Just areminder of child vaccinations, check up and review schedules as well as interpreting height and weight charts.

Jabs
2 Months: DTaP/IPV/Hib and PCV. These are to protect your child against diphtheria, tetanus, pertussis (whooping cough), polio (nowadays it is inactivated, and no longer given as a drop on a sugar lump that we may have had as children), Haemophilus Influenzae type b and pneumococcal infection.

3 Months: DTaP/IPV/Hib and Men C. These are the same as above but instead of the pneumococcal vaccine there is one for Meningococcus C - the bug that can give you meningitis.

4 Months: DTaP/IPV/Hib, Men C and PCV. These are repeats of all of the above.
Around 12 Months: Hib/Men C
Around 13 Months: MMR and PCV. I think everybody knows what the MMR is for: measles, mumps and rubella.
3 Years 4 Months to 5 Years: DTaP/IPV or DTaP/IPV and MMR. 13 to 18 Years: TD/IPV - tetanus, diphtheria and polio.

Each vaccination is given as a single injection into the muscle in the thigh or upper arm (so only two injections most of the time). It is really important to have the full course of vaccinations for them to really work and protect your child against these dangerous infectious diseases.

Check ups in the first years of life
These are screening checks to make sure that any problem with your child is picked up and treated sooner rather than later.

At birth: Before leaving hospital your child should have a full physical examination by a paediatrician, including eyes and hips. Your child should also have a hearing test done by a trained audiology technician.

First few days at home: Your baby should be reviewed by your midwife to make sure feeding and weight gain are going well. She should also do a Guthrie test at 5 days of life - this is a heel prick blood test on some special blotting paper and tests for PKU (phenylketonuria), hypothyroidism (under active thyroid), sickle cell and cystic fibrosis.

It is advisable to bring your baby to your local baby clinic once a week to get weighed and to have a chat with the Health Visitor - just for reassurance or trouble shooting if need be.

6-8 week review: This is usually done by your GP and is another full physical examination as well as a chat with you to see how things are going and how you are feeling. Your baby's development will also be reviewed at this check.

8-12 month review: This is more of a developmental review of your child and an opportunity to discuss any ongoing concerns you might have with development, feeding, speech and language for instance. If there have been any concerns about hearing in the neonatal screening or during the child's development, this is when a repeat hearing test may be arranged.

2-3 years: At this age your child may be offered another general developmental review, although his depends very much on your primary care trust and your GP surgery. Some parents may be sent a questionnaire about their child's progress and invited to attend a review should there be any concerns.

4-5 years: School entry review in reception.
Do attend all scheduled reviews as they are there to pick up any potential problems early so as not to miss any windows of opportunity for treatment. Equally, should you have any active concerns about your baby or child, do no wait specifically for these reviews but make an appointment with your GP as soon as possible.

Height and weight
Every parent will worry at some point or another about whether their child is growing properly or gaining weight adequately. These parameters can be measured and plotted on the growth charts that every child's personal health record (the little red book you should be given when you leave hospital with your new baby) contains. Do remember that your child's initial birth weight may not be predictive of their natural physiognomy.

The charts have the child's age (in weeks for the first year, in months thereafter) on the bottom horizontal line and the child's height (in cm), weight (in kg) or head circumference (in cm) on the vertical line. Along the vertical line you will also see the following numbers: 0.4th, 2nd, 9th, 25th, 50th, 75th, 91st, 98th and 99.6th , all at the end of plain or dotted lines. These numbers are the "centiles" and the lines are the "centile lines". They can give you an idea of where your child lies compared to the rest of the population at that age.

Example: If you child's weight at the age of two is 11.4kg, then they will be just below the 25th centile - this means that 25% of children will weigh less than them at the same age, and that 75% of children will weigh more.

If your child's weight has always been along the 25th centile line then there is no need to worry: your child is growing along his/her own line and that is his/her normal weight.

If on the other hand your child has always been on the 75th centile and suddenly drops by two centiles to the 25th, then you may have good reason to be concerned about your child crossing the centile lines and not thriving as he/she should.

Sudden jumps in the other direction (from low centile to high) are also of concern as they may equally indicate serious medical problems. This sort of drastic change should never be ignored and you should make an appointment with your doctor. This of course also applies for height and head circumference. Height and weight charts can also give you an idea as to whether your child's weight is appropriate for their height (either too much or too little), as both parameters should be roughly on the same centile, or "in proportion".

It is important to remember though that values, both for height and for weight, can hover above and under the centile lines and still be entirely normal. Children tend to grow in a step wise progression with faster and slower periods of growth, and if you measure your child frequently you may see this on his/her growth chart. Periods of illness or teething may, for example, affect these measurements without always meaning that there is a serious problem. It is always important to look at the context as a whole.

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