>1. what medical information would be useful for the
>physician and myself (both of us are already convinced breastfeeding is
>worth the effort)?

Hypotonia is the main issue in getting children with Down Syndrome to nurse
effectively.  They also often have small mouths and jaws, but regular sized
tongues (usually described as having big tongues, but that isn't really the
case).

They often have impaired immune systems, thus the normal development of the
immune system and the augmentation of the child's immune system provided by
breast milk are all the more important for these children.  Likewise, the
potential for an addition 5-10 IQ points will be especially important for
this baby, as he will most likely have some degree of mental retardation.
Those 5 points mean a lot more at the low end of the scale than they do at
the high end.  If the baby is NOT successful in extracting milk from the
breast, the mother should be encouraged to pump and feed with a bottle for
as long as possible.  In fact, it might not be a bad idea to have her pump
with a good pump from the beginning to try to bring in a good supply of milk
-- rather than wait a week or so to see if the baby will be strong enough to
breastfeed, and *then* decide that the milk supply is dwindling and try to
bring it back.  It may also be a good idea for her to pump after each
feeding and give any high fat hind milk that the baby has left.

2. what information would be of most use to the mother?

The information that her child will be a very *easy* baby -- very content,
very happy, very cuddly, but otherwise 99% like a regular child.  And that
her child will grow up and be able to walk and talk, read and write, enjoy
TV and movies, play baseball, tell silly jokes, and do most of the other
things kids do.  That although she will forever grieve for the child she
didn't have (the normal baby of her imagination), that the pain of that loss
will fade with time, and that she and her family will be immensely enriched
by the presence of this angel in their midst.  Tell her to flood the baby
with sensory input and stimulation of all kinds.

There is a good bood called "Babies with Down Syndrome" that she should get
and read.  Tell her to avoid reading anything more than about 10 years old.
And tell her not to listen to dire predictions of outcome.

Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University