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Centers for Disease Control and Prevention

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Growth charts for children with Down syndrome in the United States are available for download below. These charts can help healthcare providers monitor growth among children with Down syndrome and assess how well a child with Down syndrome is growing when compared to peers with Down syndrome.
Clinical Growth Charts

The clinical charts are shown in metric units (kilograms and centimeters). Each chart is available for boys and girls. Each chart shows the 5 th, 10 th, 25 th, 50 th, 75 th, 90 th, and 95 th percentiles. The available charts include the following:

For children from birth to 3 years of age:

Weight in kilograms*

Length/height in centimeters (length is measured unless the child can stand unsupported, in which case height is measured)

Head circumference (measurement around a child's head in the largest area)

Weight-for-length

*Weight percentile curves start at age 0 months; other "birth to 3 years of age" growth curves start at 1 month of age.

For individuals aged 2-20 years:

0-36 months

2-20 years1,2

¹Body mass index (BMI) growth charts are available at https://www.cdc.gov/growthcharts/clinical_charts.htm
²Please see the publication by Zemel at al.external icon for body mass index (BMI) growth charts for a sample of children with Down syndrome

Methods and Development

For more information about the methods and development of the growth charts for children with Down syndrome, please see http://pediatrics.aappublications.org/content/early/2015/10/21/peds.2015-1652.abstractexternal icon .

Background

The information below is provided to help you read and interpret the growth charts for children with Down syndrome.

What is a percentile?
Percentiles are the most commonly used indicator to assess the size and growth patterns of individual children in the United States. Percentiles rank the position of an individual by indicating what percent of the reference population the individual would equal or exceed. The reference population is the group of individuals whose growth patterns were used to develop the growth charts.

What is a z-score?
A z-score is a measure of how an individual relates to the average value for the reference population. A z-score has a direct relationship to percentiles. For more technical information about these scores and how they are calculated, visit https://www.cdc.gov/growthcharts/growthchart_faq.htm.

My child is at or below the 5th percentile on a chart, what should I do?
If you are concerned about your child's growth, talk with your child's healthcare provider.

Are there considerations I should keep in mind when using these charts?
Specialized growth charts, like these new growth charts for children with Down syndrome, provide useful growth references for children with Down syndrome, but may have some limitations. For example, for this study the researchers took growth measurements from a group of 637 individuals with Down syndrome recruited from medical and community locations, mostly from the Philadelphia area. These children might not be representative of all children with Down syndrome in the United States. For more information about the methods and development of the growth charts for children with Down syndrome, please see http://pediatrics.aappublications.org/content/early/2015/10/21/peds.2015-1652.abstractexternal icon .

Reference

Zemel BS, Pipan M, Stallings VA, Hall W, Schadt K, Freedman DS, Thorpe P. Growth charts for children with Down syndrome in the United States. Pediatrics. 2015 Nov 1;136(5):e1204-11.

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national center on birth defects and developmental disabilities

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Growth Charts for Children with Down Syndrome | CDC

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Growth charts for children with Down syndrome in the United States are available for download below. These charts can help healthcare providers monitor growth among children with Down syndrome and assess how well a child with Down syndrome is growing when compared to peers with Down syndrome.

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Please go through the resources you have available to you.
Feel free to leave questions below & I will address them during our session on Thursday

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Centers for Disease Control and Prevention

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Milestones in Action, a media library on developmental milestones

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The Milestones in Action library aid parents and providers with examples of important developmental milestones for children ages 2 months to 5 years.

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This EPA article was first published in Harian Metro on 21 September 2016.

*EPA stands for Educational Press Articles, which are published by Positive Parenting every fortnight.

Please download the BM published article here.
By Datuk Dr Musa Mohd Nordin, Consultant Paediatrician & Neonatologist

Every year, vaccines save the lives of over 2.5 million people and prevent 750,000 more from disabilities.

Immunity is the body's way of preventing disease. The immune system recognizes germs that enter the body (called antigens) and produces proteins called antibodies to fight them. Most of the time, the immune system isn't able to work fast enough to prevent the antigen from causing disease, so the child still gets sick.

Nevertheless, the immune system "remembers" that particular antigen and if it reappears, the body will be ready and respond much faster next time round to prevent any infections. This protection is called immunity.

Vaccination, on the other hand, helps your child develop immunity without him/her getting sick in the process.
Why Vaccines?
* Routine childhood vaccinations protect your child from serious diseases like tuberculosis, hepatitis B, diphtheria, pertussis, tetanus, influenza, measles mumps and rubella.

* Vaccination protects children from serious illness and complications of vaccine-preventable diseases which in some cases can lead to brain damage or even death.

* Some vaccine-preventable diseases can also result in prolonged disabilities and can take a financial toll because of lost time at work, medical bills or long-term disability care.
What is the NIP?
NIP stands for the 'National Immunisation Programme'. It consists of a list of recommended routine vaccinations for children which must be taken - without exception! The vaccines are provided for free and is available at all public hospitals and selected clinics (klinik kesihatan).
Why So Many?
The immune system is robust and is able to take on more than just a few weakened antigens. In fact, the human body takes in far more antigens from the air, water and environment daily.
Are There Any Side Affects?
Vaccines are manufactured to meet the most stringent and highest standards of safety. However, a very small percentage of people may experience mild side effects. In extremely rare circumstances, more serious side effects can occur, like allergic reactions.

