My personal child health record - DCHS Home · My personal child health record ... This is your child's personal child health record. ... Top copy: remain in PCHR 2nd Copy: ...

Somewhere HealthcareNHS Trust

My personal child health record

My name ........................................................................................

My NHS number...............................................

My date of birth ...............................................

If this book is found please return to:

My photo

IndexChild, family and birth details / local and information sources1 Child’s details2 Local information3 Birth details5 Important health problems6 Family history7 Information sources

Immunisation13 Your child will be offered the following immunisations14 Primary course of immunisations15 MMR immunisation – first dose and second year boosters16 MMR immunisation – second dose and pre-school booster

Screening and routine reviews17 Screening and routine reviews18 Can your baby see?19 Can your baby hear?21 Newborn hearing screening programme22 Dislocation of the hip23 New baby review25 6-8 week review27 1 year review29 2-21/2 year review31 Health review33 School health service34 School entry review in reception class

Your child’s firsts and growth charts35 Your child’s developmental firsts40 Dental health

Notes41 Weight conversion chart42 Height conversion chart

Growth charts

All rights reserved. No part of this publication may be reproduced in any form,stored in a retrieval system of any nature, or transmitted in any form or by anymeans including electronic, mechanical, photocopying, recording, scanning orotherwise without the prior written permission of the copyright owners except inaccordance with the Copyright, Designs and Patents Act 1988. Applications forthe copyright owner’s written permission to reproduce any part of this publicationshould be addressed to the publisher.

The doing of an unauthorised act in relation to a copyright work may result inboth a civil claim for damages and criminal prosecution.

© Harlow Printing Limited (2009) (typographical arrangement, design and layout)© Royal College of Paediatrics & Child Health (2009)

Copyright material owned by the Royal College of Paediatrics is reproduced withthe permission of the Royal College of Paediatrics.

Whilst we have tried to ensure the accuracy of this publication, the publisherscannot accept responsibility for any errors, omissions, mis-statements or mistakes.

For supplies contact Harlow Printing Limited:Tel 0191 455 4286, Fax 0191 427 0195For further information visit www.harlowprinting.co.ukand www.healthforallchildren.co.uk

Harlow Healthcare 79534dtp

Personal Child Health RecordThis is your child's personal child health record. It is the main record of your child's health, growth anddevelopment. It is for you – and the other people who care for your child – to be able to see and to write in, sowe ask you to keep it in a safe place.

Bring this book with you whenever you visit:

Q your midwife

Q the children’s centre

Q the child health clinic

Q your health visitor

Q your family doctor

Q a hospital emergency or outpatients department

Q if your child is admitted to hospital

Q a therapist (eg speech and language therapist)

Q the dentist

Q the school nurse

Q any other health appointment

You may like to show it to other carers of your child such as

Q childminder

Q playgroup leader

Q nursery school teacher

Q primary school teacher

Q anyone else who helps you care for your child.

Sections with this symbol are to be filled in by yourself as a parent, or by your midwife, healthvisitor and doctor.

The Healthy Child ProgrammeHealth advice, immunisations, screening and routine health reviews are all important parts of the healthy childprogramme. They are carried out by health professionals usually doctors, midwives, health visitors, othermembers of the health visiting team, practice nurses and school nurses. A record of these will be made in thepersonal child health record.

Every parent can expect the following as a minimum:

Q Soon after birth: full physical examination Q By 12 months: health review

Q 5-8 days: heelprick blood spot test Q 12 and 13 months: immunisations

Q 10-14 days: new baby review Q 2-21/2 years: health review

Q In first month: hearing test Q 3 years 4 months: immunisations

Q 6-8 weeks: full physical examination Q 4-5 years: eye sight check

Q 8, 12, 16 weeks: immunisations Q School entry (reception class): Height, weight and hearing check

For more information on these see Birth to Five.

Some of the early appointments will be made by your health visitor in your home. You may need to go to yourlocal doctor’s surgery or health centre for others and some may not need a face-to-face contact. Health reviewsfor school aged children are usually done in school.

If you are worried about any aspect of your child’s health or development, don’t wait for the next review todiscuss it. You can find out information on many minor health issues in Birth to Five but if you are still worriedcontact your health visitor or family doctor.

How we handle informationWe wish to make sure that your child has the opportunity to have his/her immunisations and health checks whenthey are due. We also want to be able to plan and provide any other services your child needs. Therefore, weenter some of your child’s details from this record on to our computer system.

We treat this information as strictly confidential and only release it to:

Q Yourself as parent(s)

Q Your child’s health care professionals, who work directly with your family.

This information may be used anonymously so that we can plan services for all children.

We will not normally release any information that could be linked to your child to any other person ororganisation without seeking your permission first. However, it is sometimes necessary to use this sort ofinformation for audit purposes and public health reasons such as monitoring the effectiveness and safety ofvaccines.

We may also give the Department of Health contact details of children due immunisations so that they can sendinformation leaflets about immunisation. These contact details are kept by the Department of Health only untilthe leaflets are sent out.

We are subject to the terms of the Data Protection Act, 1998 in respect of personal data held by us. You havethe right under the Act to ask to see details of the information held regarding your child.

Ch

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Child, familyand birth details/ local andinformationsources

Child’s detailsQ Please place a sticker (if available) otherwise

write in space provided.

Ch

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1

Mother’s name: ................................................................................................ Date of birth:........../........../ ........

Father’s name:.................................................................................................. Date of birth:........../........../ ........

Change of address (including post code)

1):...................................................................................................................................... Tel:.............................

2):...................................................................................................................................... Tel:.............................

3):...................................................................................................................................... Tel:.............................

Named Midwife/Team

Name:................................................................................................................................ Tel:.............................

Family Doctor

1) Name: ............................................ Address: ................................................................. Tel: ............................

2) Name: ............................................ Address: ................................................................. Tel: ............................

3) Name: ............................................ Address: ................................................................. Tel: ............................

Health Visitor/Team

1) Name: ............................................ Address: ................................................................. Tel: ............................

2) Name: ............................................ Address: ................................................................. Tel: ............................

3) Name: ............................................ Address: ................................................................. Tel: ............................

Dentist

Name: ................................................ Address: ................................................................. Tel: ............................

Surname:

First names:

NHS number: Unit no:

Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

2

Child health clinics

1) Name: ........................................................................... Time: ......................... Tel: ..........................................

2) Name: ........................................................................... Time: ......................... Tel: ..........................................

3) Name: ........................................................................... Time: ......................... Tel: ..........................................

4) Name: ........................................................................... Time: ......................... Tel: ..........................................

5) Name: ........................................................................... Time: ......................... Tel: ..........................................

Children’s centre

.............................................................................................................................................................................

Baby/toddler & parents’ groups

Name: ............................................................................... Time: ......................... Tel: ..........................................

Name: ............................................................................... Time: ......................... Tel: ..........................................

Playgroups

............................................................................................................................ Tel: ..........................................

............................................................................................................................ Tel: ..........................................

Nursery schools/classes

............................................................................................................................ Tel: ..........................................

............................................................................................................................ Tel: ..........................................

Other useful contacts

............................................................................................................................ Tel: ..........................................

............................................................................................................................ Tel: ..........................................

............................................................................................................................ Tel: ..........................................

............................................................................................................................ Tel: ..........................................

Local information

Birth

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Place of birth:..................................................

Date of birth:.........../.........../...................

Length of pregnancy in weeks: .......................

