Breastfeeding babies with Down syndrome

Contrary to the misleading information families sometimes receive, a diagnosis of Down syndrome is not a reason to give up the idea of breastfeeding your baby. Many babies with Down syndrome experience no difficulty in establishing breastfeeding. But you may have to be persistent, which can be difficult at a time when you may be dealing with an array of other concerns and emotions.

There are several good reasons to persevere with breastfeeding your baby, even if it is not all smooth sailing. These include:

 Breast milk provides the best possible nutrition for all babies.

 Breastfeeding your baby encourages the bonding process between mother and baby.

 Breastfeeding helps stimulate and develop the muscles around and in the mouth. These muscles are important for later feeding skills and for speech development. Breastfeeding helps with lip closure and can discourage tongue thrusting as the child gets older. It also contributes to jaw stability.

 Infants with Down syndrome are often more susceptible to infection than other babies, and breast milk helps to provide important disease immunity. The antibodies in breast milk offer good protection against respiratory and other infections.

 There is some evidence that babies who are breastfed are less susceptible to coeliac disease (gluten intolerance) which is more prevalent in people with Down syndrome than the general population.

Here are some common concerns about babies with Down syndrome:

 Is my baby too sleepy? It is very common for babies with Down syndrome to be sleepy initially and you may need to make some effort to rouse your baby and to keep him or her awake during feeding. You may find that you need to establish a regular feeding schedule rather than waiting for your baby to wake to be fed.

 Is my baby strong enough to breastfeed? Babies with Down syndrome, and particularly those with heart conditions, may tire easily and find it difficult to muster the energy for a lengthy feed. You may need to feed more frequently or use top-up feeding strategies (see below) in the initial stages.

 Is breastfeeding too difficult for my baby? Babies with Down syndrome often take longer to establish breastfeeding than other babies. This may be due to lack of energy or it may be that reduced muscle tone means that your baby may have trouble grasping the nipple and attaching correctly. Some babies have trouble coordinating sucking, swallowing and breathing and may gulp and choke as they feed. They may get less milk for their effort and get tired easily. Both energy levels and muscle tone gradually improve and as your baby grows they will become stronger, learn control of those muscles and be more able to feed effectively.

 Is my baby gaining enough weight? In order not to compromise your baby's weight gain, you may initially need to feed more frequently or to top-up breastfeeds using expressed breast milk given by dropper, spoon bottle (possibly with a special teat) or tube.

 Is support available? In the early days of establishing breastfeeding, you and your baby are likely to need some extra help, so it is important that you access good and encouraging support to help you stay calm and patient while your baby learns.

There is more practical information and advice on dealing with each of these issues on our website at Early feeding skills and first foods.

For support and advice, or if you are having trouble establishing breastfeeding, there are several avenues of support available:

 A great support is to talk to other mothers who have actually experienced your situation. Down Syndrome Victoria can put you in contact with other mothers who have experience of breastfeeding a baby with Down syndrome and who can offer advice and encouragement. Contact our Family Support Coordinator, Sue Modra, on 1300 658 873

 Many maternity units in large hospitals employ lactation consultants, while others work in private practice. The following sites may help you find a consultant close to you: Australian Lactation Consultants Association and the Network of Australian Lactation Colleges

 A local Australian Breastfeeding Association (ABA) Breastfeeding Counsellor. ABA has some designated counsellors who have experience of breastfeeding a baby with Down syndrome. You can call ABA on (03) 9885 0855 or 1800 6862 686, or visit the website at: www.breastfeeding.asn.au/products/counselling.asp

 Your Maternal and Child Health Nurse: find the closest one to you via the Maternal and Child Health Centre Directory

 The Maternal and Child Health Advisory Line, 13 22 29 (local call) 24 hours, 7 days

 the Royal Children's Hospital stock a wide range of special teats and bottles.

This article appeared in Voice, Down Syndrome Victoria Members Journal, Summer 2009 issue (Early years).