Ask: Down syndrome and breast-feeding

06/24/2014 1:00 AM

06/23/2014 10:30 PM

Q: My baby with Down syndrome will be born in July. I really want to breast-feed her, but I am hearing conflicting information. Someone told me that she will not be able to breast-feed, and then others are telling me that she can. What is the truth?

A: Although infants with Down syndrome can have more difficulties breast-feeding, it is not impossible. Detecting possible problems quickly and providing specialized therapy can significantly increase a baby’s success. There is no question that all babies benefit from human milk and the experience of breast-feeding.

Benefits particular to breast-feeding a baby with Down syndrome:

• Human milk has immune protection properties that can help protect against infection. Babies with Down syndrome tend to have increased respiratory, viral and ear infections.
• The action of the tongue, lips and jaw used during breast-feeding can increase muscle strength and help ensure that these muscles are used correctly for feeding and speech development.

Some of the reasons that breast-feeding can be more challenging:

• Low muscle tone in a baby’s body, mouth, face and throat can make feeding and swallowing more difficult. Feeding therapy strengthens muscle tone and teaches correct oral patterns. Strong muscles help with speech and feeding development.
• Tongue thrust (tongue pushing-out pattern) during sucking can make latching and staying latched more difficult and reduce effective milk transfer. Specialized exercises done before latching your baby onto the breast can reduce a tongue thrust pattern. Correct tongue movements can also increase milk transfer.
• Respiratory problems can significantly affect feeding skills. “If you can’t breathe, you can’t eat.” Children with Down syndrome are at significant risk for aspiration (food going the wrong way). Feeding therapy can provide ways to reduce aspiration and increase safe swallowing patterns.
• Heart issues can cause fatigue. Supportive positioning and special feeding techniques can reduce feeding fatigue and reduce sleepiness that can make it difficult to finish a feeding.
• Due in part to low muscle tone, reflux and constipation are particularly bothersome for infants with Down syndrome. These GI issues can slow feeding development.

If your baby is having difficulty breast-feeding, seek professional help right away to ensure your baby’s chance of success.

Helpful tips:

• Provide supportive positioning by swaddling or supporting your baby’s head, neck and upper back.
• Calm surroundings can reduce fatigue or sleepiness. Classical music can also help.
• Make sure that all feedings are enjoyable. Get help so that breast-feeding is a stress-free and positive experience for you and your baby.

I recommend you try breast-feeding. Get help if you need it so you can enjoy one of life’s precious mommy experiences.

Joan Dietrich Comrie of Carolina Pediatric Dysphagia (feeding.com) is a specialist in dysphagia.

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