Type of delivery: ..............................................

Mother’s NHS Number: ...................................

Problems in pregnancy, birth or neonatal period:

.......................................................................

.......................................................................

Admitted to Neonatal Intensive Care Unit?

No c Yes, for ..................days

Birth details & newborn examinationQ Please place a sticker (if available) otherwise write in space provided.

S = Satisfactory P = Problem O = Continue observation T = Treatment being received R = Referral N = Not examinedTop copy: remain in PCHR 2nd Copy: Health Visitor 3rd Copy: Child Health Department contd...

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

Birth Weight: ..............kg Length: ..............cm Head circumference: .............cm Date: ........../........../...........

Newborn Examination

Item Guide to Content Coded Outcome (ring one) Comment/Action Taken

Examination of hips Barlow and Ortolani S P O T R Ntests on both

Testes Ring ‘N’ for girls S P O T R N

Examination of eyes Includes inspection S P O T R Nand red reflex

Examination of heart Colour, pulses, S P O T R Nheart sounds, murmurs

Rest of Physical Including fontanelle, S P O T R NExamination palate, spine,

abdomen, urine system,passage of meconium

Date Performed:...................... Performed by:.................................... Signature: ..................................................

3 part NCR

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Heel prick tests Date blood taken: ........../........../........... (results on page 25)

BCG indicated: YES c NO c BCG given: YES c NO c If YES please enter details on separate BCG page

Hep B indicated: YES c NO c Hep B given: YES c NO c If YES please enter details on separate Hep B page

Vitamin K given: Date:.................................. Route: ................................. Further doses needed? YES c NO c

If YES: Dose No. Date due Date given

2 ......./......./........ ......./......./........

3 ......./......./........ ......./......./........

4 ......./......./........ ......./......./........

Follow-up required: No c Yes c : GP c Community Paediatrician c Hospital c Other: .......................

Location/Clinic: .......................................................................................................... Date: .................................

Reason: .................................................................................................................................................................

Birth details & newborn examination continuedQ Please place a sticker (if available) otherwise write in space provided.

First milk feed:

Breast c Formula c

Breast feeding at discharge:

Totally c Partially c Not at all c

Top copy: remain in PCHR 2nd Copy: Health Visitor 3rd Copy: Child Health Department

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR

1: ......................................................................................................................... Date: .......................................

2: ......................................................................................................................... Date: .......................................

3: ......................................................................................................................... Date: .......................................

4: ......................................................................................................................... Date: .......................................

Specialist Clinics

Name: .................................................................................................................. Unit Number: ..........................

Name: .................................................................................................................. Unit Number: ..........................

Name: .................................................................................................................. Unit Number: ..........................

Special needs: (social, physical, educational, emotional)

1: ......................................................................................................................... Date: .......................................

2: ......................................................................................................................... Date: .......................................

3: ......................................................................................................................... Date: .......................................

4: ......................................................................................................................... Date: .......................................

Serious allergies and reactions to drugs or vaccines

1: ......................................................................................................................... Date: .......................................

2: ......................................................................................................................... Date: .......................................

3: ......................................................................................................................... Date: .......................................

4: ......................................................................................................................... Date: .......................................

Important health problemsIm

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Parents: Mother’s name:........................................................................ Date of birth:........../........../ ..........

Mother’s educational level: .............................................................................................................

Father’s name:.......................................................................... Date of birth:........../........../ ..........

Are there any other children in the family?

Siblings name(s): .................................... .................................. .................................. ..............................

Sex: .................................... .................................. .................................. ..............................

Date of Birth: .................................... .................................. .................................. ..............................

Is there any family history of: Yes No Comments

Childhood deafness c c ..................................................................................

Fits in childhood c c ..................................................................................

Eye problems in childhood c c ..................................................................................

Hip problems in childhood c c ..................................................................................

Reading and spelling difficulties c c ..................................................................................

Asthma / eczema / hayfever / allergies c c ..................................................................................

Tuberculosis (TB) c c ..................................................................................

Heart Conditions c c ..................................................................................

Are there any other particular illnesses or conditions in the mother’s or father’s family that you feel are important?

.............................................................................................................................................................................

Is an interpreting service needed? No c Yes c If yes, which language? .................................................

Family History

6

Information sourcesBirth to five

Birth to Five is an easy-to-use and practical guide for parents. It gives the latest advice and information on all aspectsof child health, immunisation, healthy eating, childhood illnesses, child safety and reducing the risk of cot death.

Fully illustrated with photographs, cartoons and helpful diagrams it explains:

Q the first few weeks and how your child will develop;

Q learning and playing, habits and behaviour;

Q feeding the family;

Q where to get help and advice; and

Q your rights and benefits.

The book is available from your health visitor and can also be viewed by searching for Birth to Five at www.dh.gov.uk

NHS direct

NHS Direct is a 24-hour nurse-led helpline providing confidential healthcare advice and information on:

Q What to do if you're feeling ill;

Q Health concerns for you and your family;

Q Local health services;

Q Self-help and support organisations.

Calls to NHS Direct are charged at local rates.

NHS Direct Online provides a gateway to high quality and authoritative health information on the Internet. It isunique in being the only UK website supported by a 24-hour nurse-led helpline.

www.nhsdirect.nhs.uk

Info

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Direct0845CALL 24 HOURS ON

4647


4647


4647

BreastfeedingNational Breastfeeding Helpline

Call 0844 20 909 20 for breastfeeding information and help for you and your baby. You can also call the Helpline tospeak to your nearest trained volunteer mother who will be happy to listen to you in confidence.

Lines open 9.30am – 9.30pm every day of the week, do call again later if you don’t get an answer straight away.

Best Beginnings

You should have received your FREE from bump to breastfeeding DVD.

Now’s a good time to watch it again.

If you have not received your copy yet, ask your midwife or health visitor, or go to www.bestbeginnings.info

What are the topics covered?

In the main film, we meet nine different women and follow them on their journey...

Q preparing for birth Q birth, skin-to-skin and early feeds

Q graphic of a baby attaching on the breast Q the early days and weeks

Q feeding out and about Q overcoming challenges

Q introducing other foods

There are also five extra films, covering:

Q the first few weeks

Q overcoming challenges

Q expressing and returning to work

Q breastfeeding your sick or pre-term baby

Q breastfeeding twins or more

For further information about breastfeeding see Birth to Five.

8

Children’s centres, playgroups, nurseries and day carePlaygroups, Pre-school Education and Child Care are available in all districts. Look at the links below or ask yourHealth Visitor for details of services in your area.

Sure Start Children’s Centres offer advice and support for families with children underfive years. The aim is to make sure your child gets the best possible start in life.

Children’s Centres vary from area to area in terms of what they offer but all aim to support learning for your child.It is planned there will be a Centre for every community by 2010. There may already be one in your locality. Ask yourhealth visitor for further information.

Are you thinking of childcare for your child as he or she grows?

Find out more about local childminders, day nurseries and playgroups from your health visitor or local FamilyInformation Service (FIS). Find your nearest FIS through ChildcareLink on 0800 2 346 346 or visitwww.childcarelink.gov.uk

All children are entitled to some free early education from the age of three until they start school. You can look forpart-time early education for your child in a school nursery class, nursery school, day nursery, playgroup or pre-schoolor with a childminder if they are part of a registered childminder network.

