Breastfeeding a Child With Down Syndrome

It can be overwhelming and difficult to learn that the child you are expecting or have just delivered has Down syndrome. You may experience conflicting feelings and have many questions. While breastfeeding may not be among the first things you think about, how you choose to feed your baby will be among the many important decisions you'll make as a parent.

Children with Down syndrome often have physical characteristics that can make breastfeeding a challenge. However, with patience and perseverance, many babies with this condition learn to breastfeed successfully.

Benefits of Breastfeeding

Down syndrome (trisomy 21) is one of the most common congenital abnormalities, affecting about one in every 700 U.S. births. It occurs when a baby receives an extra copy of chromosome 21 during development. This extra chromosome affects the development of the baby's brain and body, resulting in physical and mental challenges. 

Breastfeeding offers many benefits to both babies and their breastfeeding parent, and babies with Down syndrome stand to benefit just as much or more than babies without the condition. Some of the positive effects of breastfeeding a child with Down syndrome include:

• Feelings of empowerment: When you have a child with a health issue, you may experience a sense of helplessness. Breastfeeding (or providing pumped breast milk if your baby is unable to breastfeed) provides the opportunity for a tangible contribution you can make to your child’s health, and for some parents, this can feel empowering.
• Improved digestion: Breast milk is more easily digestible than formula, making breast milk particularly helpful for babies with Down syndrome, who often have gastrointestinal (GI) issues.
• Improved immunity: Babies with Down syndrome may also have other health concerns, and they tend to be at higher risk of getting infections. Breast milk, with its protective antibodies and immune-boosting properties, can help prevent ear and respiratory infections.
• Physical contact: Breastfeeding brings you into close contact with your baby often during the day. The close connection and affection are good for your baby’s physical and emotional development.
• Reinforced bonding: Breastfeeding and the physical contact and bond it often supports can help you overcome any negative and confusing emotions you may experience as you navigate your child’s diagnosis.
• Strengthened facial muscles: Breastfeeding can also help children with Down syndrome develop coordination and gain strength in their facial muscles, which is important for speech development.

Getting Started

Although muscle weakness is commonly seen in babies with Down syndrome, many still breastfeed successfully. Others may have trouble latching on at first due to poor muscle tone, lack of coordination, and/or a protruding tongue.

Give yourself and your baby plenty of time to learn how to breastfeed together, maintaining reasonable expectations along the way. It can take several weeks for infants with Down syndrome to figure out how to latch on.

Because the learning process can take a little while in the beginning, it's important to start breastfeeding as soon as possible after birth. Put your baby to the breast often (every one to two hours), and spend lots of time holding your baby skin-to-skin to encourage them to nurse.

When you're first starting out, get help from a lactation consultant to learn techniques for breastfeeding your child. While pregnancy may seem too early to meet with a lactation consultant, if you already know that your child has Down syndrome, late pregnancy can be a great time to establish a relationship, gather information, and let them know about your baby's diagnosis.

Other healthcare team members such as physical, occupational, and speech therapists can also help your baby breastfeed successfully. Ask your doctor for a referral as soon as possible after your baby's birth.

Tips for Success

Breastfeeding a baby with special needs often requires extra patience and commitment. Your baby may latch on right from the start, or you may encounter some challenges as you begin your breastfeeding journey.

But you don't have to navigate challenges alone; work with your healthcare team to figure out any problems and know that no matter what, your child won't go hungry. Whether your child is fed breast milk, formula, or both, they will receive the nutrition they need.

The following are some things to keep in mind when breastfeeding a child with Down syndrome:

• A nipple shield may help your baby latch on. If your infant has trouble latching on or getting a good seal around the latch, consider asking your doctor or lactation consultant about using a nipple shield.
• Babies with Down syndrome may tire easily during feedings. You may need to wake your baby up for feedings (at least eight to 12 times a day is recommended for infants) to ensure they get enough milk. If your baby falls asleep while feeding, try to wake them up with gentle touches or skin-to-skin contact. You can also try shorter, more frequent nursing sessions.
• 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 support your breast. A bed pillow or nursing pillow may be helpful when you're just starting out.
• Help your baby relax before feedings. Your baby might arch their back and neck when you try to hold them for nursing. To help them feel calm and supported, try swaddling or choosing another breastfeeding position.
• Your child may have trouble with the coordination required to breastfeed. If they choke and gag as they work to suck, swallow, and breathe, try breastfeeding in an upright position.
• 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 them to the breast every hour or so to encourage breastfeeding.

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. Keep an eye out for signs that your baby is getting enough milk. You can also help encourage better feedings using these tips.

• Count your baby's 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 them to the breast.
• Follow up with your pediatrician often to make sure your baby is gaining enough weight. Keep in mind that babies with Down syndrome tend to gain weight slowly, even if they are formula-fed. The Centers for Disease Control and Prevention (CDC) provides growth charts specific to Down syndrome.
• Keep your baby awake and sucking as long as possible during each feeding.
• Try switch nursing. This method involves switching breasts if your baby loses interest on one side.
• Your pediatrician may recommend supplementing to be sure your baby is getting the nutrition they need. 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 if recommended.

Your Breast Milk Supply

If you choose to breastfeed, it is important to establish and maintain a healthy supply of breast milk. Having enough breast milk available helps 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.

Except in rare cases of true low supply, the amount of breast milk your body produces is a matter of supply and demand. The more your baby nurses, the more milk you will make. Putting them to the breast early and often and using frequent skin-to-skin contact can encourage nursing and breast milk production.

Pumping for Your Child

If breastfeeding isn’t going well, it can be difficult and stressful to keep trying. Some babies with Down syndrome are unable to breastfeed due to low muscle tone or other physical issues. But because breast milk is so beneficial for your baby, you may still want to provide it by a different route.

Pumping is a great way to continue giving your baby all the benefits of your breast milk even if they aren't able to feed directly from the breast. While manual pumps are convenient and inexpensive, if you are exclusively pumping, you'll want to invest in a high-quality electric pump.

Using a hospital grade or double electric breast pump is the most effective way to empty both breasts at once, stimulating them to produce more milk. If you're exclusively pumping, try to pump every three hours to maintain your milk supply.

A Word From Verywell

Finding out that your child has Down syndrome can be distressing and heartbreaking. It’s normal to be scared or have a negative reaction to the news; try not to feel guilty if this is the case for you. Allow yourself time to process the information and learn more about the condition.

As you process your feelings and learn more about your child and Down syndrome, breastfeeding is one of the many ways you can bond with your child while also providing a number of health benefits. You may encounter challenges with breastfeeding, but with patience, time, encouragement, and support, babies with Down syndrome can go on to breastfeed well if that's your goal.