PCHR for babies

who have
Down syndrome

DOWN SYNDROME
(Fifth Edition, January 2020)

© Down Syndrome Medical Interest Group (2020)

c/o Staff Library, Duncan Macmillan House,
Down Syndrome All rights are reserved. No part of this
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1
 INTRODUCTION

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 & Ireland). They give
additional information regarding your child’s development and common health issues in
children who have Down syndrome. They also include specific growth charts for boys and
girls who have Down syndrome.
Babies and young children who have Down syndrome have the same needs as any child.
DOWN SYNDROME

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
wellbeing. 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 information for parents in
the Health Series on the Down Syndrome Association website (www.downs-syndrome.org.uk).
A wide range of information for healthcare professionals can be found on the DSMIG
website. (www.dsmig.org.uk)

2 Down syndrome insert © DSMIG 2020

DOWN SYNDROME – CHILD DEVELOPMENT

There is no such thing as a typical child who has Down syndrome. Children who have Down
syndrome are as different from each other as are all children. However, their development
is generally slower than most children. The charts which follow give the usual developmental
progress of children who have Down syndrome. By understanding what is usual for a child
who has Down syndrome you will be able to recognise any additional issues at an early
stage.

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 who have Down Syndrome. Information on how to access this can be found
in the Sources of Help and Advice section on page 15.

Down syndrome insert © DSMIG 2020 3

 DOWN SYNDROME – DEVELOPMENTAL MILESTONES
Finding out about moving

Activity Children who have Down syndrome Typical Children

DOWN SYNDROME

Average age Range Average age Range

Holds head steady 5 months 3-5 months 3 months 1 - 4 months
when sitting
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 2020

DOWN SYNDROME – DEVELOPMENTAL MILESTONES
Finding out about hands

Activity Children who have Down syndrome Typical Children

DOWN SYNDROME
Average age Range Average age Range
Follows objects 3 months 1.5-6 months 1.5 months 1-3 months
with eyes
Reaches out and 6 months 4-11 months 4 months 2-6 months
grasps objects
Passes objects 8 months 6-12 months 5.5 months 4-8 months
hand to hand
Builds a tower of 30 months 14-32 months 15 months 10-19 months
2 cubes
Copies a circle 48 months 36-60 months+ 30 months 24-40 months

Adapted with permission from Cunningham. Down Syndrome: An Introduction for Parents and Carers (3rd Edition). 2006. Souvenir Press

Down syndrome insert © DSMIG 2020 5

 DOWN SYNDROME – DEVELOPMENTAL MILESTONES
Finding out about words

Activity Children who have Down syndrome Typical Children

DOWN SYNDROME

Average age Range Average age Range

Responds to 1 month 0.5-1.5 months 0 month 0-1 month
sounds
Babbles “Da-da” 7 months 4-8 months 4 months 2-6 months
and “Ma-ma”
Responds to 16 months 12-24 months 10 months 6-14 months
simple instructions
First words spoken 18 months 13-36 months 14 months 10-23 months
with meaning
2-word phrases 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 2020

DOWN SYNDROME – DEVELOPMENTAL MILESTONES
Finding out about people

Activity Children who have Down syndrome Typical Children

DOWN SYNDROME
Average age Range Average age Range
Smiles when 2 months 1.5-4 months 1 month 1-2 months
talked to
Plays pat-a-cake or 11 months 9-16 months 8 months 5-13 months
peek-a-boo
Drinks from an 20 months 12-30 months 12 months 9-17 months
ordinary cup
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

Adapted with permission from Cunningham. Down Syndrome: An Introduction for Parents and Carers (3rd Edition). 2006. Souvenir Press

Down syndrome insert © DSMIG 2020 7

 DOWN SYNDROME - HEALTH ISSUES
Children who have Down syndrome have health issues that can affect any child. However, some health issues
occur more often in children who have Down syndrome. It can sometimes be hard to recognise the health
problems and therefore it is recommended to have some extra health checks (see next section) to identify and
manage the condition as soon as possible.