Most families can access funding to pay for a substantial amount of their childcare costs through the tax creditsystem, subject to individual circumstances. Some employers can also give you tax-free vouchers to help pay forchildcare. To find out more about child benefits phone 0845 302 1444 and for information on tax credits phone0845 300 3900 or visit www.hmrc.gov.uk/taxcredits

Ch

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Parent Line PlusParentline Plus is a national charity offering help and information forparents and families via a range of services including a free 24-hourconfidential helpline, workshops, courses, information leaflets andwebsite.

Services

Q A free confidential, 24-hour helpline 0808 800 22 22

Q A free text phone for people with a speech or hearing impairment 0800 783 6783

Q Parenting courses and workshops

Q Information leaflets

Q A helpful website www.parentlineplus.org.uk

Q Referral Telephone Support

Q Training for professionals

Q Volunteer opportunities.

Values

Parentline Plus works to recognise and to value the different types of families that exist and to shape and expand theservices available to them. We understand that it is not possible to separate children’s needs from the needs of theirparents and carers and encourages people to see it as a sign of strength to seek help. We believe that it is normalfor all parents to have difficulties from time to time.

10

Contact a FamilyEvery day over 75 children in the UK are born or diagnosedwith a serious disability. Discovering that a child is ill or has aspecial need or disability is always very difficult and parents mayfeel very isolated.

Contact a Family gives support, information and advice to families across the UK, regardless of the medical conditionof the child.

Contact a Family advisers can:

Q put families in touch with support groups or, where there isn’t a group, try to link families directly on a one-to-one basis

Q give medical information on all conditions affecting children, including rare conditions

Q advise on services like respite and benefits

Q send a range of helpful factsheets

Q talk via an interpreter in over 100 languages if a language other than English is preferred

To get in touch with Contact a Family, parents can:

Q phone the National Freephone Helpline, tel 0808 808 3555 (10am-4pm, Monday to Friday and Monday evening5.30pm-7.30pm). The Service is free and confidential.

Q use Minicom on 020 7608 8702

Q email [email protected]

Q write to Contact a Family, 209-211 City Road, London, EC1V 1JN

Q look at the website www.cafamily.org.uk which contains the directory of rare conditions and syndromesaffecting children, information about sources of support, as well as regional contacts

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BookstartBookstart is the national programme that encourages a lifelong love of reading byproviding free packs of books for babies, toddlers and three-year-olds.

Your health visitor can tell you how to collect your packs or you can ask at yourlocal library.

Sharing books with your child is a wonderful wayto build a loving relationship, increase theirlanguage skills and help them have a lifelong loveof books.

For more information about Bookstart visit www.bookstart.org.uk

Special packs are available for children that are deaf or visually impaired.

Bookstart for babies

Date received.......................................

Signed .................................................

Bookstart + for toddlers

Date received.......................................

Signed .................................................

My Bookstart Treasure Chestfor nursery age children

Date received.......................................

Signed .................................................

12

Imm

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isation

Immunisation

Your child will be offered the following immunisationsAge Due Immunisation

8 weeks DTaP/IPV/Hib and PCV (Diphtheria, Tetanus, acellular Pertussis [whooping cough],Inactivated Polio Vaccine, Haemophilus influenzae b [Hib] and Pneumococcal conjugate vaccine)

12 weeks DTaP/IPV/Hib and Men C (Diphtheria, Tetanus, acellular Pertussis [whooping cough],Inactivated Polio Vaccine, Haemophilus influenzae b [Hib] and Meningococcal C)

16 weeks DTaP/IPV/Hib, Men C and PCV (Diphtheria, Tetanus, acellular Pertussis [whoopingcough], Inactivated Polio Vaccine, Haemophilus influenzae b [Hib], Meningococcal C and Pneumococcal conjugate vaccine)

12 months Hib/Men C (Haemophilus influenzae b [Hib] and Meningococcal C)

13 months MMR (1st) and PCV (Measles, Mumps, Rubella and Pneumococcal conjugate vaccine)

3 years 4 months DTaP/IPV or dTaP/IPV (Diphtheria or low dose diphtheria, Tetanus, acellular Pertussis,Inactivated Polio Vaccine pre-school booster)

3 years 4 months MMR (2nd) (Measles, Mumps, Rubella)

12-13 years (girls) HPV (Human Papilloma vaccine) (3 doses over 6 months)

13-18 years dT/IPV (low dose diphtheria, Tetanus, Inactivated Polio Vaccine booster)

Some babies will need Hepatitis B and /or BCG vaccines. If in doubt discuss this with your midwife/health visitor.

The immunisations your child is offered may change with time. Your health visitor or practice nurse will talk to youand give you written information about immunisations. This and other information is available onwww.immunisation.nhs.uk.

Do you know if you are immune to rubella (German measles)? If you are not immune you can be immunised,with MMR vaccine, to protect you and future babies.

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Babies should receive a four-dose course of a hepatitis B vaccine according to the following schedule:

Dose Age Date Batch No. Site VenueSignature Name in CAPITALS

1st Dose Within 48 hoursof birth

2nd Dose 1 month

3rd Dose 2 months

Booster 12 months

Serology12 months(HBs Ag)

Booster 3 years 4 months

Mother’s hepatitis B statusHepatitis B surface antigen: Pos c Neg c Hepatitis B e antibody: Pos c Neg cHepatitis B e antigen: Pos c Neg c Acute hepatitis B in pregnancy: Yes c No c

Other:.......................................................................................................................................................................

Hepatitis B Immunoglobulin given: No c Yes c Date given:........../........../...........

Hepatitis B immunoglobulin given:

No c Yes c Date given: ........./......../.........

Mother’s surname:

......................................................................

Mother’s first name:

......................................................................

Mother’s NHS number:

......................................................................

Top copy: remain in PCHRAll subsequent copies return to Immunisation Section as each immunisation is completed

Immuniser

Hepatitis B infant immunisation programmeQ Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

Hep

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7 part NCR - INCLUDED ONLY IF SPECIFIED ON ORDER

Top copy: remain in PCHR 2nd Copy: GP 3rd Copy: Immunisation Section

Please press firmly

Administration of prior skin test (if indicated):Test Date Batch No. Site Signature Name in CAPITALS Venue

Mantoux

Result – Date Signature Name in CAPITALS Venue

Measurement (mm)

Administration of BCG:Date Batch No. Site Signature Name in CAPITALS Venue

Reason for BCG (please tick): (see Department of Health guidelines for specific details)

c Universal neonatal programme

c Parent/grandparent born in a country with a high TB rate*, please specify country: ______________________________________

c TB in a relative or close contact

c Travel to a country with a high TB rate*

c Born or lived in a country with a high TB rate*

c Other, please specify: __________________________________________________________________________________________

* High TB rate = 40/100,000 or higher. For information on TB incidence by country see www.hpa.org.uk

Immuniser

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BCG vaccinationQ Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

For Babies Only

Mother’s surname:

......................................................................

Mother’s first name:

......................................................................

Mother’s NHS number:

......................................................................


Breastfeedingat 1st Imm:


at 2nd Imm:


at 3rd Imm:



Antigen Date Batch No. Site VenueSignature Name in CAPITALS

8 weeks

DTaP/IPV/Hib

PCV

12 weeks

DTaP/IPV/Hib

Men C

16 weeks

DTaP/IPV/Hib

Men C

PCV

Immuniser

Primary

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14Please press firmlyPrimary course of immunisations

Q Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

4 part NCR

Breastfeeding at all at 1st birthday:

Yes c No c



12 months

Hib/Men C

13 months

MMR (1st dose)

PCV

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Please press firmlyMMR immunisation – first dose & second year boostersQ Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR

Top copy: remain in PCHR 2nd copy: to Immunisation Section


MMR (2nd dose)

DTaP/IPV

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dTaP/IPV

Other

Immuniser

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Please press firmlyMMR immunisation – second dose & pre-school boosterQ Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR - 1st & 2nd copies

This additional copy should only be used if the MMR (2nd dose) is administered separately, and return to Immunisation Section.


