Lactation

Breastfeeding a Baby With Down Syndrome

Key takeaways: Many babies with Down syndrome breastfeed, though low muscle tone, sleepiness, and heart conditions can make it harder at first. Supporting your baby’s chin and jaw, upright positions, breast compressions, and pumping to protect supply help. Watch weight closely and work with an IBCLC and your baby’s medical team.

Breast milk offers important benefits to babies with Down syndrome. Many can breastfeed with extra support.

Common Challenges

  • Low muscle tone (hypotonia): can make latching and sucking weaker.
  • Sleepiness: babies may not wake to feed.
  • Tongue protrusion and a smaller mouth.
  • Heart defects: about half of babies with Down syndrome have a heart condition, which can make feeding tiring.
  • Other conditions, such as gut problems, may affect feeding.

Positioning Tips

  • Support your baby’s head and body well; try cross-cradle or football hold.
  • Use the Dancer hand position: support your breast with your hand in a “U” shape, then bring your thumb and index finger forward to support your baby’s chin and cheeks. This can steady the jaw.
  • Keep your baby upright, which helps with tone and swallowing.

Keeping Your Baby Feeding

  • Wake your baby for feeds as advised.
  • Use breast compressions to increase milk flow.
  • Keep feeds to a reasonable length so your baby doesn’t tire.

Protecting Your Supply

Many parents pump after feeds in the early weeks and give expressed milk as a supplement. This keeps supply strong while your baby builds skills.

Weight Checks

Babies with Down syndrome have their own growth charts. Your pediatrician will track growth.

Heart Conditions

If your baby has a heart defect, they may tire easily and need extra calories. Your cardiology team may advise fortified breast milk or limits on feed length.

Support

  • An IBCLC with experience in hypotonia.
  • Feeding or occupational therapy.
  • Down syndrome parent groups.

Call your baby’s doctor if your baby: has few wet diapers, isn’t gaining weight, turns blue or sweats during feeds, breathes fast, or is hard to wake.

The Bottom Line

Many babies with Down syndrome breastfeed with support. Positioning, the Dancer hand, compressions, pumping, and close follow-up help.

Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.

Sources

  1. Bull MJ, Trotter T, Santoro SL, et al; Council on Genetics. Health supervision for children and adolescents with Down syndrome. Pediatrics. 2022;149(5):e2022057010.
  2. Thomas J, Marinelli KA; Academy of Breastfeeding Medicine. ABM Clinical Protocol #16: Breastfeeding the hypotonic infant, revision 2016. Breastfeed Med. 2016;11(6):271-276.
  3. Lawrence RA, Lawrence RM. Breastfeeding: A Guide for the Medical Profession. 9th ed. Elsevier; 2022.

This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.

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