Overview
Growth in people with Down syndrome differs from the general population. Mean birthweight at term (3 Kg) is less than in typical babies, and weight gain is slower. The difference in growth rates continues throughout childhood so that short stature is characteristic with mean adult height 146cm for women and 157 cm for men. Whilst this may in part be constitutional, associated medical conditions, and feeding difficulties also contribute. Down syndrome specific growth charts should be used to identify those children whose growth deviates from that expected for a child with Down syndrome, who should be investigated for underlying pathology.
There has been debate about the use of growth hormone to treat short stature in children with Down syndrome, even though growth hormone deficiency is unusual. There is evidence of short term benefit on longitudinal growth with growth hormone benefit , but further research is needed to explore long term outcomes .
Obesity also commonly occurs in Down syndrome , but is not inevitable. The Down syndrome specific charts do suggest that overweight is the norm so Standard BMI charts , or the BMI look up chart on the UK Down syndrome specific charts should be used to identify those who may be overweight. Assessment for possible medical causes and management, including advice re diet and exercise should be as for the general population.
Topic Page Updated by Dr Liz Marder October 2024
DSMIG Guidance
DSMIG Guidelines Basic Medical Surveillance Essential for people with Down syndrome: Growth
DSMIG evidence-based guidelines for basic essential medical surveillance.
Last updated: Feb 2012
Growth charts for children with Down syndrome (2011)
Joint DSMIG/RCPCH UK/Republic of Ireland cross-sectional growth reference charts.
Why we need special charts for children with Down syndrome and how to use the charts to monitor children’s growth, including premature babies and older infants and children. It also includes some advice on growth in puberty and over-weight and obesity.
Presentations at DSMIG Meetings
Materials from meetings are available for members only who need to log in to access them. For details on how to become a member click here.
Additional Resources
To support the drive to digitise healthcare the RCPCH have developed an API to accurately calculate centiles for a child’s height, weight, head circumference and BMI for digital growth assessments. Down syndrome specific data base on the DSMIG Growth Charts data are included. Guidance, support and links for developers and health professionals are available from the RCPCH.
Background information about the UK Down syndrome growth charts which were commissioned by DSMIG.
Styles ME, Cole TJ, Dennis J, Preece MA. Arch Dis Ch. 2002. 87. 104-108.
iGrow software has been designed to provide a system for monitoring growth . Charts for children with Down syndrome are included.
GH treatment in pediatric Down syndrome: a systematic review and mini meta-analysis
Shaki D, Hershkovitz E, Tamam S, et al (2023)
Front. Endocrinol. 14:1135768.doi: 10.3389/fendo.2023.1135768