Growth Centiles for a 2-Year-5-Month-Old Girl with Down Syndrome
For a 2-year-5-month-old girl with Down syndrome weighing 10.7 kg and measuring 81 cm, specific Down syndrome growth charts should be used rather than standard WHO growth charts, as children with Down syndrome have different growth patterns.
Growth Assessment for Children with Down Syndrome
- Children with Down syndrome have lower birth weights and grow more slowly than children without Down syndrome, necessitating syndrome-specific growth charts 1
- UK-specific growth charts for Down syndrome were developed in 2002 and are more appropriate for assessing growth in children with Down syndrome in the UK and Republic of Ireland 2
- These charts were created using data from 1089 children with uncomplicated Down syndrome and differ substantially from previous charts 2
Interpretation Using Down Syndrome-Specific Charts
- At 2 years and 5 months of age, a weight of 10.7 kg and height of 81 cm should be plotted on the Down syndrome-specific growth charts 2
- Growth assessment should consider the child's previous growth pattern and overall health status 3
- Children with Down syndrome typically track between lower percentiles compared to typical children, with growth charts showing marked differences in expected height and weight 1
Considerations When Assessing Growth in Down Syndrome
- Children with Down syndrome may have congenital heart disease which can further affect growth - those with moderate or severe heart disease are typically 1.5-2.0 cm shorter and about 1 kg lighter than those without significant cardiac issues 4
- Regular plotting of measurements on appropriate syndrome-specific growth charts is essential for identifying potential growth concerns 3
- Growth should be monitored longitudinally to establish growth trajectory rather than focusing on a single measurement 5
Transition Between Growth Charts
- For typical children, WHO growth charts are recommended for children under 24 months, while CDC charts are recommended for children 2-19 years 6, 3
- However, for children with Down syndrome, syndrome-specific growth charts should be used throughout childhood 2, 1
- The transition point at age 2 years (when clinicians switch from WHO to CDC charts for typical children) coincides with the change from recumbent length to standing height measurements 3
Common Pitfalls to Avoid
- Using standard WHO or CDC growth charts for children with Down syndrome can lead to incorrect assessment of growth status 2, 1
- Failing to consider comorbidities such as congenital heart disease that may further affect growth patterns 4
- Not accounting for the tendency of children with Down syndrome to become overweight beginning in late infancy 4
- Overlooking feeding difficulties which are common in children with Down syndrome and may affect growth 7