Heart
About half of all children who have Down syndrome are born with a heart problem. It is important to identify
these in the first 2 months, as early treatment may be needed. It is recommended that all children must have
a thorough heart examination, including an echocardiogram, by six weeks of age to enable prompt treatment.
DOWN SYNDROME

Blood
Children who have Down syndrome should have their blood count and blood film checked within the first
three days of birth, to identify any serious blood disorders. A few may need treatment or on-going checks.

Vision and Hearing

Children who have Down syndrome are more prone to have difficulties with their hearing and vision. It is
important to identify these early on, so that appropriate help can be given to minimise the effect of a hearing
or visual impairment on your child’s development.

Thyroid
The thyroid gland is more frequently underactive in children who have Down syndrome. The symptoms of
thyroid disorders can be difficult to spot. An underactive thyroid can affect your child’s growth, learning and
general health. Treatment is simple and effective. It is recommended that your child has an annual blood test
to identify the condition early on.

Constipation
Constipation is common in children who have Down syndrome. In most cases it is not due to any underlying
bowel condition and can be managed as it would be in any child. If constipation is present since birth, or is
severe and persists despite simple measures, then discuss your concerns with your doctor.

8 Down syndrome insert © DSMIG 2020

Toilet training
Children who have Down syndrome are usually toilet trained by the age of 3.5 - 4 years old. If your child is still
in nappies at 4 years old then they need to be seen by a medical specialist to make sure that their bladder and
kidneys are working properly.

Coeliac Disease
Although Coeliac disease (sensitivity to a protein in wheat, called gluten) can occur more frequently in children
who have Down syndrome, routine screening is currently not recommended. Symptoms of Coeliac disease
include bowel problems, tiredness or a change in behaviour. There should be a low threshold for checking for
Coeliac disease and, if your child has symptoms seek advice from your doctor.

DOWN SYNDROME
Breathing
Babies often have nasal congestion. Saline drops and nasal suction can sometimes help. Sleep apnoea occurs
more commonly in children who have Down syndrome. Symptoms of sleep apnoea include gasping
momentarily stopping to breathe or snoring whilst sleeping. It is recommended for all children who have Down
syndrome to have their oxygen levels checked overnight, whilst asleep, at around the age of six months and
then once a year until the age of 5. This is an easy procedure which can be done at home. This is to ensure
that their breathing pattern and oxygen levels are normal.

Infections
Children who have Down syndrome are more vulnerable to chest infections and other serious infections. They
may not show the same signs and symptoms as other children. If you are worried that your child may have a
serious infection seek urgent medical advice so that a serious illness such as sepsis or pneumonia can be
identified and treated early. Your child should receive all childhood immunisations, including the flu vaccine
every year and Pneumovax II at 2 years of age.

Teeth
Baby and permanent teeth often come late and in a different order compared to other children. Gum and
teeth infections can occur more commonly and can be serious. Children should brush their teeth twice a day
and visit a dentist every six months.

Down syndrome insert © DSMIG 2020 9

 Arthritis
Children who have Down syndrome are more commonly affected by arthritis. They may not easily express the
pain that they are experiencing. A change in your child’s ability to perform daily living activities, e.g. in their
handwriting or walking abilities may be an indication of early onset arthritis. Seek advice from your doctor if
your child is experiencing any of these difficulties or if you are concerned.

Neck Instability
Neck instability can occur at any age in children who have Down syndrome and though this is rare, it can be
very serious. Routine neck X-ray screening does not help to detect the problem. Children with neck instability,
usually have warning symptoms e.g. neck pain, holding their head or neck in an odd position or a change in
their motor skills or continence. If your child develops any of these symptoms, seek an urgent medical
DOWN SYNDROME

assessment.

Other conditions
It is not possible in this small booklet to cover all the conditions which may occur more frequently in children
who have 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.

