2n
105
0.4
100
100
95
95
90
90
85
85
80
80
Age in years
75
4
5
6
7
8
9
10
11
75
12
13
14
15
16
17
18
DOWN SYNDROME GROWTH CHARTS
Girls Down
syndrome
MEASUREMENT RECORD
DOWN SYNDROME GROWTH CHARTS
Date
Age
Ht/Lth
Wt
H/C
Signature
Date
Age
Ht/Lth
Wt
H/C
Signature