MMR (2nd dose)

DTaP/IPV

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dTaP/IPV

Other

Immuniser

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Please press firmlyMMR immunisation – second dose & pre-school boosterQ Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR -3rd copy


Antigen Date Batch No. Site VenueSignature Name in CAPITALSImmuniser

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Please press firmlyAdditional immunisationsQ Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:


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Screening androutine reviews

Screening and routine reviewsYour doctor, health visitor, midwife or school nurse will offer simple routine checks for your child.

Some of these are called screening tests and include:

Q hearing tests within first few weeks after birth

Q blood tests for certain conditions which could cause health problems (for example phenylketonuria, hypothyroidism andsickle cell disease).

Checks of your baby’s:

hips

heart

eyes/vision

testes, if a boy

Other checks or reviews may include:

Q growth

Q hearing

Q general development

Screening tests and other health checks and reviews are done to pick up problems before they have been noticed. They cannever be fully accurate in all cases. This means that sometimes there is a false alarm, when you will be told that your babymay have a condition. However, further tests may show that in fact she or he does not have the condition.

It also means that sometimes a problem may not be picked up even if it is present. So even if your baby has had a check fora condition and was found to be OK, if you think there may be a problem you should still point it out to your health visitoror GP. Do not assume that because the check was ‘normal’, there cannot be a problem.

For more information on screening and routine reviews see Birth to Five and www.screening.nhs.uk

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Can your baby see?There is no easy way to test a young baby's eyesight accurately, but you can help check that there is no serious problem bywatching how your baby uses his/her eyes.

Ask your health visitor or doctor at any time if you are worried about your child’s eyesight, especially in relation to thequestions below.

First two monthsYour child’s eyes will be examined as part of the routine baby check during this period Yes No

Does your baby open his/her eyes and look at you? c c

Does he/she keep looking at you when you move your head from side to side? c c

Do the eyes look normal? c c

Does anyone in the family have serious eye disease that started in childhood? c c

Babies and toddlers

Does your baby ever seem to have a squint (a ‘turn or a ‘lazy’ eye)? c c

Does your baby have any difficulty in seeing small objects (tiny bits of food, crumbs, bits of fluff) or c c

recognising familiar people?

Does anyone in the family have a squint (a ‘turn or a ‘lazy’ eye), or wear glasses (starting in childhood)? c c

Age two to school entry

Your child should be offered a vision test as part of their routine school entry physical examination (between 4 and 5 years). Ifyou are concerned before that test is done, for example that your child may need glasses, talk to your doctor or health visitor.

Does your child have any squint (a ‘turn or a ‘lazy’ eye) or any difficulty in seeing (e.g. watching T.V., c c

recognising you across a room, bumping into things, being unusually clumsy)?

18

Can your baby hear?These two lists give pointers about what to look and listen out for as your babygrows to check if he/she can hear. Babies do differ in what they can do at any givenage. The ages presented here are approximate only.

Checklist for Reaction to Sounds

Shortly after birth – a baby:Is startled by a sudden loud noise such as a hand clap or a door slamming. Blinks or opens eyes widely to such sounds orstops sucking or starts to cry.

1 month – a baby:Starts to notice sudden prolonged sounds like the noise of a vacuum cleaner and may turn towards the noise. Pauses andlistens to the noises when they begin.

4 months – a baby:Quietens or smiles to the sound of familiar voice even when unable to see speaker and turns eyes or head towards voice.Shows excitement at sounds e.g. voices, footsteps etc.

7 months – a baby:Turns immediately to familiar voice across the room or to very quiet noises made on each side (if not too occupied with otherthings).

9 months – a baby:Listens attentively to familiar everyday sounds and searches for very quiet sounds made out of sight.

12 months – a baby:Shows some response to own name. May also respond to expressions like ‘no’ and ‘bye bye’ even when any accompanyinggesture cannot be seen.

If at any stage in the baby or child’s development you think he/she may have difficulties hearing, contact your health visitoror family doctor.

Adapted from: The ‘Can Your Baby Hear You’ form, B. McCormick, 1982, Children’s Hearing Assessment Centre, Nottingham, UK.

Screening ProgrammesNewborn Hearing

Can

you

rb

aby

hear?

19

Checklist for Making Sounds

4 months – a baby:Makes soft sounds when awake. Gurgles and coos.

6 months – a baby:Makes laughter-like sounds. Starts to make sing-song vowel sounds,e.g. a-a, muh, goo, der, aroo, adah.

9 months – a baby:Makes sounds to communicate in friendliness or annoyance. Babbles (e.g. ‘da da da’, ‘ma ma ma’, ‘ba ba ba’). Shows pleasurein babbling loudly and tunefully. Starts to imitate other sounds like coughing or smacking lips.

12 months – a baby:Babbles loudly, often in a conversational-type rhythm. May start to use one or two recognisable words.

15 months – a baby:Makes lots of speech-like sounds. Uses 2-6 recognisable words meaningfully (e.g. ‘teddy’ when seeing or wanting the teddybear).

18 months – a baby:Makes speech-like sounds with conversational-type rhythm when playing. Uses 6-20 recognisable words. Tries to join innursery rhymes and songs.

24 months – a child:Uses 50 or more recognisable words appropriately. Puts 2 or more words together to make simple sentences e.g. more milk.Joins in nursery rhymes and songs. Talks to self during play (may be incomprehensible to others).

30 months – a child:Uses 200 or more recognisable words. Uses pronouns (e.g. I, me, you). Uses sentences but many will lack adult structure. Talksintelligibly to self during play. Asks questions. Says a few nursery rhymes.

36 months – a child:Has a large vocabulary intelligible to everyone.

Adapted from: M. D. Sheridan (Revised by M. Frost and A. Sharma), 1997, Routledge, London, New York.

20


Top copy: stay in PCHR 2nd copy: to Health Visitor or Hospital Record 3rd copy: Child Health Department

Place:....................................................................(District/Hospital where screened)

Hosp c Clinic c Home c

NICU Protocol: Yes c No c

Community screening programme data: Screener ID:........................................... Equipment No:....................................

Consent: Screen: Yes c No c Data: Yes c No c

Clear response:

Test No. (Community):

Not Tested: Reason:

LeftEar:

Clear response:

Test No. (Community):

Not Tested: Reason:

RightEar:

Further Management:Discharge to routine child health surveillance c For further screen: OAE / AABR c Refer to audiology c

Later follow-up at 8 months (corrected) c State reason: Declined Screen c Risk factor c give details below:

Risk factor details (if family history, state exact relative):............................................................................................................

Name: ......................................................... Signature: ............................................ Screener/Screening Co-ordinator/HV**delete as applicable

1st OAEDate: ........../........./ ...........

Yes c No c

.........................................

.........................................

Yes c No c

.........................................

.........................................

2nd OAEDate: ........../........./ ...........

Yes c No c

.........................................

.........................................

Yes c No c

.........................................

.........................................

AABRDate: ........../........./ ...........

Yes c No c

.........................................

