Breastfeeding a Child With Down Syndrome

Getting Started and Tips for Success

Mother holding baby girl with Down syndrome
JGI/Tom Grill/Getty Images 

It can be overwhelming and difficult to learn that the child you are expecting, or the child you just delivered has Down syndrome. You may experience many different feelings and have a ton of questions. And, while breastfeeding may not be among the first things you think about, it may cross your mind at some point. You may believe that since your child has Down syndrome, you cannot breastfeed, but that's not always true. There will likely be challenges. However, babies with Down syndrome not only benefit from breastfeeding, but they can breastfeed successfully, too.

Down Syndrome and Breastfeeding

Down syndrome or trisomy 21 is one of the most common congenital disabilities. It is a chromosome issue that happens when a baby receives and an extra copy of chromosome 21 during development. So, the baby ends up with three copies of chromosome 21 instead of two. 

Babies born with Down syndrome or other medical issues and special needs and their moms can benefit from breast milk even more than healthy babies. Some of the benefits of breastfeeding a child with Down syndrome are:

  • Reinforced bonding: Breastfeeding can help to overcome some of the scary and negative feelings you may have when you first learn about your child’s diagnosis.
  • Feeling helpful: When you have a child with a health issue, you may feel helpless and like there is nothing you can do. Breastfeeding, or providing pumped breast milk if your baby is unable to breastfeed, can make you feel like you’re doing something to contribute to your child’s health.
  • Physical contact: Breastfeeding brings the baby in close contact with you very often during the day. The close connection and affection are good for the baby’s physical and emotional development.
  • Strengthened facial muscles: Breastfeeding can help a child with down syndrome develop coordination and even build up strength in their facial muscles. Strengthening the facial muscles is also good for speech so it may help the child speak better in the future.
  • Fight infection: Babies with Down syndrome may also have other health issues and tend to be a higher risk of getting infections. Breast milk, with its protective antibodies and immune boosting properties, can help fight against ear infections, respiratory illness, and other illnesses.

    Getting Started

    Many babies born with Down syndrome and muscle weakness can breastfeed just fine. Others have trouble latching on because they have poor muscle tone, a large tongue, and a small mouth. But, even when a baby has some difficulty at first, with time and assistance, it is possible that the child can go on to breastfeed well. Here are some tips for getting started.

    • Try to breastfeed as soon as it's safe for you and your child.
    • Put the baby to the breast very often.
    • Spend as much time as you can holding your baby skin-to-skin to encourage her to latch on and breastfeed.
    • Get help from a lactation professional very early on to be sure that you're on the right track.
    • Other healthcare team members such as physical, occupational and speech therapists can also help your baby breastfeed better. So, ask for a referral as soon as possible.

    7 Tips for Success

    Breastfeeding a baby with special needs often requires patience and commitment. Your baby may latch on right from the start, but it’s likely that you may encounter some challenges as you begin your breastfeeding journey. Give yourself and your baby time to learn how to breastfeed together. Here are some tips for breastfeeding success:

    1. You may not be able to tell when your baby is hungry. Newborns with Down syndrome may give very subtle feeding cues if they give any at all. In the beginning, try to wake the baby and put her to the breast every hour or so to encourage breastfeeding.
    2. Due to the muscle weakness, your baby will need extra support during feedings. You may have to try different breastfeeding positions until you feel comfortable and confident that you can support your baby’s body, head, and jaw if necessary. You may also need a free hand to hold up your breast, too. A bed pillow or nursing pillow may be helpful especially when you're just starting out.
    3. Understand that your child may have trouble with the coordination she needs to breastfeed. She may choke and gag as she tries to suck, swallow, and breathe. Breastfeeding in an upright position may make it easier.
    4. Be aware that babies with weak muscles can get tired quickly during feedings. If your baby falls asleep, try to wake him up and keep him sucking for as long as possible. If he gets worn out quickly, try feeding him more often but for shorter periods of time.
    1. A nipple shield may make it easier for your baby to latch on and breastfeed. Since one of the traits of down syndrome is a small mouth, your baby may have trouble latching on or getting a good seal around the latch. You may want to ask your doctor or a lactation professional about using a nipple shield.
    2. Try to relax your baby's body. Your baby might arch her back and neck when you try to hold her for a feeding. To calm and comfort her, you can try swaddling her before a feeding or choose another breastfeeding position.
    3. Don’t give up if it doesn’t go smoothly right away. Keep trying and continue to get help and support from a lactation consultant or a local breastfeeding support group.

