Today I began working with a baby with Down Syndrome. He is 2 weeks and has been on nipple shield and bottles (all breastmilk). Mom wants to get him to breast as soon as possible, one reason being that he "gags" with bottle feeding because she says he forgets to swallow. He does less of this when he is feeding with the shield or at breast. The doc is concerned with weight gain, though I believe he is ok given his limitations. By the way, his heart is fine and he seems to have a lot going for him. :) One of the major problems is that he is very sleepy and the times he has been at the breast, whether shield or the few times at breast, he goes to sleep very easily before a good feeding. (just too comfy there.) They have a lot of trouble waking him or keeping him awake regardless of how he is fed. The BAB says sleepiness for a few weeks; any word on that? What I want from you is: are there any teats that work better if she has to use a bottle while we are working on his becoming a breastfed baby? (Haberman?) Would finger feeding have any advantage? Would he benifit from work with a speech therapist? (My experience has been that they know how to work with bottles only.) Are we working with just a baby who has nipple preference and we need to encourage a change of preference, or does his having Down Syndrome present further problems of latch-on. Milk supply is very good as are bm's and wets, and Mom is ready to reach out for solid help. I accessed the Archives and got a lot of good information, especially support, and if any of you have suggestions please post them. Patricia Gima, IBCLC Milwaukee mailto:[log in to unmask]