Down syndrome and breastfeeding

Abstract

Aim: The aim of the study was to investigate the frequency of breastfeeding among children with Down syndrome. Methods: The mothers of 560 children with Down syndrome attending four university hospitals in Italy were interviewed and the neonatal clinical records retrieved. Information was collected on the type of infant feeding and on why some mothers had not breastfed their children. Two groups of healthy children whose feeding habits had been previously investigated were recruited as control subjects (1601 and 714, respectively). A paediatrician in each hospital was interviewed about the neonatal admission policy of children with Down syndrome. Results: Among the 560 Down children, 246 (44%) were admitted to the neonatal unit. Compared with the two control groups, children with Down syndrome were significantly more frequently bottle‐fed (57% vs 15% and 24%, respectively, odds ratio 7.5, 95% CI 6.0–9.4 and 4.2, 95% CI 3.3–5.4. respectively). Only 30% of infants admitted to the neonatal unit were breastfed. The main reasons reported by the mothers for not having breastfed were infants’illness in infants who had been admitted to the neonatal unit and frustration or depression, perceived milk insufficiency and difficulty with suckling for those babies who had not been admitted to the unit. The paediatricians reported that the admission of a baby with Down syndrome to the neonatal unit could sometimes take place not for medical reasons, but for diagnostic work‐up or for a more appropriate diagnosis and to maintain communication with the family. Conclusions: Down syndrome babies are less frequently breastfed compared with healthy children. Support in breastfeeding should become a relevant point of health supervision for children with Down syndrome.

Feeding and nonnutritive sucking habits and prevalence of open bite and crossbite in children/adolescents with Down syndrome

“…9,28 Mothers need to be persistent as well as duly encouraged and oriented immediately postpartum with regard to the importance of breastfeeding their children with DS and exercising discipline in the use of bottle feeding and nonnutritive sucking habits. 23,24 CONCLUSIONS N The children and adolescents with DS in the present sample had a high prevalence of open bite, anterior crossbite, and posterior crossbite. N The use of bottle feeding for more than 24 months was associated with the occurrence of open bite and posterior crossbite in children/adolescents with DS.…”

“…2,9,11,23,24 In a study carried out in Japan involving children with DS and those with normal development, Mizuno and Ueda 11 found significant development in the sucking behavior of the individuals with DS over time, but the sucking capacity of these infants was lower than that of normal infants. After the logistic analysis, the malocclusions investigated were strongly associated with the duration of breastfeeding and bottle feeding and with nonnutritive sucking habits.…”

Oral sucking habits among children with Down syndrome and cerebral palsy

“…Hypotonia of the facial and lip muscles and tongue movement can causes children with DS and CP experience difficulties in sucking and swallowing. The underdevelopment of the maxilla and facial muscles can also results in insufficient seal and mouth breathing . The interaction among these factors can lead to breastfeeding problems and the establishment of nonnutritive sucking habits.…”

“…Developmental delays from DS and CP children are expected because they have motor impairment, reduced coordination, and learning disabilities . Several studies showed that children with CP and DS are breastfed for less time than those with normal development, and have a higher percentage of artificial sucking habits . Pisacane conducted a study in Italy with 560 mothers of children with DS, and the type of infant feeding was compared with two controls groups.…”

Breastfeeding the Hypotonic Infant

“…For example, in addition to the oral abnormalities and malocclusion, children with Down syndrome also have developmental delay, are more susceptible to ear, respiratory, and other infections, and have an increased incidence of other congenital anomalies such as heart and gastrointestinal malformations. 20 The ability to breastfeed their babies may empower these mothers. 2 Breastfeeding helps with normal mouth and tongue coordination.…”