Sara,
Babies with Down syndrome have many issues that could lead to poor weight
gain.  Low muscle tone reduces the efficiency of their suck and increases
fatigue, there may be increased metabolic need, especially if there is a heart
defect... Since this baby began bf at 2 months, I take it that mom was
pumping.  Would she be adverse to pumping after feedings and complementing
with that higher fat milk?  (supplementing is replacing a feeding at breast,
complementing is adding to one).  Has she worked with an LC or the baby's
physical or occupational therapist to optimize positioning at the breast so
that baby needs to spend less energy on maintaining body stability and has
more to dedicate to sucking well?  I think that is a vital issue when a baby
has any neurologic condition that produces hypotonia.
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]