>I've run into a situation with a mother of a newborn. The newborn girl has
>Down Syndrome and has been feeding well at the breast. At 2 weeks of age
>she was diagnosed with heart problems, A-V Canal defect and a hole, and
>will need open heart surgery. The baby started diuretics(lasix and
>aldactone) on 6/17. The Cardiologist is allowing bf for now, but stated it
>probably will be neccesary to transition to a bottle because it is easier
>for the infant to feed and they can mix a suppliment to increase the
>calories.
It is probably easier for the baby with Down Syndrome to feed from a bottle.
Whether easier is better is debatable. It's also easier for the child to be
put in a wheelchair rather than be encouraged to learn to walk. It's also
easier for the child to be allowed to remain mute than to teach it to talk.
It is easier to allow the child to never learn to read than to insist that
he try, and keep on trying. Hard work has its rewards. Breastfeeding may
be hard work for the baby, this will be rewarded with proper muscle
development in the face, including the mouth and tongue, which will help
greatly with pronunciation later when she is learning to speak. HOWEVER,
you don't want it to be so difficult for the baby that she becomes exhausted
and falls asleep at the breast before getting enough to eat (which is what
happened with Peter). If the breastfeeding is closely monitored, there is
no reason why the baby shouldn't start each feeding at the breast. The baby
should be offered the breast several times an hour, as she probably won't be
able to sustain effective sucking for long periods of time. Careful before
and after weighing with a Medela scale can help determine how effective the
baby is at removing milk. The mother should also be encouraged to pump with
a good quality pump after each feeding and give any hind milk she gets to
the baby with a cup or spoon (no need for a bottle). That should alleviate
the doctors fears that the baby needs caloric supplementation.
When the mother answered that she had heard of studies done by
>LLL that bf was easier, he replied that of course LLL is skewed in their
>viewpoint, and that in his 20 years of experience he did not observe
>this(of course how many mothers did he give the chance too?).
I believe the studies show less "stress" for the breastfeeding baby, as in
high heart and respiratory rate. Bottle-feeding is "easier" in the sense
that it takes less muscular effort. So "easier" is an ambiguous term.
She would like to bf up to and right after the babies surgery.
It's her baby -- she can do what she wants.
> She really wants all the advantages of bf since the infant has Downs with
>the problems of ear infection/speech development and mental function, not
>to mention the comfort/bonding she needs at this time.
It is even more important for babies with Down Syndrome to have breast milk
than for other babies, as Down Syndrome carries with it cognitive deficits
and immune deficiencies. If you add the cognitive deficits and immune
deficiencies of formula on top of that, you are looking at significant
impairment for the baby that is not necessary.
>
>Lastly, since the cardiologist emphasis is on weight gain,
Make sure the cardiologist is aware that children with Down Syndrome grow
more slowly than other children, regardless of heart defects, regardless of
intake. They just grow slowly. There are special growth charts for Down
Syndrome children, from the late 1980s, I believe. First author is
Christine Cronk. The doctor needs to be using these, so that he isn't
over-zealous in trying to get the baby to reach "normal kid" growth levels
-- it ain't gonna happen, no matter what they do.
and then a poor day of
>feeding(very sleepy, can barely be roused awake, then falls asleep in
>seconds).
Many children with Down Syndrome, in the newborn period, sleep for extended
periods of time and difficult to rouse -- again, whether or not they have a
heart defect. Peter did not have any kind of heart defect, yet at 3 weeks
of age, when we brought him home from the NICU, he was still sleeping 23
hours out of every 24. He didn't really "wake up" until he was about 4
months old. He would have episodes of bradychardia (slow heart beat) where
he would turn as white as a sheet, and NOTHING would wake him from these
episodes -- we just had to wait them out. They were apparently harmless.
Hope this helps. Feel free to share with the doctor. Remember that a
cardiologist is focusing on the heart issues, and may know little or nothing
about the other aspects of Down Syndrome that impact on sleep/wake issues,
growth, etc.
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Katherine A. Dettwyler, Ph.D. email: [log in to unmask]
Anthropology Department phone: (409) 845-5256
Texas A&M University fax: (409) 845-4070
College Station, TX 77843-4352
http://www.prairienet.org/laleche/dettwyler.html
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