WILL OUR BABY HAVE HEALTH PROBLEMS?

Chest and sinus problems

Babies and young children with Down's syndrome tend to be prone to chest and sinus infections but, thanks to better medical knowledge and care, such infections are no longer as serious as they used to be.

Feeding problems

Some babies with Down's syndrome seem to lack the strength and determination to feed in the early days. Some may be slow to sort out the complicated co-ordination necessary to suck, swallow, and breathe at the same time, and they splutter and choke a bit. These problems often settle down during the first two weeks. Initially, the baby may not be able to cope with breast-feeding, but if the mother keeps her milk going the baby may take to it eventually.

Many babies with Down's syndrome find it easier to feed from a bottle, and it will not harm them to have formula milk. The important thing is for both mother and child to be as contented and comfortable as possible.

Initially, it is worth trying to hold the baby fairly upright to feed and check that the tongue is not sticking to the roof of the mouth. For a baby to suckle and get adequate milk, the nipple or teat must be on the tongue (not under it). Specially adapted teats are available to help babies who have difficulty feeding.

Do not hurry the feed. Babies with Down's syndrome often feed very slowly, so do not stop too quickly. The baby may fall asleep at intervals. If this happens in the middle of a feed, try tickling his cheeks, chin and feet.

Temperature control

The body's heat-regulating mechanism does not always work well in early life. It is therefore important that the baby's bedroom is not cold (18°C is ideal), and that there are no draughts. Overheating can be hazardous for all babies, however, and it is important that they do not get too hot through over-wrapping when indoors. Humidifying the air will help the baby to breathe more freely, too.

Skincare

The baby's skin may be very dry. Massage with a little baby oil and put some in the bath water. A little moisturising cream (e.g. E45 cream, unperfumed cold cream) or olive oil rubbed gently on the skin every day should prevent drying and cracking. Keep an eye out for allergic reactions. The doctor or pharmacist can help with alternatives. Some creams are available on prescription.

Tongue control

The baby may need particular attention to help control the tongue. Playing games, pulling faces, and making noises, assists the child to exercise face and tongue muscles, and also helps with early sounds and speech. Try to avoid a blocked nose which would encourage open-mouth breathing and protruding tongue.

Humidifying the air in the baby's room will help prevent a dry, blocked nose. Making a game of pushing in the tongue over and over again will help.

Heart problems

About one in three children born with Down's syndrome has a heart defect. Some heart defects are quite minor, such as heart murmurs. Some defects are severe, requiring medication and/or surgery.

The baby's heart is one of the things that a paediatrician checks at the first neonatal examination, and, if there is any doubt about a heart defect being present, then further tests will be made to make sure that everything is as it should be. However, heart defects are not always picked up by these tests when a baby is very small, so the paediatrician will continue to make regular checks in the first year or so for any signs of a defect. If worried about anything, ask the doctor (for a detailed explanation of the more common heart defects that can affect babies with Down's syndrome, see the separate article "Congenital Heart Defects").

To talk to someone whose child has a similar problem or has had heart surgery, contact:
Down's Syndrome Association
155 Mitcham Road
London
SW17 9PG
020-8682 4001
020-8682 4012

Down's Syndrome Association - Scotland
158-160 Balgreen Road
Edinburgh
EH11 3AU
0131-313 4225