Hi Sarah.  You asked, "how do we help a mum to transition a baby from naso gastric feeding to breast feeding?"  

Assuming fatigue is *the* problem, there are a couple approaches.  First, mom could do a partial feeding at the breast topping off with tube, which would give baby shorter, frequent opportunity to use his muscles.  Over time, the baby's time spent at the breast will improve.  The other approach (though they often go hand in hand) is for the mom to realize that most babies have a certain time of day when they have the most energy.  For neuro-typical babies, this is often morning.  During this period, baby is likely to have a better feed, and then feeds will go down hill throughout the day/night since baby used his energy up.  Putting these two approaches together, it is likely that baby will have one feed each day where he has a bit more energy, and mom needs to know the next feed may be harder...and that it's okay.  It's a process.

If the baby is capable and not overwhelmed, mom could also try tube feeding at the breast so baby works less hard.  But this will probably need to be added to one of the ideas above. 

Wishing this mom and baby well.  My niece has DS, too.
Amy Peterson
Idaho, USA

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