My baby has Down’s syndrome. How do I feed him?

Sometimes babies with Down's Syndrome feed easily with no more problems than any other baby. But sometimes feeding them can be harder and needs more time, patience and perseverance

Down’s Syndrome 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. They may also 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 and 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. Plot their weight gain on the special Down's syndrome growth chart, part of the insert for your personal child health record.

When should I feed my baby?

Your newborn needs at least one night feed and frequent feeds during the day. Your health visitor can give you advice. Some Down’s syndrome babies wake up by themselves and show obvious signs of hunger. Others will need to be woken up. Some don't cry or show you they are hungry even when they are awake. So you will need to set a routine feeding pattern.

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

You can often wake babies by

• Removing their covers

• Talking to them

• Changing their nappy

• Gently rubbing hands and feet

• Gently moving arms and legs

• Wiping their face with a cool damp cloth

• Holding 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 breastfeeding, try swapping to the other breast several times.

For some babies who 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 who want to can breastfeed or provide breast milk for their baby with Down's syndrome.
Sometimes breastfeeding is established easily with no more problems than with any other baby. Sometimes breastfeeding a baby with Down's 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 breastfeed?

Many babies with Down's syndrome are able to breastfeed successfully from birth. 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.

A few babies have major medical problems which affect feeding. Babies with gastro-intestinal tract (GI tract) disorders who need an operation will not be allowed to feed at first. Instead they get nutrients through a drip 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. Their milk can be given to their babies by naso-gastric tube when the babies are well enough.

How does breastfeeding help babies with Down's syndrome?

Breastfeeding has many benefits for all babies. Some are especially important for babies with Down's syndrome.

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

Less infections. Breast milk has antibodies that help your baby fight the infections that babies with Down's syndrome often pick up more easily than other babies.

Less constipation. Many babies with Down's syndrome become constipated probably due to their low muscle tone which can make their bowels sluggish. Babies who are breast fed generally don't get constipated.

Best nutrition. Breast milk provides the best possible nutrition.

When should I introduce solids to my baby?

Babies with Down's syndrome should be introduced to solids at the same time and in the same way as other babies. It may take longer for our babies to co-ordinate the actions needed for eating solids.

How should I treat my baby?

You have a baby with the same needs as all babies; so use baby books, magazines and support from your family and friends just as you planned during pregnancy. Remember, most of your baby's behaviour is due to
being a baby rather than being due to Down's syndrome!

Involve your baby in everyday family activities. Play and interact together as you would with any baby. If your baby is floppy, make sure your pushchair and car seat offer good support and don't allow legs to flop apart. Carry your baby with legs together not on your hip. Your baby may not be responsive but it is still important to respond to your baby's noises, and talk to your baby about what you are doing and where you are going.

What will my baby achieve and when?

Children with Down's syndrome do learn to walk, talk and be toilet trained but in general will meet these developmental milestones later than children who do not have Down's syndrome.

There is a wide range of ability in children with Down's syndrome just like in the rest of the population. Each baby is different but generally Down's syndrome babies:

• Smile between one and a half and four months (the average is two months)

• Roll over between four and 22 months (the average is eight months)

• Sit alone between six and 28 months (the average is ten months)

• Crawl between seven and 21 months (the average is 12 months)

• Finger feed between eight and 28 months (the average is 12 months)

• Say their first words between nine and 31 months (the average is 16 months)

• Walk between 12 and 65 months (the average is 24 months)

Like all babies, Down's syndrome babies learn and develop, but their development is slower than that of other children. Like all parents you should try to enjoy your children and celebrate their achievements. Although much of Down's syndrome children's development rate depends on their individual make-up, parents can help them through play, everyday activities and early intervention programmes which develop their skills in small steps.

When you are ready, you can find out more information about child development and who can help your child from the DSA's early support booklet.

Related links

My baby has Down’s syndrome... What does that mean and what can I do? You've given birth, but been told your gorgeous new baby suffers from Down's syndrome. What does that mean and what do you need to know about it?

Baby's first foods - what do you need to know about solids? Once your baby is around six months old, it’s likely he’ll be ready to try his first solid foods. But just how do you go about helping him make the transition?

Breastfeeding - we reply to your questions: There’s no doubt breast milk gives your baby the best start in life, but it isn’t without its challenges, as these mums’ questions demonstrate!

Find out more

The Down's syndrome Association has a wealth of advice to offer.

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