.........................................

Yes c No c

.........................................

.........................................

New

bo

rnh

earing

screenin

gp

rog

ramm

e21

Newborn hearing screening programmeQ Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR


Developmental dislocation of the hip(Sometimes called “Developmental Dysplasia of the Hip”- DDH)

In some babies, the top of one or both of the thigh bones may be out of the hip joint, or have a tendency to move out ofthe joint. It is important to pick this up as soon as possible so that it can be treated. Soon after birth and at about 6-8 weeksyour baby’s hips will be checked for this problem. Unfortunately, even experts cannot always pick it up, and sometimes itdevelops later on. There are some things that indicate there could be a problem. If you notice any of the following, you shouldcontact your health visitor or General Practitioner.

Q A difference in the deep skin creases of the thighs between the two legs

Q When you change your baby’s nappy, one leg cannot be moved out sideways as far as the other.

Q Your baby drags a leg when crawling

Q One leg seems to be longer than the other

Q You can hear or feel a click in one or both hips.

Q Your child walks with a limp.

Develo

pm

ental

dislo

cation

of

the

hip

22

New baby review Q A member of the health visiting team will visit you and your family at home, usually when your new baby is between

10-14 days old.

Q This first visit gives you the chance to discuss any issues about the health and well-being of yourself, your new baby andthe rest of the family. This is a chance to ask for any advice or information and to discuss any worries you may have.

Q The health visiting team is led by a health visitor who is a trained nurse with specialist qualifications in child and family health.

Here are some of the things you may want to discuss:

Q contacting the health visitor team in the future

Q child health clinics

Q feeding

Q sleeping and crying

Q advice on reducing the risk of cot death

Q immunisation

Q family health (yourself, your partner, your baby’s brothers or sisters)

Q registering your baby’s birth

Q child benefit

Q home and car safety

You may find it helpful to write down here anything you would like to discuss at the new baby review:

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

23

Breast feeding: Totally c Partially c Not at all c Ethnicity of baby: .......................................................

Any concerns about the baby’s feeding?.............................................................................................................................

...........................................................................................................................................................................................

Mother current smoker c Other smoker in household c No smoker in household c

Any concerns about the baby’s health or behaviour? ..........................................................................................................

...........................................................................................................................................................................................

How is mother / family?......................................................................................................................................................

...........................................................................................................................................................................................

Clinic/surgery to be attended for 6-8 week review:.............................................................................................................

Clinic/surgery to be attended for immunisations: ................................................................................................................

Follow-up required: No c Yes c : GP c Community Paediatrician c Hospital c Other: ....................................

Location/Clinic: ................................................................................................................. Date/Interval: ............................

Reason: .................................................................................................... Signature: .........................................................

Top copy: stay in PCHR 2nd copy: HV 3rd copy: Community information system

New

bab

yreview

24

New baby reviewQ Please place a sticker (if available) otherwise write in space provided.

Date of contact:....................................................

Nature of contact/location: ...................................

.............................................................................

.............................................................................

By whom: .............................................................

Weight (if indicated): ............................................

Age: .....................................................................

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR

Results of newborn bloodspot screeningCondition Results received? Follow up required? If follow up, outcome of follow up

yes / no / not done no / yes & reasonPKUHypothyroidismSickle CellCystic FibrosisMCADDOther

You may find it helpful to write down here anything you would like to discuss at the 6-8 week review:

...........................................................................................................................................................................................

...........................................................................................................................................................................................

Yes No Not sure

Do you feel well yourself?

Is all going well feeding your baby?

Are you pleased with your baby’s weight gain?

Does your baby watch your face and follow with his/her eyes?

Does your baby turn towards the light?

Does your baby smile at you?

Do you think your baby can hear you?

Is your baby startled by loud noises?

Is your baby easy to look after?

Do you have any worries about your baby?

6-8 week reviewThis review is usually done by yourhealth visitor or a doctor. At thisreview your baby will have a fullphysical examination. This is achance to talk about your baby,their health and general behaviourand discuss any worries, evenminor things. Here are somethings you may want to talkabout when you go for thereview. Remember that if you areworried about your child’s healthgrowth or development you cancontact your health visitor ordoctor at any time.

25

Printed on reverse of 1st copy of ‘New baby review’




Item Guide to Content Coded Outcome (ring one) Comment/Action Taken

Hips Check for DDH S P O T R N

Testes/Genitalia ‘O’ if testes not fully descended S P O T R N

Heart Murmur, Cyanosis, Femorals S P O T R N

Eyes Cataract, Eye movements S P O T R N

Other physical features General examination, S P O T R NFontanelle, Palate, Spine

Hearing Stills, Startles, Risk factors S P O T R N

Locomotion Tone, Head control S P O T R N

Manipulation S P O T R N

Speech/Language Social smile S P O T R N

Behaviour Parental concerns, Sleep, Feeding S P O T R N

6-8w

eekreview

26

6-8 week reviewQ Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR

Date of contact: ...................... Age: ....................

Seen by: ...............................................................

Place seen:............................................................

Length (if indicated): ........cm .....................centile

Weight: ............................kg .....................centile

Head circ.: .......................cm .....................centile

Breast feeding: Totally c Partially c Not at all c

Third dose Vit K? No c Not Needed c Given c

Any previous medical problems? Yes c No c

If YES specify: .......................................................

S = Satisfactory P = Problem O = Continue observation T = Treatment being received R = Referral N = Not examinedTop copy: remain in PCHR 2nd Copy: Health Visitor 3rd Copy: Child Health Department

1 year reviewYour baby is now one year old and is learning many new skills, such as:

Q turning to his/her name and making lots of new sounds

Q enjoying pat-a-cake games and toys that make noises like rattles

Q almost walking alone but you need to be close by

Q picking up small things and exploring them so you need to keep him/her safe

Q being demanding and pointing to things out of reach

Q holding a spoon but needing more practice to feed him/herself

Q using a feeder cup

S/he has his/her first tooth and has got used to tooth brushing with a fluoride toothpaste.S/he has been to the dentist. S/he needs to have his/her next immunisations.

Birth to Five gives information about what children are usually doing at this age.

Other things you may want to talk about at the review are:

Q your child's growth or weight

Q vision or hearing

Q sleep and routines

Q behaviour

Q encouraging your child’s development

Q childcare if you want to go back to work or training

Q your own health

You may find it helpful to write down here anything you would like to discuss at the 1 year review:

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

27

Printed on reverse of 1st copy of ‘6-8 week review’


Date of last breastfeed: .........../.........../...................

Mother current smoker c Other smoker in household c No smoker in household c

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................




1year

review28

1 year reviewQ Please place a sticker (if available) otherwise write in space provided.

Date of contact:....................................................


.............................................................................

.............................................................................

By whom: .............................................................


Age: .....................................................................

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR

2-21/2 year reviewYour child is 2-21/2 years old and is learning many new skills, such as:

Q wanting to explore everything and be more independent

Q wanting to run and climb and always being on the go

Q enjoying messy play but not sharing!

Q starting to join up words and trying to repeat words you say. Favourite words are “NO” and “MINE!”

Q enjoying books and joining in with songs and rhymes

Q liking being close to you and having cuddles and hugs

Q playing with other children

Q using a spoon at mealtimes and using a feeder cup

Q starting to show an interest in potty training

Q turning from laughter to anger very quickly, which can be hard work

S/he has got used to tooth brushing with a fluoride toothpaste.S/he has been to the dentist.

