10 tips to Breastfeed baby with Down’s Syndrome
By: Prachi Omkar Shetye, Ibclc
Tags: Breastfeeding, Breastfeeding Latch, Downs Syndrome, Breastfeeding Tips, Baby

The 10 tips that can help mother with the Down’s Syndrome baby to breastfeed the baby:

Breastfeeding Initiation Breastfeeding Latch Colostrum Expression Breastfeeding positions and Dancer’s grip Burping the baby Skin to skin Oral muscles stimulation Suck training Top up feed with syringe feeding or cup feeding Pumping

Down’s Syndrome:

This is a genetic disorder caused by an extra copy of chromosome 21. This is characterized by low tone in all the muscles of the body.

This can pose specific problems in breastfeeding the baby with Down’s Syndrome. Since the babies with Down’s Syndrome may have varying degrees of low tone, each baby and his/her sucking capacity will be different.

Effects of Down’s Syndrome on Breastfeeding baby:

These babies may find it difficult especially during initial days to latch properly and draw adequate milk from the breast because of the following problems associated with Down’s syndrome.

Weak sucking: The sucking of the baby is weak and the sucking bursts are small. This means the baby will suck with less force and get tired very easily making it difficult for the baby to complete feed, especially in the beginning.

Weak lip sealing: The lip seal around the breast while breastfeeding is not very strong because of which a lot of air can pass while feeding , making burping very important.

Weak neck tone: Just after birth, babies don’t have any neck control, this control develops by 1 and half to 2 months. In Down’s syndrome baby this can get delayed further, so it is important to support the neck until the baby is able to do it himself/herself.

Benefits of breastmilk for the baby:

Along with other benefits of breastmilk the most important benefits of breast milk are:

Immunological Protection: The immunity of a newborn is not fully mature, especially in preterm babies. So, the immunological components of breast milk (both colostrum and mature milk) complement this by transferring living tissue containing enzymes, immunoglobulins and leukocytes via breast milk. They actively fight with pathogens to protect the baby against infection.

The immunity of a newborn is not fully mature, especially in preterm babies. So, the immunological components of breast milk (both colostrum and mature milk) complement this by transferring living tissue containing enzymes, immunoglobulins and leukocytes via breast milk. They actively fight with pathogens to protect the baby against infection. Reduction in Lower Respiratory tract Infections :There are studies indicating that exclusive breastfeeding for first six months of life is associated with reduced risk of Lower Respiratory Tract Infection in preschool kids.

Tips for Breastfeeding:

The tips for breastfeeding the Down’s Syndrome baby , to ensure that baby gets enough milk/

1. Breastfeeding Initiation: Initiation of breastfeeding should be done as early as possible, mother should breastfeed the baby within the first hour of birth, if possible.

There are chances that the baby may not be able to suck effectively but this breastfeeding session can still help to trigger mother’s breast milk supply and also help in bonding with the baby.

2. Breastfeeding Latch: The latch is important and more often than not a tricky part of the entire breastfeeding charade.

You can hand express some milk to make the nipple wet with milk, this can help the baby to get immediate milk to entice him/her to suck.

Move the nipple along the lips of the baby without forcing the baby to open the mouth, the smell and taste of milk on lips will make babies open their mouth.

As the baby opens his/her mouth wide, bring the baby to the breast.

The baby’s mouth should be wide open making an angle of more than 100 degrees.

Most of the areola should be in the baby’s mouth as shown in this picture. This can help the baby compress all the milk ducts that enter the areola and more milk will flow in the baby’s mouth. It is however important to note that a baby with small mouth or mother with large breasts might have this situation, and the bigger part of areola can be seen outside the mouth . In such special conditions , it is important to ensure the angle of the mouth.

Once the baby starts sucking, check for the swallowing by listening to the sound and looking at the jaw movements that are slower and wider.

The baby that is sucking without swallowing will suck faster and no swallowing sounds will be heard. Refer to baby sucking patterns for more information on this.

