Assoc. Prof. Dr. Pawin Puapornpong
Today, women marry and have children later, at higher ages. When the mother is over 35, the risk of having a child with Down syndrome rises with age. Although Down syndrome can be diagnosed prenatally, some mothers choose to care for the baby even with Down syndrome. These infants have lower muscle tone and do not suckle the breast well; feeding at the breast may tire them and they may not get enough milk. Heart or kidney abnormalities may also be present. So, when breastfeeding an infant with Down syndrome, if the baby cannot suckle the breast at first, a feeding aid may be needed, for example, a tube attached to a syringe of milk, squeezed to help the milk flow while the baby suckles. Once the baby is trained to suckle well, it can feed directly at the breast; the mother must also express milk by hand or pump, because the baby cannot stimulate the breast well enough by suckling. Training the baby to suckle together with skin-to-skin holding helps develop the nervous system and muscle control. As the muscles strengthen, the baby can feed at the breast. As with normal infants, breast milk is beneficial, but the benefits are even clearer in infants with Down syndrome: besides aiding development and intelligence, breast milk builds immunity and reduces the severe complications of infection in these infants.
References
Cadwell K, Turner-Maffei C. Pocket guide for lactation management. 2nd ed. Burlington: Jones & Bartlett Learning 2014.