Birth to Five gives information about what children are usually doing at this age.

Other things you may want to talk about at the review are:

Q speech and language

Q learning

Q diet

Q behaviour

Q safety

Q your own health

You may find it helpful to write down here anything you would like to discuss at the 2-21/2 year review:

...........................................................................................................................................................................................

...........................................................................................................................................................................................

29

Printed on reverse of 1st copy of ‘1 Year review’


...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................




2-21/

2year

review30

2-21/2 year reviewQ Please place a sticker (if available) otherwise write in space provided.

Date of contact:....................................................


.............................................................................

.............................................................................

By whom: .............................................................


Age: .....................................................................

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR


...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................




Health reviewQ Please place a sticker (if available) otherwise write in space provided.

Date of contact:....................................................


.............................................................................

.............................................................................

By whom: .............................................................


Age: .....................................................................

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCRH

ealthreview

31


...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................




Health reviewQ Please place a sticker (if available) otherwise write in space provided.

Date of contact:....................................................


.............................................................................

.............................................................................

By whom: .............................................................


Age: .....................................................................

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCRH

ealthreview

32

School Health ServiceQ The School Health Service offers advice and support throughout your child’s school years.

Q The school nurse or doctor can help if you have concerns about your child’s health or development that may affect theireducation. They also support school staff in meeting children’s special needs in school.

Q Tests of eyesight and hearing are usually offered during the first year at school as well as a general health assessmentincluding height and weight. If you have any concerns, discuss these with the school nurse.

Q As your child gets older he or she will be able to talk to the school nurse about their health or about any worries theymay have.

Q It is important that your child’s immunisations are up to date before starting school. If you are unsure please check withyour health visitor or general practitioner.

Please note anything you would like to discuss with the school nurse: ...............................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

Scho

ol

Health

Service33


School entry review in reception classQ Please place a sticker (if available) otherwise write in space provided.

Surname:

First names:


Address: ............................................................................ Sex: M / F

................................Post code: ................................D.O.B:........../ ......../........

G.P: Code:

H.V: Code:

3 part NCR Sch

oo

len

tryreview

inrecep

tion

class34

Date of contact:....................................................


.............................................................................

Weight:.......................kg ..........................centile

Height: .......................cm ..........................centile

Hearing screen: Pass c Fail c

Vision screen: Pass c Fail c

By whom: .............................................................

Age: .....................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

...........................................................................................................................................................................................

Immunisations complete? Yes c No c What vaccines are needed? ..........................................................................




You

rch

ild’s

firstsan

dg

row

thch

arts

Your child’s firstsand growth charts

Your child’s developmental firstsBabies want to explore the world around them. Your baby grows and learns faster in the first year than at any other time. Thereare many things that all babies and young children do, but not always at the same age or in the same order. Use these pages tonote down when your child does things for the first time.

Finding out about moving...

Lifts head clear of ground,

aged:..............

Rolls over,

aged:..............

Sits with support,

aged:..............

Sits alone,

aged:..............

Crawls,

aged:..............

and/or

Bottom shuffles,

aged:..............

Walks holding on,

aged:..............

Walks alone,

aged:..............

First outdoor walk,

aged:..............

Find

ing

ou

tab

ou

tm

ovin

g35

Stands holding on,

aged:..............

Stands alone,

aged:..............

See Birth to Five for more information on children’s development.

36

Finding out about hands...

Stares at hands,

aged:..............

Drops things on purpose,

aged:..............

Reaches out for thingssuch as your hair,

aged:..............

Finger feeds,

aged:..............

Holds pencil and makes marks,

aged:..............

Opens cupboards,

aged:..............

Feeds with a spoon,

aged:..............

Picks up smallthings using fingerand thumb,

aged:..............

Grabs and holds thingsusing whole hand,

aged:..............


Finding out about words...

Smiles,

aged:..............

Laughs,

aged:..............

Babbles,

aged:..............

Copies noises,

aged:..............

Says “mama” – to anyone,

aged:..............

Says recognisable word,

aged:..............

Helps turn pagesin a book,

aged:..............

Joins tworecognisable words,

aged:..............

Speaks insentences,

aged:..............

Find

ing

ou

tab

ou

tw

ord

s37


Holds up arms tobe lifted,

aged:..............

Cries when youleave the room,

aged:..............

38

Favourite games... Aged: Aged:

............................................................................. ................. ............................................................................. ..............

............................................................................. ................. ............................................................................. ..............

Comments:................................................................................................................................................................................

.................................................................................................................................................................................................

Finding out about people...

Moves eyes towatch you,

aged:..............

Smiles for special people,

aged:..............

Usually sleepsthrough the night,

aged:..............

Stares at your face,

aged:..............


Other firsts...

.................................................................................................................................................................................................

.................................................................................................................................................................................................

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Oth

erfirsts

39

40

Dental health

You can take your child to see an NHS dentist for preventive advice as soon as he/she is born.

NHS dental treatment for children is free.

Put your child’s age in months on the chart below as each tooth appears...

For more information on caring for your child’s teeth see Birth to Five.Can also be viewed by searching for Birth to Five at www.dh.gov.uk

Age first tooth came through:

..................................

top teeth

bottom teeth

All entries should be dated and signed

NotesThese pages are for you and others who are in contact with your child to record any information about your child’s health and/ordevelopment. Keep a note here of anything you would like to discuss with your HV / GP or other health professional.

Date Comments & any advice or treatment Name & designation___________________________________________________________________________________________________________

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Weight conversion chart

gm

lbs

oz

500

12

550

13

600

15

650

17

700

19

750

110

800

112

850

114

900

20

950

21

1kg

1.00

23

1.05

25

1.10

27

1.15

28

1.20

210

1.25

212

1.30

214

1.35

30

1.40

31

1.45

33

1.50

35

1.55

37

1.60

38

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7

UK-WHOGrowth Charts0–4 years

GROWTH MONITORING USING GROWTHCHARTS The UK–WHO growth charts The charts in this book are based on measurements ofhealthy breastfed children from several countries, whosemothers did not smoke. They represent the pattern ofgrowth for healthy children, whether breastfed or formulafed, and of all ethnic origins.Babies come in all shapes and sizes and they do not all gainweight at the same rate, so every chart will look differentwhen it is filled in.

Weighing and measuring Babies and children up to 2 years of age should be weighedwithout any clothes or nappy on, as this can make a bigdifference to the weight.Toddlers (aged 2 years and older) can be weighed wearingtheir vest and pants, but they should not wear shoes.Be aware that different scales sometimes give differentreadings, particularly if they are not electronic. If you noticethis, try to take your baby/child to the same place forweighing each time.Length or height should always be measured if there are anyconcerns about a child’s growth.Up to the age of 2, your child’s length (i.e. lying down) ismeasured, rather than height. Special equipment is neededto measure length accurately. Your child should not bewearing a nappy.From age 2, their height (i.e. standing up) will be measured.Children should not be wearing shoes when their length orheight is measured.

How often to weighIt is normal for a baby to lose some weight in the first fewdays after birth. Your baby should be weighed in the firstweek as part of the assessment of feeding. Most babies get

back to their birth weight by 2 weeks of age. This is a signthat feeding is going well and that your baby is healthy.After that, weight will usually be measured only when yourbaby is seen routinely, unless there is concern. Your healthvisitor may ask you to bring your baby more often if he/shewishes to monitor them more closely. Weighing your babytoo often may cause unnecessary concern; the list belowshows how often, as a maximum, babies should beweighed to monitor their growth. However, most childrenwill not need to be weighed as often as this.

