NDLI: Altered sucking dynamics in a breastfed infant with Down syndrome: a case report

Content Provider	Springer Nature : BioMed Central
Author	Coentro, Viviane Silva Geddes, Donna T. Perrella, Sharon L.
Abstract	Background The health and developmental advantages of human milk and breastfeeding are particularly important for infants with Down syndrome. However, they typically have shorter breastfeeding duration due to sucking issues that are not well understood. This case report describes serial measures of milk transfer volumes, sucking dynamics and tongue movement in a breastfeeding infant with Down syndrome. Management of maternal milk production enabled feeding of only breast milk until maturation of breastfeeding skills and the achievement of full breastfeeding by 6 months. Case presentation The mother of a term infant with Down syndrome and no associated health complications presented with concerns regarding adequacy of milk removal at the breast and low milk supply. We monitored sucking dynamics during breastfeeding by measuring intraoral vacuum strength, nutritive and non-nutritive suck rates and burst durations, and tongue movement using submental ultrasound. Breastfeeds were monitored at 4, 10, 14, 19 and 24 weeks, and maternal 24 h milk production was measured at 4, 10 and 24 weeks postpartum. We observed a weaker suck strength and shorter nutritive suck duration, and atypical tongue movement up to 19 weeks, with low milk transfer volumes. Regular breast expression was effective in increasing maternal milk production, providing expressed milk for all complementary feeds. Full breastfeeding was achieved by 6 months when reference sucking values were observed. Conclusions This case report illustrates that infants with Down syndrome may have low intraoral vacuum and limited nutritive sucking that persists for several months, likely due to delayed oro-motor development. In the absence of effective sucking human milk feeding can continue when milk production is stimulated with frequent and adequate breast expression. It is possible for infants with Down syndrome and no associated health complications to eventually establish full breastfeeding. Mothers that wish to breastfeed their infant with Down syndrome require anticipatory guidance and continuing lactation and family support.
Related Links	https://internationalbreastfeedingjournal.biomedcentral.com/counter/pdf/10.1186/s13006-020-00318-4.pdf
Ending Page	6
Page Count	6
Starting Page	1
File Format	HTM / HTML
ISSN	17464358
DOI	10.1186/s13006-020-00318-4
Journal	International Breastfeeding Journal
Issue Number	1
Volume Number	15
Language	English
Publisher	BioMed Central
Publisher Date	2020-08-15
Access Restriction	Open
Subject Keyword	Maternal and Child Health Breastfeeding Sucking skills Tongue movement Down syndrome
Content Type	Text
Resource Type	Case study
Subject	Obstetrics and Gynecology Pediatrics, Perinatology and Child Health
Journal Impact Factor	2.9/2023
5-Year Journal Impact Factor	3.6/2023

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