I found this article and I thought interezante share it with you .. Cinergy Health Regards Guidelines for health care of people with Down syndrome. Neonatal (birth to one month) Karyotype. Genetic counseling if necessary. Address concerns of parents. If vomiting or absence of stools, check gastrointestinal blockage (duodenal atresia or Hirschsprung’s disease). Evaluation by a pediatric cardiologist including echocardiogram, (even if no murmur). Consider prophylaxis for bacterial endocarditis (PEB), in susceptible children with heart disease. Review food (proper technique, swallowing problems), to ensure adequate caloric intake. Thyroid testing: take T4 and TSH or revise metabolic screening. Recommend early intervention program. Refer a support group for parents. Children (1-12 months) general neurological examination, neuromotor and musculoskeletal. TSH and T4 for thyroid function at 12 months. Evaluation by pediatric cardiologist if it was not made at birth. Consider pulmonary hypertension in patients with septal defects even when they have data of heart failure. Pediatric Well Child Care (development and growth charts for children with Down syndrome, full immunization chart.) Assess food history, calorie monitor, monitor and consider constipation Hirschsprung’s disease. Recommend balanced diet high in fiber. Examine ears, nose and throat (as needed) especially if there is suspicion of otitis media. Consideration for vision, especially if there is nystagmus, strabismus or poor vision data (at 6 months and then yearly). Recommend early intervention program, if not already done so. Addressing concerns of parents. Childhood and Pre-teens (1-12 years) TSH and T4 to assess thyroid function every year. Echocardiogram and cardiac evaluation if they have not done before. Audiometry each year, if necessary. Neurological evaluation by the pediatrician or family doctor for possible atlanto-axial instability (root compression), and if data taking RX cervical spine (from 4 years). Continue pediatric consultation-child visits, using weight and height charts for children with SD and full immunization chart. Cinergy Health Assess annual immunization for influenza and pneumococcal immunization schedule, according to the local scheme. Review of the Year ‘view when needed (refractive errors are common). Test for celiac disease IgA (between 2 and 3 years), if symptoms occur. Ask about sleep pattern focused on obstructive sleep apnea, and if it is necessary to consider consultation with ENT. Prophylaxis for bacterial endocarditis in children with heart disease. Dental exams after 2 years and then annually, for prophylaxis and correction of abnormal rash Teething (aimed at improving the articulation and swallowing).