Age No more than2 weeks to 6 months Once a month6–12 months Once every 2 monthsOver 12 months Once every 3 months

Remember that if you want to ask something you canalways phone your health visitor or visit the clinic,without having your child weighed.

Royal College ofPaediatrics and

Child Health

Plotting and interpreting measurementsThe chart is a guide to how your child is growing. Itcompares your child’s length and height with other childrenof the same age. It also shows how quickly your child isgrowing.Your baby’s charts shows weight in kilograms and height incentimetres. If you want to change these measurementsinto pounds/ounces and feet/inches you can use theconversion chart in this record or ask your health visitor toconvert them.Someone who has been appropriately trained shouldcomplete the growth chart. If your baby was bornprematurely (less than 37 weeks), the weight will be plottedon the preterm chart, until your baby reaches the estimateddelivery date (EDD) plus 2 weeks (42 weeks). After this, hisor her weight will be plotted on the 0–1 year weight chartbut with an allowance to take account of prematurity. Thisshould continue until at least 1 year of age.

Normal weight and heightThe curves on the chart are called centile lines. These showthe range of weights and heights (or lengths) of mostchildren. If your child’s height is on the 25th centile, forexample, this means that if you lined up 100 children of thesame age in height order, your child would be number 25;75 children would be taller than your child. It is quite normalfor a child’s weight or height to be anywhere within thecentile lines on the chart.

When are children unusually big or small?There is not an exact point at which it can be said that achild’s weight or height is definitely abnormal. However,only four in every thousand healthy children are at or belowthe 0.4th centile. A paediatrician usually assesses thesechildren to make sure that there are no problems. Beingvery small can sometimes indicate a medical or healthproblem.Babies on the top weight or length centile are usuallyhealthy. If your child’s weight goes above the top centile

after 12 months of age, this may be a sign that they areoverweight. Your health visitor may want to assess thisfurther.

What is a normal rate of weight gain?Weight gain in the early days varies a lot from baby to babyso there are no lines on the chart for 0–2 weeks. By 2 weeksof age most babies weight will be on a centile close to theirbirth centile.It is unlikely that your baby’s weight will exactly follow asingle centile line, particularly in the first year. It is mostlikely to track within one centile space (i.e. the gap betweentwo centile lines).Children may lose weight during an illness but their weightwill usually go back to their usual centile within2–3 weeks. However, if your baby’s weight remains down bytwo or more centile spaces, they should be assessed by yourhealth visitor and their length should also be measured.

Length and height Under the age of 2 years, a child’s length is measured lyingdown. When your child reaches 2 years of age their heightwill be measured instead. When standing up, the spine issquashed a little, which will mean that your child’s height isslightly less than their length. However, their height will beon the same centile as their length and your child shouldcontinue to grow approximately along the same centile.Healthy children may be on a different length/height centilefrom the weight centile, although the two are usuallysimilar.To get an idea of how tall your child may be as an adult, plottheir height and follow the centile line to the scale at theside of the 2–4 years height chart. Four out of five healthychildren have an adult height that is within 6cm above orbelow this value. So, if, for example, your child’s height is onthe 25th centile, the average adult height for a girl for thiscentile is 161cm and for a boy is 174 cm. A girl’s adultheight is therefore likely to be between 155cm and 167cmand a boy’s adult height between 168cm and 180cm.

Measurement RecordYour health visitor or doctor should fill in these boxes when they weigh your child and then plot the measurements on the appropriate centile charts.

Date

Date of Birth

Age Wt (kg) Wt (lb) Name orInitials

OtherMeasurements

Date Age Wt (kg) Wt (lb) Name orInitials

OtherMeasurements

Birth Weight Gestation wkskg●

head

wei

ght

Wei

ght (

kg)

Hea

d Ci

rcum

fere

nce

(cm

)

5.5

5

4.5

4

3.5

3

2.5

2

1.5

1

5.5

5

4.5

4

3.5

3

2.5

2

1.5

1

38 40 40

34 36 38 40 34 36 38 40

Gestation in weeks Gestation in weeks

40

39

38

37

36

35

34

33

32

31

30

29

28

27

26

40

39

38

37

36

35

34

33

32

31

30

29

28

27

26

UK

- W

HO

Cha

rt 2

009

© D

H C

opyr

ight

200

9

Preterm BOYS WEIGHT (kg) BOYS HEADCIRCUMFERENCE (cm)

99.6

th98

th91

st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6

th

98th

91st

75th

50th

25th

9th

2nd

0.4t

h

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4t

h

Actual age

Gestational age(7 weeks preterm)

For preterm infants (lessthan 37 weeks gestation),plot on this chart until 2weeks after expected dateof delivery (42 weeks). Aswith term infants, someweight loss is common inthe early days.

From 42 weeks, plot on the0-1 year charts withgestational correction.Plot at actual age thendraw a line back thenumber of weeks the infantwas preterm and mark spotwith arrow; this is thegestationally correctedcentile.

4232

42 42

4232

weight

2 3 4 8 9 10

Age in weeks/ months


3 4 5 6 7 8 9 10 11

14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50

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

1 5 76 11

BOYS WEIGHT (kg)

0–1 year

91st

0.4th

2nd

9th

25th

50th

75th

98th

99.6th

99.6

th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

Some degree of weightloss is common after birth.Calculating the percentageweight loss is a useful wayto identify babies whoneed extra support.

0 52

5213.5

13

12.5

12

11.5

11

10.5

10

9.5

9

8.5

8

7.5

7

6.5

6

5.5

5

4.5

4

3.5

3

2.5

2

1.5

1

0.5

Wei

ght (

kg)

13.5

13

12.5

12

11.5

11

10.5

10

9.5

9

8.5

8

7.5

7

6.5

6

5.5

5

4.5

4

3.5

3

2.5

2

1.5

1

0.5

weightWei

ght (

kg)

28

27

26

25

24

23

22

21

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

5

4

21 22 23 25 26 27 28 29 31 32 33 34 35 37 38 39 40 41 43 44 45 46 47

2

211/2

21/2

21/2

3

3

31/2

31/2

Age in months/ years


99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

BOYS WEIGHT (kg)

1–4 years

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

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 4712 48

4828

27

26

25

24

23

22

21

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

5

4 UK

- W

HO

Cha

rt 2

009

© D

H C

opyr

ight

200

9

98

96

94

92

90

88

86

84

82

80

78

76

74

72

70

68

66

64

62

60

58

56

54

52

50

48

46

44

length

2nd

91st

0.4th

9th

25th

50th

75th

98th

99.6th

8 97 10 11 13 14 15 16 17 19 20 21 22 23

Leng

th (c

m)

1/2

1/2

1

1

11/2

11/2

10 2 3 4 5 7 8 9 10 11 13 14 15 16 17 19 20 21 22 23

24

24

98

96

94

92

90

88

86

84

82

80

78

76

74

72

70

68

66

64

62

60

58

56

54

52

50

48

46

44


BOYS LENGTH (cm)

0–2 years

99.6

th98

th91

st75

th50

th25

th9t

h2n

d0.

