Renee - I had a very similar experience with a mother of a Downs Syndrome baby, except that the mom I worked with never acknowledged the fact of the Downs. I understand your wish that she could have told you about the baby, so you would have felt better prepared, but I think you did the right thing just to work with the mom & baby as they presented themselves. My first thought was that maybe the mom was having a really hard time acknowledging her baby's condition - at 3 weeks, she might just have gotten the results of her chromosome analysis and be trying to come to terms with it all, or maybe she's known since before the baby's birth, but either way, 3 wks. is such a short time for her to start to come to terms with the reality. My second thought was that maybe the fact that she couldn't/didn't say anything at first doesn't even matter that much (from the perspective of her & baby, that is); she wanted help getting the baby to latch and nurse, you gave that help and in the process proved that the baby could latch on & nurse well, and you accepted her and her baby for exactly what they are - a mom who wants the best for her baby and a baby who needed your expert help to figure it out. So, while there's no doubt that the fact of the baby's trisomy will be something they will all be dealing with for the rest of that child's life, your acceptance and care for them was a good early lesson that it's not the Downs Syndrome that's central - the baby with Downs is still a baby FIRST. When you think about it, would you have done anything very different at that first meeting if you'd known? Cathy Bargar, RN IBCLC