3. Colostrum Expression: If the mother is aware about the baby’s condition then she should learn how to express colostrum and feed the baby, as the sucking of these babies is weak and they will require additional help to empty the breasts , especially in the beginning.

Colostrum expression and feeding is different from the normal breast milk expression and feeding, as the quantity of colostrum is less and the milk is thicker.

Always do hand expression for removing colostrum instead of using the breast pump, as drops of colostrum get wasted in the pump parts.

Always massage the breast starting from the base of the breast and then moving to the nipple, as that is the direction for expressing the milk from the breasts.

Do not press at the nipples for expressing milk, press on the base of areola.

Collect the expressed milk in the spoon or syringe if you are going to feed the baby immediately.

4. Proper breastfeeding position and holds: It is important for a mother to know how to hold a Down’s baby during breastfeeding. Normally, cross cradle hold is the ideal hold for these babies as the muscle tone of Down’s babies is generally lower than other babies.

The dancer’s hold can be very beneficial to help baby in maintaining the latch during breastfeeding.

5. Burping the baby: Burping the baby, even the one on exclusive breast milk is important to reduce discomfort. The weak breastfeeding latch can increase the amount of air entering the tummy while breastfeeding. This air gets trapped in baby’s tummy. Since younger babies don’t move on their own or do any activity as such the chance of getting this air out is difficult. The most comfortable position to burp the baby is over the shoulder as you can provide good neck support.

6. Skin to skin: Babies with Down’s Syndrome like to be held and cuddled and skin to skin gives mothers additional opportunity to bond with the baby while trying to perfect the latch. Skin to skin or kangaroo care is done for 30–45 minutes at least once or twice a day. Mothers should attempt for breastfeeding latch at the end of the skin to skin by gently moving the baby from between the breasts to one of the breasts.

7. Oral muscle stimulation: The physiotherapist can help the mother in stimulating the muscles around lips to encourage lip closure and this can help in enhancing the breastfeeding latch and maintaining the lip seal around the areola for a longer time while breastfeeding.

8. Suck training: Your Lactation Consultant can teach you suck training that can reinforce baby’s sucking and improve overall breastfeeding.

9. Top up with syringe feeding/Cup feeding: It is important to give top up feed to the baby using syringe or cup, if the weight gain is not appropriate.

For syringe feeding collect the expressed milk/formula in a container.

Take a syringe of 10 cc , it has capacity of 10 ml (sometimes with newborns 5cc works better)

Fill it with expressed milk, by pulling the plunger back.

Place the baby in your lap, in such a way that the head is higher than the body.

Slowly release the plunger for brief seconds and then stop allowing the baby to suck, every few sucks the baby will swallow, wait for that before you release the plunger for the next time.

The syringe feeding should be paced depending upon baby’s ability to swallow the feed, Initially, baby requires longer time but within next few feedings, baby is able to take feeds better.

In case of a problem in any of these steps or baby coughs a lot during feeding, then this is the indication that feeding isn’t progressing the way it should and in that case, get in touch with your Lactation Consultant at the earliest.

10. Building breast milk supply by expressing breast milk: In the first 6–8 weeks while breast milk supply is still building, so if the baby is not able to breastfeed effectively then breasts are not completely empty and breast milk production will not be boosted, instead it will stay stagnant and later drop in the long term.

It is advisable to empty the breasts after breastfeeding.

This will trigger the feedback for more milk production.

It is preferable to use an electric dual breast pump as it is less time consuming and easy to use for mother as she has to use it often in daily routine.

When the mother is giving a top feed after feeding, it is important to organize the pumping and feeding with additional help.

All these tips can help the baby with Down’s Syndrome baby better in breastfeeding.

The free printable on Tips for Breastfeeding is available, claim your copy now or for more free printables , do sign in and get lifetime access to free information on various aspects of breastfeeding, updated every Sunday. For booking an appointment with Prachi (IBCLC Lactation Consultant) in the clinic or for an online consultation email on prachilactation@gmail.com

Citations:

International Breastfeeding Journal

Originally published on www.prachilactation.com