4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th


height

6.3

6.2

6.1

6.0

5.11

5.10

5.9

5.8

5.7

5.6

5.5

5.4

5.3

190

185

180

175

170

165

160

192H

eigh

t (cm

)

116

112

108

104

100

96

92

88

84

80

76

116

112

108

104

100

96

92

88

84

80

76

0.4th

2nd

9th

25th

50th

75th

91st

98th

99.6th

21/2

3

3

31/2

31/2

25 26 27 28 29

31 32 33 34 35 37 38 39 40 41 43 44 45 46 47

31 32 33 34 35 37 38 39 40 41 43 44 45 46 47

cmft/in

Adult HeightPredictionBOYS HEIGHT (cm)

2–4 years

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th


99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

24 48

48

Plot your son’sheight centileon the bluelines; the blacknumbers showaverage maleadult height forthis centile;four out of fivewill be within6 cm above orbelow thisvalue.


0.4th

2nd

9th

25th

50th

75th

91st

head

99.6th

52

51

50

49

48

47

46

45

44

43

42

41

40

39

38

37

36

35

34

33

32

31

Hea

d Ci

rcum

fere

nce

(cm

)52

51

50

49

48

47

46

45

44

43

42

41

40

39

38

37

36

35

34

33

32

31

Months

MonthsWeeks

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 232 4 6 8 10 12 14 16 18 20 22 24 26

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

0

BOYS HEADCIRCUMFERENCE (cm)0–2 years

99.6

th98

th91

st75

th50

th25

th9t

h2n

d0.

4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

98th

For preterm infants (lessthan 37 weeks gestation),plot on this chart until 2weeks after expected dateof delivery (42 weeks). Aswith term infants, someweight loss is common inthe early days.

From 42 weeks, plot on the0-1 year chart withgestational correction.Plot at actual age thendraw a line back thenumber of weeks the infantwas preterm and mark spotwith arrow; this is thegestationally correctedcentile.

39

38

37

36

35

34

33

32

31

30

29

28

27

26

25

head

wei

ght

Wei

ght (

kg)

Hea

d Ci

rcum

fere

nce

(cm

)

5.5

5

4.5

4

3.5

3

2.5

2

1.5

1

5.5

5

4.5

4

3.5

3

2.5

2

1.5

1

38 40 40

34 36 38 40 34 36 38 40

Gestation in weeks Gestation in weeks

Actual age

Gestational age(7 weeks preterm)

GIRLS HEADCIRCUMFERENCE (cm)39

38

37

36

35

34

33

32

31

30

29

28

27

26

25

GIRLS WEIGHT (kg)

99.6

th98

th91

st

75th

50th

25th

9th

2nd

0.4th

99.6

th

98th

91st

75th

50th

25th

9th

2nd

0.4t

h

99.6th

99.6th

98th

98th

91st

91st

75th

75th

50th

50th

25th

25th

9th

9th

2nd

2nd

0.4th

0.4th

Preterm

UK

- W

HO

Cha

rt 2

009

© D

H C

opyr

ight

200

9

42

32 42

42

32 42

91st

0.4th

2nd

9th

25th

50th

75th

98th

99.6th

weight

Wei

ght (

kg)

2 3 4 8 9 10



3 4 5 6 7 8 9 10 11

14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50

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

1 5 76 11

0

13.5

13

12.5

12

11.5

11

10.5

10

9.5

9

8.5

8

7.5

7

6.5

6

5.5

5

4.5

4

3.5

3

2.5

2

1.5

1

0.552

5213.5

13

12.5

12

11.5

11

10.5

10

9.5

9

8.5

8

7.5

7

6.5

6

5.5

5

4.5

4

3.5

3

2.5

2

1.5

1

0.5

GIRLS WEIGHT (kg)

0–1 year

99.6

th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

Some degree of weightloss is common after birth.Calculating the percentageweight loss is a useful wayto identify babies whoneed extra support.

weight

Wei

ght (

kg)

21 22 23

2120191716151413 22 23

25 26 27 28 29 31 32 33 34 35 37 38 39 40 41

25 26 27 28 29 31 32 33 34 35 37 38 39 40 41

43 44 45 46 47


2

211/2

21/2

21/2

3

3

31/2

31/2


43 44 45 46 47

GIRLS WEIGHT (kg)

1–4 years

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

UK

- W

HO

Cha

rt 2

009

© D

H C

opyr

ight

200

9

4829

28

27

26

25

24

23

22

21

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

54812

29

28

27

26

25

24

23

22

21

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

5

98

96

94

92

90

88

86

84

82

80

78

76

74

72

70

68

66

64

62

60

58

56

54

52

50

48

46

44

length

8 97 10 11 13 14 15 16 17 19 20 21 22 23

Leng

th (c

m)

1/2

1/2

1

1

11/2

11/2

24

10 2 3 4 5 7 8 9 10 11 13 14 15 16 17 19 20 21 22 23 24

98

96

94

92

90

88

86

84

82

80

78

76

74

72

70

68

66

64

62

60

58

56

54

52

50

48

46

440.4th

2nd

9th

25th

50th

75th

91st

98th

99.6th

GIRLS LENGTH (cm)

0–2 years Age in months/ years


99.6

th98

th91

st75

th50

th25

th9t

h2n

d0.

4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

ft/in

98th

99.6th

height

5.9

5.8

5.7

5.6

5.5

5.4

5.3

5.2

5.1

5.0

4.11

175

170

165

160

155

150

Hei

ght (

cm)

116

112

108

104

100

96

92

88

84

80

76

116

112

108

104

100

96

92

88

84

80

76

91st

75th

50th

25th

9th

2nd

0.4th

21/2

3

3

31/2

31/2

24 25 26 27 28 29

31 32 33 34 35 37 38 39 40 41 43 44 45 46 47

31 32 33 34 35 37 38 39 40 41 43 44 45 46 47 48

48

cm

Adult HeightPredictionGIRLS HEIGHT (cm)

2–4 years Age in months/ years

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

Plot yourdaughter’sheight centileon the pinklines; the blacknumbers showaverage femaleadult height forthis centile;four out of fivewill be within6 cm above orbelow thisvalue.


0.4th

25th

50th

91st

99.6th

75th

9th

head

Hea

d Ci

rcum

fere

nce

(cm

)52

51

50

49

48

47

46

45

44

43

42

41

40

39

38

37

36

35

34

33

32

31

52

51

50

49

48

47

46

45

44

43

42

41

40

39

38

37

36

35

34

33

32

31

Months

MonthsWeeks

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23GIRLS HEADCIRCUMFERENCE (cm)0–2 years

2nd

98th

99.6

th98

th91

st75

th50

th25

th9t

h2n

d0.

4th

99.6th

98th

91st

75th

50th

25th

9th

2nd

0.4th

2 4 6 8 10 12 14 16 18 20 22 24 260

Age Reason for contact Date/time due PlaceWithin 72 hours Full physical examination

5-8 days Blood sample for screening tests(heel prick)

10-14 days (usually) New baby review

In 1st month Hearing screening

6-8 weeks Full physical examination

8 weeks 1st set of immunisations

12 weeks 2nd set of immunisations

16 weeks 3rd set of immunisations

By 12 months Health review

12 months Booster immunisations

13 months 1st dose MMR vaccine and booster immunisations

2-21/2 years Health review

3 years 4 months 2nd dose MMR vaccine (can be given earlier)and pre-school booster immunisations

4-5 years Vision check

School entry Height, weight and hearing check(reception class)

12-13 years HPV vaccine(girls only)

13-18 years School leavers’ booster immunisations

This is a list of the minimum contacts that are provided for your child during their pre-school and school aged years.This may vary according to your child’s needs and to local policy.

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