10 Down syndrome insert © DSMIG 2020

FEEDING

Many babies who have Down syndrome feed just as well as other babies. Some babies may have feeding
difficulties, in the first few weeks, especially if they have additional health issues.
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 it
may take longer to establish. You may find it helpful to express breast milk for a time and use this to feed your
baby. You can go back to breast feeding, if and when your baby is able to manage to breast feed. Your health
visitor or a breast-feeding expert will be able to advise you about these issues. Breast feeding support groups
such as La Leche League and the National Childbirth Trust provide useful information, some of it specifically
about feeding babies who have Down syndrome. The organisations listed on page 15 could help put you in

DOWN SYNDROME
touch with local breastfeeding support/or groups in your area.

The most common feeding issues are:

your baby falls asleep soon after starting feeding so doesn’t take enough
your baby may have a weak suck
your baby’s coordination of sucking, breathing and swallowing has not yet matured so she/he gets tired and
distressed and again he/she ends up not getting enough milk.

These issues usually get better after the first few weeks but understandably can be very worrying for parents
at the time. If your baby is experiencing these issues, 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.

Some children may have issues with feeding at later stages of development, for example 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 who have Down syndrome feed just as well as other children.

Down syndrome insert © DSMIG 2020 11

 DOWN SYNDROME - IMMUNISATIONS AND CHILD HEALTH CHECKS
Immunisations
Children who have Down syndrome may be particularly susceptible to infections and 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 some respiratory infections.You can discuss this with your GP, Paediatrician, Health
Visitor or Practice Nurse.

Child health checks

You will find information about routine child health checks in the main part of your PCHR. Your child should
DOWN SYNDROME

be included in just the same way as other children in your area. It is also advisable for children who have Down
syndrome to have a few extra tests or checks, as detailed in this insert.

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.

12 Down syndrome insert © DSMIG 2020

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 Special checks Preschool checks School age
under 2 years
Thyroid blood Newborn routine Age 4-6 months and then every year from the age of 1 year or more often if
tests heel prick - blood spot clinically indicated:
test Venous thyroid blood test including thyroid antibodies or Fingerprick TSH test
Eye checks 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

DOWN SYNDROME
refraction for long or Refraction and optometrist or
or short sight assessment of near and ophthalmologist or if
distant vision and visual concerns
acuity
Visual behaviour to be monitored at every review particularly in first year
Hearing Universal newborn Full audiological review Annual audiological review or more frequently
checks hearing screen by 10 months including and if indicated
hearing test 2 yearly audiological review or more frequently if
impedance check recommended
Growth Length, weight and head circumference should be Height and weight should be checked and plotted
monitoring checked frequently and plotted on Down syndrome on Down syndrome growth charts at least annually
growth charts (BMI checked if concern regarding overweight)
Heart checks 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
Breathing Enquire at every review for uneven breathing during sleep and poor quality sleep.
checks Screen with an overnight pulse oximetery once in infancy and yearly until the age of 5, or at any age if there are
symptoms or concerns. Low threshold for detailed sleep studies if symptoms persist, despite normal tests
Blood checks Within the first three days If blood film is abnormal treatment or monitoring
of life, full blood count and may be required
blood film to check for a
serious blood disorder
Detailed recommendations for Medical Surveillance Essentials for children with Down syndrome can be found at www.dsmig.org.uk

Down syndrome insert © DSMIG 2020 13

 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.
Date Age Type of Test By whom or Result (please enter actual figures where possible)
where
DOWN SYNDROME