Nevertheless, we must remember that any medical intervention comes with some degree of risks. But avoiding it altogether solely because you want to avoid risk is senseless because doing nothing is also associated with risks!
Will Vaccines Cause Autism
The association of autism with vaccination (particularly the MMR vaccine) is one of the biggest myths in medicine. Researchers have time and time again, debunked the link between the MMR (Measles, Mumps and Rubella) vaccine and autism. The latest study which referenced 67 high quality scientific articles concluded that immunization does not lead to autism. And this has been confirmed by global health agencies e.g. WHO and the CDC.

Having your child immunised helps to protect them from many serious childhood infections, some of which may be life threatening. There's no doubt that vaccines are the best option for both your child and the population at large. Don't wait, make the right decision and see your doctor to have your child immunised today.
Source:
1. Taylor, L. E., Swerdfeger, A. L., & Eslick, G. D. (2014). Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies. Vaccine, 32(29), 3623-3629.

2. http://www.cdc.gov/vaccines/vac-gen/howvpd.htm

3. http://www.mmgazette.com/pneumonia-missing-the-signs-immunise4life/

4. http://mypositiveparenting.org/2014/10/08/childhood-vaccinations-fundamentals-for-young-parents/

5. http://www.webmd.com/children/vaccines/tc/importance-of-immunizations-topic-overview

6. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunization/Pages/default.aspx

Please download the article in English and BM below...
English Version Malay Version

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Routine Childhood Immunisation - The Malaysian Paediatric Association

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This EPA article was first published in Harian Metro on 21 September 2016. *EPA stands for Educational Press Articles, which are published by Positive Parenting every fortnight. Please download the BM published article here. By Datuk Dr Musa Mohd Nordin, Consultant Paediatrician & Neonatologist Every year, vaccines save the lives of over 2.5 million people and prevent 750,000 more from disabilities.

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Intro

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The Malaysian National Immunisation Programme (NIP) was introduced in the early 1950s. Our Malaysian NIP was designed based on the World Health Organisation (WHO) Expanded Programme on Immunisation (EPI). The EPI recommends that all countries immunise against 6 childhood diseases, however our Malaysian National Immunisation Programme (NIP) has expanded protection against 12 major childhood diseases
1. What diseases does the National Immunisation Programme (NIP) cover today?
Our NIP protects Malaysian children against 12 major childhood diseases.
What are the 12 disease preventable under the NIP?
Diphtheria

An infectious disease caused by bacteria that live in the mouth and throat of the infected person

Haemophilus influenzae type B (HIB)

A serious infection that mainly affects children under 5 years.

Hepatitis B

Infection of the liver by the Hepatitis B virus.

Human papillomavirus (HPV)

Most common sexually transmitted infection (STI) that causes cervical cancer which is the third most common cancer in women.

Japanese encephalitis (JE)

Infection of the brain caused by JE virus.

A highly contagious viral disease.

A viral infection that is the most common cause of inflammation of the brain (encephalitis)

Pertussis - Whooping Cough

Highly contagious, with violent and persistent coughing that may cause a child to struggle to breathe and, turn blue (cyanosed).

Poliomyelitis (polio)

An infectious and incurable viral disease that attacks the nervous system.

Also known as German measles that may cause abnormalities to the foetus.

Also known as lockjaw, caused by bacteria toxins that attacks the body's nervous system.

Tuberculosis (TB)

A disease that commonly infects the lungs, but can also attack other parts such as the kidney, spine, skin, intestines and brain.
2. Where can our children receive their vaccinations under the National Immunisation Programme (NIP)?
The National Immunisation Programme (NIP) vaccinations are provided free-of-charge at all government clinics across the country. They are also available at private clinics, where you may have to pay a small fee.
3. When does my child have to get these vaccines?
There is a National Immunisation Programme (NIP) schedule (see below). It is important to follow this schedule closely as doctors and other public health experts have worked hard to come up with the optimal vaccination schedule, affording the most complete and safest protection possible. It is not advisable to skip or delay vaccines, as this will leave the child vulnerable to disease.

1. BCG stands for Bacille Calmette-Guerin, which is the vaccine to protect against tuberculosis.

2. DTaP is the combination vaccine that protects against diphtheria, tetanus and pertussis. This vaccine is given together with the Hib and polio vaccines.

3. IPV stands for inactivated polio vaccine.

4. Hib stands for Haemophilus influenzae type b.

5. MMR stands for measles, mumps and rubella.

6. MR stands for measles and rubella, given to those born before July 2015.

7. DT is a booster dose given to protect against diphtheria and tetanus.

8. HPV stands for Human Papillomavirus. The vaccine is available to 13-year-old girls in 2 doses over a period of 6 months.

9. JE stands for Japanese Encephalitis. The vaccine is only given in Sarawak.

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Basic Protection - National Immunisation Programme (NIP)

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The Malaysian National Immunisation Programme (NIP) was introduced in the early 1950s. Our Malaysian NIP was designed based on the World Health Organisation (WHO) Expanded Programme on Immunisation (EPI). The EPI recommends that all countries immunise against 6 childhood diseases, however our Malays

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Refer to paediatric protocol

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YouTube is a resource you can use since bedside teaching is currently not an option. Always defer back to your manuals & textbook for correct information. Use these resources to see how they demonstrate techniques & how they interpret cues.

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developmental assessment paediatrics - YouTube

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Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.