    Making Sure Your Child Is Getting Enough Breast Milk

    Newborns who are sleepy and have a weak suck may not get a full feeding at each nursing session. You should keep a lookout for the signs that your baby is getting enough milk. You can also help encourage better feedings. Here are some tips.

    • Make sure your baby has wet diapers. Look for at least six wet diapers a day once your milk comes in.
    • Express a little bit of breast milk before starting a feeding to get the milk flowing and ready for your child when you bring him to the breast.
    • Try to keep your baby awake and sucking as long as possible during each feeding.
    • Try switch nursing.
    • Follow up with your baby’s pediatrician often for weight checks to be sure the baby is getting enough breast milk. Keep in mind that babies with Down syndrome tend to gain weight slowly even if they are formula fed. There are growth charts specific to Down syndrome available.
    • If breastfeeding isn’t going well, the doctor may recommend a supplement to be sure your baby is getting the nutrition he needs. You may want to try using a nursing supplementer device at the breast, or you can provide a bottle of your expressed breast milk or infant formula after each nursing session.

    Your Breast Milk Supply

    It is important to build up and maintain a healthy supply of breast milk for your baby. Having breast milk available in your breasts can help to encourage your child to breastfeed. An abundant supply of milk also allows you to pump extra breast milk to give to your baby as a supplement if and when you need it. To establish and keep up your supply you can:

    • Put the baby to breast early and often
    • Hold your baby skin-to-skin
    • Use a good quality electric breast pump after or in-between feedings to remove the milk in your breasts and stimulate milk production. 

    Pumping for Your Child

    If breastfeeding isn’t going well, it can be difficult and stressful to keep trying. But, since breast milk is so beneficial for your baby, you may still want to provide your milk. Pumping is a great way to continue giving your baby all the benefits of your breast milk without the struggle of putting your baby to the breast. 

    Of course, exclusive pumping is also a commitment. To maintain your breast milk supply you should use a high-quality electric pump and pump every two to three hours. 

    A Word From Verywell

    Finding out that your child has Down syndrome can be shocking and heartbreaking. If you find out during your pregnancy, you have time to prepare and learn all you can about having a baby with special needs. But, if you weren’t expecting it and find out when your child is born, it can be even more devastating.

    It’s normal to be scared or have a negative reaction to the news, and you shouldn’t feel guilty if you do. You just need a little time to take it all in and learn more about the condition. As you do, breastfeeding is one of the ways you can bond with your child. It can help you to accept your child’s condition and move on from any initial negative feelings.

    And, yes, there will be some challenges with both breastfeeding and raising your child. But, with patience, time, encouragement, and support babies born with down syndrome can not only go on to breastfeed well but also enrich the lives of their families and live happy, full lives of their own.  

    View Article Sources
    • Eidelman AI, Schanler RJ, Johnston M, Landers S, Noble L, Szucs K, Viehmann L. Breastfeeding and the use of human milk. Pediatrics. 2012 Mar 1;129(3):e827-41.
    • Lawrence, Ruth A., MD, Lawrence, Robert M., MD.  Breastfeeding A Guide For The Medical Profession Eighth Edition. Elsevier Health Sciences. 2015.
    • Riordan, J., and Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2014.
    • Sooben RD. Breastfeeding patterns in infants with Down's syndrome: A literature review. British Journal of Midwifery. 2012 Mar;20(3):187-92.
    • Thomas J, Marinelli KA, Academy of Breastfeeding Medicine. ABM Clinical Protocol# 16: Breastfeeding the Hypotonic Infant, Revision 2016. Breastfeeding Medicine. 2016 Aug 1;11(6):271-6.