14 Down syndrome insert © DSMIG 2020

SOURCES OF HELP AND ADVICE
In case of difficulty contacting the organisations listed below, please check the Other Organisations page at
www.dsmig.org.uk/information-resources/other-organisations for updated information)
Down’s Syndrome Association (DSA)
Langdon Down Centre, 2a Langdon Park,
Teddington TW11 9PS
Helpline 0333 1212 300 Mon-Fri 10am – 4pm
Email: info@downs-syndrome.org.uk
http://www.downs-syndrome.org.uk
(Services in Wales, Northern Ireland and
England)
Down’s Syndrome Scotland (DSS)
Riverside House, 502 Gorgie Road,
Edinburgh EH11 3AF
Tel: 0131 442 8840
Email: familysupportservice@dsscotland.org.uk
http://www.dsscotland.org.uk
Down Syndrome Ireland
Unit 3 Park Way House, Western Parkway
Business Park, Ballymount Drive,
Dublin D12 HP70
Tel: 01 426 6500
Email: info@downsyndrome.ie
http://www.downsyndrome.ie
Down’s Heart Group
Advice and support for families with
children with heart problems.
PO Box 4260, Dunstable, Beds. LU6 2ZT
Tel: 0300 102 1644
Fax: 0300 102 1645
Email: info@dhg.org.uk
http://www.dhg.org.uk
Down Syndrome Education
International (DSE)
Supports scientific research and delivers
evidence-based advice and information to
improve outcomes for children with Down
syndrome worldwide.
6 Underley Business Centre, Kirkby
Lonsdale, Cumbria LA6 2DY
Tel: 0330 043 0021 Fax: 0330 043 0025
Email: hello@dseinternational.org
http://www.dseinternational.org
Down Syndrome Medical Interest
Group (DSMIG U.K & Ireland)
c/o Staff Library, Duncan Macmillan House,
Porchester Road, Nottingham NG3 6AA
Tel: 0115 969 1300 ext. 11186
Email: info@dsmig.org.uk
http://www.dsmig.org.uk
Contact
209 City Road London EC1V 1JN
Helpline 0808 808 3555 for parents and
families (Mon-Fri 9.30 am– 5.00pm)
Email: info@contact.org.uk
http://contact.org.uk
The charity for families with disabled
children. The national helpline also covers
Wales, Scotland and Northern Ireland.
Contact Scotland
The Melting Pot, 5 Rose Street,
Edinburgh EH2 2PR
https://contact.org.uk/advice-and-support/
local-support/contact-in-your-area/offices/
edinburgh/
Contact Wales
https://contact.org.uk/advice-and-support/
local-support/contact-in-your-area/offices/
cardiff/
Contact Northern Ireland
63-75 Duncairn Gardens, Belfast BT15 2GB
Tel: 028 9262 7552
https://contact.org.uk/advice-and-support/
local-support/contact-in-your-area/offices/
northern-ireland/
Developmental Journal for Babies and
Children with Down Syndrome
This was part of the Early Support
Programme which has now closed.
The journal is still available at
https://councilfordisabledchildren.org.uk/
help-resources/resources/downs-syndrome-
development-journal-early-support
MENCAP
123 Golden Lane, London EC1Y 0RT
Learning Disability Helpline: 0808 808 1111
Email: helpline@mencap.org.uk
http://www.mencap.org.uk
Supporting people with a learning disability
and their families and carers. Offices in
Peterborough, Wales and Northern Ireland.
Enable Scotland
INSPIRE House, 3 Renshaw Place,
Eurocentral, North Lanarkshire ML1 4UF
Tel: 01698 737 000
DOWN SYNDROME
Fax: 0844 854 9748
Email: enabledirect@enable.org.uk
Local services:
Contact the DSA or DSS to find a local
group in your area. DSA/DSS head offices
will provide information or check their
websites. 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.
Each local authority will have a 'local offer'
website that provides details of services
within their locality.
Further copies of this insert contact:
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Street, South Shields, Tyne & Wear
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Tel: 0191 455 4286
Fax: 0191 427 0195
Email: sales@harlowprinting.co.uk
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Down syndrome insert © DSMIG 2020 15
 INFECTION ALERT
This page has been included to highlight to health professionals and parents/carers that children
who have Down syndrome may respond differently to infections and need special consideration.

If you are worried that your child may have a serious infection please
seek medical advice and show this page.

