Generally, an echocardiogram will be done on a baby with Down syndrome.
  An EKG is not accurate enough to say whether or not there is a
structural defect in the heart, some defects show up as electrical
conduction changes, some do not.

I think Linda hit the nail right on the head when she focused on the
baby's very low muscle tone as the major issue.  There is a wide range
of severity in DS, and lower tone usually means more severe issues.
Everything is more effort for a hypotonic infant, because muscles are
normally underactivated by the brain, they need to be worked harder to
achieve any movement.  Also, the body has less stability when the
muscles are hypotonic.  Hypotonic children tend to over-contract muscles
to increase stability when trying to perform an activity (this is called
fixing), which can be even more exhausting.

I would personally try fingerfeeding with a 5 french feeding tube and
syringe, in addition to the pacifier exercises recommended by Barbara.
Mom can carefully regulate the size and timing of the bolus to help her
baby coordinate sucking, swallowing and breathing.  If mom presses milk
from the syringe, and does not expect baby to be able to pull it out
alone, this will decrease his work of feeding.  They might be able to
optimize milk intake this way.  It can be easier for the baby with DS to
organize the relatively large tongue with the strong tactile input of
the finger rather than the relatively weaker input from a bottle nipple
or the breast. A nipple shield might also help him to take the breast,
though he might not be able to do much there yet.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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