• Finding Out
• First Questions
• Telling Others
• Your Feelings
• Looking After Yourselves
• Feeding Your Baby
• Your Baby's Development
• Early Intervention

Feeding Your Baby

Feeding a baby with Down syndrome is very similar to feeding any other baby so use the usual sources of information and support (Plunket, La Leche etc.) just as you planned during pregnancy. This section just covers areas that are especially important when feeding a baby with Down syndrome.

Will my baby have problems with feeding?
• Sometimes our babies feed easily with no more problems than with any other baby.

• Sometimes feeding babies with Down syndrome can be harder and needs more time, patience and perseverance.

• Our babies have low muscle tone and so may have trouble latching correctly to the breast or the teat of a bottle and in coordinating sucking, swallowing and breathing.

• Our babies may have difficulty maintaining a seal. Gentle upward pressure on the chin may help this.

• Our babies may be too sleepy to feed. They may tire quickly before they have had enough milk.

•Our babies may find it hard to gain weight. Like all babies our babies lose up to 10% of their birth weight in the first three or four days, but it may take them longer to regain this weight.

• Our babies tend to gain weight slowly. Plot their weight gain on the special Down syndrome growth chart in the booklet ‘Your baby’s health’.

When should I feed my baby?
• Your baby needs at least one night feed and frequent feeds during the day. Seek the advice of your health care team.

• Some of our babies wake up by themselves and show obvious signs of hunger. Others need to be woken up.

• Some of our babies don’t cry or show you they are hungry even when they are awake.

• Babies who are sleeping lightly and getting ready to feed may
• Have rapid eye movement
• Move their arms and legs about more
• Make sucking movements with their lips
• Start pulling faces

• Babies can often be woken up if you
• Loosen or remove their covers
• Talk to them
• Change their nappy
• Gently rub their hands and feet
• Gently move their arms and legs
•Wipe their face with a cool damp cloth
• Hold them in an upright or standing position

• You may need to burp your baby and use continued gentle stimulation to keep your baby awake during the feed. If you are breastfeeding try swapping to the other breast several times.

• Sometimes babies won’t wake up to feed, or don’t get enough milk from the breast or bottle. Milk can then be given directly into their stomach through a naso-gastric tube.

Will I be able to breastfeed?
• Almost all mothers can breast feed or provide breast milk for their babies with Down syndrome.

• Sometimes breastfeeding is established easily with no more problems than with any other baby.

• Sometimes breastfeeding a baby with Down syndrome can be harder and needs more time, patience and perseverance.

• Sometimes mothers choose not to breastfeed or find that because of their circumstances breastfeeding is not right for them.

Will my baby be able to breast feed?
• Many babies with Down syndrome are able to breastfeed successfully from birth. Often these are babies born at full-term with no additional problems.

• Other babies are not able to breastfeed fully at first, but as they grow older they usually become better at feeding and are able to be fully breast fed.

Often these babies are small, have additional health problems or are very sleepy or floppy babies.

• A few babies have major medical problems which effect feeding. Babies with gastro-intestinal (GI tract) disorders who need an operation will not be allowed to feed at first and instead will get nutrients through a big drip called a long-line into their veins.

Babies with severe heart conditions may be unable to feed because they are tired or breathless.

• Mothers of these babies can use a breast pump to build up their milk supply, and their milk can be given to their babies by naso-gastric tube when the baby is well enough.

With patience and perseverance and following surgery for any medical disorders, these babies can often fully breast feed within a few weeks or months

How does breastfeeding help a baby with Down syndrome?
Breastfeeding has many benefits for all babies. Some are especially important for babies with Down syndrome.

• Close body contact
This helps you bond to your baby and provides your baby with important sensory stimulation.

• Less infections
Breast milk has antibodies or immunoglobulins that help your baby fight infections. Babies with Down syndrome often pick up infections more easily than other babies.

• Less constipation
Many babies with Down syndrome become constipated probably due to their low muscle tone. Babies who are breast fed generally don’t get constipated.

• Helps with learning to talk
Our babies often have low tone and are floppy. The actions involved in breastfeeding will help improve muscle tone in the lips, mouth and tongue These muscles are important in learning to talk

• Best nutrition for brain growth
Breast milk provides the best possible nutrition for brain growth and development.

How should I hold my baby to breast feed?
• Once breast feeding is going well, you will be able to feed your baby anywhere, in any position and with any way of holding that is comfortable for you.

• But as you start breastfeeding a baby with Down syndrome, it is often best to use these positions and holds.

• Try to find a quiet, relaxing place with a comfortable chair offering good support. Have someone nearby who can add and move around pillows for support as needed.
• Sit upright, rather than slumping back or tensing forwards.
• If feeding from the left breast, then use your right arm to support your baby.(It may feel more natural to let your baby snuggle into the crook of your left arm, but this makes it harder for you to see how the baby is taking your nipple and may not offer your baby enough support at first.)
• Your elbow supports your baby’s buttocks,
• your arm supports the back and shoulders,
• your hand supports the neck and head.
• Turn your baby’s whole body towards your breast, baby’s chest to your chest, baby’s chin to your breast at the right level.

How should I put my baby to the breast ?
• Start your milk flowing before you put your baby to the breast, hand express a little colostrum onto the nipple by gently massaging and squeezing your whole breast.

• Support your baby so that your baby’s mouth is at or just above the level of your nipple.

•Tickle your baby’s upper lip with your nipple and wait until your baby’s mouth is wide open.

• Hold your left breast with your left hand in a ‘C shaped’ hold behind the areola (brown area around the nipple) so you can offer the breast to your baby. Don’t squash the areola as this can change the shape of your breast making it harder for your baby to latch on.

• Put the nipple and a lot of the areola (brown area around the nipple) into your baby’s mouth making sure your baby’s tongue is below the nipple.

• Your baby’s lips should be turned out; not tucked in. Your baby should be making chewing movements not sucking on your nipple.

• It may feel unusual but should not hurt. If it does hurt, gently break the suction by putting your finger into the corner of your baby’s mouth, and try again.

• As the milk flows your baby should begin to swallow. You can encourage swallowing by gently stroking in a downward motion on the outside of the throat.

• Your baby needs to coordinate sucking, swallowing and breathing. This can be a hard skill to learn and at first your baby may gulp and choke.

I’m finding breast feeding very hard, what should I do?
• If you are breastfeeding and your baby doesn’t feed often, your breasts may not get enough stimulation and your milk supply may drop. It may be helpful to hand express a little milk after feeds or use a hand or electric pump when your baby won’t feed to keep your milk supply up.

• You may need additional support and information. Many hospitals employ a lactation consultant or have midwives with a particular interest in feeding problems. A speech language therapist may also be consulted.

• Most difficulties will resolve as your baby grows stronger and learns to breastfeed. Some babies take two months or more before feeding is established but then go on to have no further problems.

• Only you can make the decision whether or not to stop breastfeeding.
If you find breastfeeding so difficult that it is affecting your own well-being and your relationship with your baby, then it may be best to stop. You don’t need to feel guilty, you have tried your best.

• The most vital part of parenting is to love your baby, breast feeding is just one part of parenting.

When should I introduce solids to my baby?
• Babies with Down syndrome should be introduced to solids at the same time and in the same way as other babies at around five to six months.

• It may take longer for our babies to coordinate the actions needed for eating solids.