Children who have Down syndrome are more vulnerable to serious infections and may present atypically.
They may not ‘appear’ to be unwell, so checking with their parents/carers about what is usual for them is
important.
DOWN SYNDROME

If a child who has Down syndrome presents with a possible infection, have a low threshold for:
• Suspecting serious infections such as sepsis or pneumonia and seek prompt paediatric advice
• Starting antibiotics and continuing them for double the length of time, e.g. 10 days instead of 5 days
• Arrange to review the child, if a viral infection is diagnosed and antibiotics are not commenced.

Please offer the recommended universal immunisations as well as, the Flu vaccine every year from the age of
6 months and the Pneumovax II at the age of 2 years.

16 Down syndrome insert © DSMIG 2020

 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Girls Down 2 3 4 5
9.5 9.5
syndrome
Age in weeks/ months
9 Weight (kg) 9
th
0 –6 months 99.6

8.5 1 2 3 4 8.5

8 98th 8

DOWN SYNDROME GROWTH CHARTS

7.5 7.5
91st

7 7
75th
6.5 Some degree of weight 6.5
loss is common after birth,

t
see instructions. 50th
6 6

i g h 25th
Weight (kg)

5.5 5.5

we
6th 9th
5 99. 5
h
98t 2nd
4.5 4.5
99.6th
t
91s
0.4th
98th 4 4
75th
91st
3.5 50th 3.5
75th
25th
50th
3 3
9th
25th
2nd
9th 2.5 2.5
2nd 0.4th

0.4th 2 2

1.5 1.5
Age in weeks/ months
1 1 2 3 4 5 1
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Girls Down 2 3 4 5
70 70
syndrome
th
Age in weeks/ months 99.6
68
Length (cm) 68
0 –6 months
9 8 th
1 2 3 4
66 66
9 1s t

64 64
75th
DOWN SYNDROME GROWTH CHARTS

62 62
50th

60

gt h 25th
60

n
58 58

le
9th
th
99.6
56 56
Length (cn)

2nd
h
98t

54 0.4th 54
91st

52 75t
h 52

50th
50 50

25th
48 48
9th

46 46
2nd

44 0.4th 44

42 42
Age in weeks/ months
40 40
1 2 3 4 5
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52
47
Girls Down 4 5 6 7 8 9 10 11 99.6th 47
syndrome
46 Age in weeks/ months 46
Head Circumference (cm) 98th

0 –1 year 91st
45 2 4 6 8 10 12 45
75th
44 44
50th
43 43

DOWN SYNDROME GROWTH CHARTS

d
25th

a
42 42
9th

41

40
h e 2nd

0.4th
41

40
Head Circumference (cm)

39 39

38 .6
th 38
99

37 98
th 37

36 st 36
91

th
35 75 35
th
50
34 34
th
25
33 33
h
9t
32 32
d
2n
31 h 31
4t
0.

30 30
Age in weeks/ months
29 1 2 3 4 5 6 7 8 9 10 11 29
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52
 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47
24 Girls Down 11/2 2 21/2 3 31/2 24

23
syndrome 23
Age in months/ years
Weight (kg) 6t h
22 99. 22
6 months to 4 years
21 7 8 9 10 11 12 13 14 15 21

20 h 20
98t

19 19
DOWN SYNDROME GROWTH CHARTS

18 91st
18

17 17

16 75th 16

15 15

14 99.6
th

eight 50th

25th
14
Weight (kg)

13 98th 13

12

11

10
91s

75th

50th
t

w 9th

2nd

0.4th
12

11

10

9 25th 9
9th
8 8
2nd
7 0.4th 7

6 6

5 5

4 4

3 3

2 Age in months/ years 2

1 1 /2
1
2 2 /2
1
3 3 /2
1
1 1
6 7 8 9 10 11 13 14 15 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47
 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47
Girls Down 11/2 2 21/2 3 31/2
104 syndrome 104
th
Age in months/ years 99.6
Length/Height (cm)
100 6 months to 4 years 100
98th
7 8 9 10 11 13 14 15
91st
96 96
1
75th

t
92 92

DOWN SYNDROME GROWTH CHARTS

h
50th

88

hei g 25th 88

84 .6t
h

th / 9th
84

g
99
2nd

len
h
98t
80 t 0.4th 80
91s
Height (cm)

h
75t
76 76
h
50t
h
25t
72 72
9th

68 2nd 68
h
0.4t

64 64

60 60

56 56

52 52

Age in months/ years

48 48
1 1 /21
2 21/2 3 31/2
6 7 8 9 10 11 13 14 15 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47
 7 8 9 10 11 12 13 14 15 16 17
100 Girls Down Age in years 99.6t
h 100
syndrome
95 Weight (kg) 95
4-18 years
90 90
5 6
98th
85 85

80 80
DOWN SYNDROME GROWTH CHARTS

75 91st 75

70 70

65 75th 65

60 60

t
Weight (kg)

50th

h
55 55

50

45
99
. 6t
h

eig 25th

9th
50

45

w
th
40 98 40
2nd
35 st 35
91
0.4th
h
30 75t 30
h
50t
25 25
25th
9th
20 20
2nd
0.4th
15 15

10 Age in years 10
5 6 7 8 9 10 11 12 13 14 15 16 17 18
 7 8 9 10 11 12 13 14 15 16 17
165
Girls Down Age in years 165
syndrome 99.6th

160 Height (cm) 98th

160
4-18 years
155 5 6 91st 155

t
75th
150 150

145

ig h 50th
145

DOWN SYNDROME GROWTH CHARTS

e
25th
140 140

h
9th
t h
135 99
.6
2nd
135
th
98
130 0.4th 130
st
91
125 th
125
75
Hiehgt (cm)

120 50
th 120
th
115 25 115
9th
110 110
d
2n

105 0.4
th 105

100 100
July 19 DOWNSINSERT

95 95

90 90

85 85
Manufacture 9

80 80

75 Age in years 75
4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
 MEASUREMENT RECORD

Date Age Ht/Lth Wt H/C Signature Date Age Ht/Lth Wt H/C Signature
DOWN SYNDROME GROWTH CHARTS
 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Boys Down 2 3 4 5
9.5 9.5
syndrome th
Age in weeks/ months 99.6
9 Weight (kg) 9
0 –6 months
8.5 1 2 3 4 98th 8.5

8 8
91st

DOWN SYNDROME GROWTH CHARTS

7.5 7.5
75th
7 7

6.5 50th 6.5

t
Some degree of weight
loss is common after birth,
6
see instructions.

ig h 25th 6

e
Weight (kg)

5.5 5.5

w
9th
h
.6t
99
5 5
h 2nd
98t
99.6th 4.5 t 4.5
91s 0.4th
98th
4 75th 4
91st
50th
75th 3.5 3.5
25th
50th
3 9th
3
25th

2nd
9th 2.5 2.5
2nd 0.4th

0.4th 2 2

1.5 1.5
Age in weeks/ months
1 1 2 3 4 5 1
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Boys Down 2 3 4 5
72 72
syndrome
th
Age in weeks/ months 99.6
70
Length (cm) 70
0 –6 months
9 8 th
1 2 3 4
68 68
91st
66 66
DOWN SYNDROME GROWTH CHARTS

75th
64 64
50th
62 62

60

g th 25th
60

n
9th

le
58 58
Length (cn)

6 th
99. 2nd
56 56
h
98t
0.4th
54 t 54
91s

52 75t
h 52

h
50 50t 50
h
25t
48 48
9th
46 46
2nd

44 h 44
0.4t
Age in weeks/ months
42 42
1 2 3 4 5
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52
49 Boys Down 4 5 6 7 8 9 10 11 49
syndrome
48 Age in weeks/ months 99.6th 48
Head Circumference (cm)
47 0 –1 year 98th 47
2 4 6 8 10 12
46 91st 46

45 75th 45

DOWN SYNDROME GROWTH CHARTS

44 50th 44

43

42

ead 25th

9th
43

42

41

h 2nd
41
Head Circumference (cm)

0.4th
40 40

39 39
th
.6
99
38 38
th
98
37 37
st
91
36 36
th
75
35 th
35
50
34 th 34
25

33 h 33
9t

32 2n
d 32
h
31 4t 31
0.

30 Age in weeks/ months 30

29 1 2 3 4 5 6 7 8 9 10 11 29
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52
 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47
24 Boys Down 11/2 2 21/2 3 31/2 24

23
syndrome 23
Age in months/ years
Weight (kg)
22 22
6 months to 4 years
21 7 8 9 10 11 12 13 14 15 21
t h
99.6
20 20

19 98th 19
DOWN SYNDROME GROWTH CHARTS

18 18
91st
17 17

16 75th 16

t
15 15

h
50th

g
14 14

i
th
99.6

e
25th
Weight (kg)

13 13

w
98th

12 91s
t 9th 12

11 75th 2nd 11

10 50th 0.4th 10
25th
9 9
9th
8 8
2nd
7 0.4th 7

6 6

5 5

4 4

3 3

2 Age in months/ years 2

1 1 /2
1
2 2 /2
1
3 3 /2
1
1 1
6 7 8 9 10 11 13 14 15 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47
 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47
Boys Down 11/2 2 21/2 3 31/2
104 syndrome th 104
99.6
Age in months/ years
Length/Height (cm)
100 98th 100
6 months to 4 years
7 8 9 10 11 13 14 15 91st
96 96
1 75th

92

ht 50th 92

DOWN SYNDROME GROWTH CHARTS

h e ig 25th

/
88 88

84
99.
6t h

g th 9th

84

n
h 2nd
98t

80
91s

75t
t

h
le 0.4th
80
Height (cm)

h
76 50t 76
h
25t

72 9th 72

2nd
68 h 68
0.4t

64 64

60 60

56 56

52 52

Age in months/ years

48 48
1 1 /2 1
2 21/2 3 31/2
6 7 8 9 10 11 13 14 15 16 17 19 20 21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47
 7 8 9 10 11 12 13 14 15 16 17 h
99.6t
100 Boys Down Age in years 100
syndrome
95 Weight (kg) 95
4-18 years
90 90
5 6
98th
85 85

80 80
DOWN SYNDROME GROWTH CHARTS

91st
75 75

70 70
75th
65 65

60 5 0th 60

t
Weight (kg)

55 55

h
h
25t

50 50

ig 9th
th
.6
99

45 45

e
2nd

h
40 0.4t 40

w
th
98

35 91
st 35

30 75t
h 30
h
50t
25 25
25th

20 9th 20
2nd
0.4th
15 15

10 Age in years 10
5 6 7 8 9 10 11 12 13 14 15 16 17 18
 7 8 9 10 11 12 13 14 15 16 17
175 Boys Down Age in years 99.6th
175
syndrome
98th
170 Height (cm) 170

165
4-18 years 91st
165
5 6
75th
160 160

t
50th
155 155

DOWN SYNDROME GROWTH CHARTS

25th

g
150 150

i
9th

145 145

e
2nd

140 140

h
0.4th

. 6th
135 99 135
th
98
Hiehgt (cm)

130 130
st
91
125 th 125
75

120 50
th 120
th
115 25 115
9th
110 110
d
2n
DOWNSINSERT

105 th 105
0.4

100 100

95 95
Julym 19

90 90
Manufacture 9

85 85

80 Age in years 80
4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
 MEASUREMENT RECORD

Date Age Ht/Lth Wt H/C Signature Date Age Ht/Lth Wt H/C Signature
DOWN SYNDROME GROWTH CHARTS