The best formula for Down syndrome babies is having the right mix of hormones, vitamins plus exercising. Are you searching for the best formula used for Down syndrome babies? Most couples who are planning on attempting a pregnancy are worried about the risks factors involved. At one time or another, each parent has discussed and wondered about the effect of bring children that have this genetic disorder. Parents who already have had a child with Down syndrome are likely to have questions about their next pregnancy as well.Down syndrome is a genetic condition that affects a baby’s growth and development, causing delays and problems with learning to talk, walk, and socialize. It occurs during the first three months of pregnancy — when the baby is forming, or developing — and most often when a mother is older. It is described as the most common birth defect.
What is Down Syndrome?
Down Syndrome is a genetic disorder, the cause of which is not yet known. It is estimated that in Ireland approximately 1 in 546 children are born with Down Syndrome.
What Effect Does it Have?
The range of abilities of children and adults with Down Syndrome is very wide. It is difficult to predict at birth the degree of disability a child may have. With appropriate support and encouragement each person with Down Syndrome can reach their individual potential.
Children with Down Syndrome have a different growth pattern to that of the general population, their average height is shorter, their head circumference is smaller and their growth rate is slower between ages of 3 – 36 months.
It is essential that growth in children with Down Syndrome is carefully monitored. Height and weight should be plotted using the growth charts specifically designed for children with Down Syndrome from birth to 18 years.
Infants and children with Down Syndrome can have feeding and drinking difficulties. A smaller oral cavity and low muscle tone in the facial muscles can be contributing factors. In addition, the tongue may appear larger due to a high arched palate, a smaller oral cavity and reduced muscle tone in the tongue. Teeth tend to appear at a later stage. Many children are mouth breathers due to smaller nasal passages, and may have difficulties coordinating sucking, swallowing and breathing whilst feeding. All of these factors can impact on how a child develops efficient oral and feeding skills.
Mothers of infants with Down Syndrome may have no difficulty breast feeding, whereas other mothers may choose to bottle feed their child. Some infants have no difficulty with the introduction of solid foods and follow the normal weaning process successfully. Sometimes parents prefer to delay the weaning process, depending on their child’s feeding skills.
Infants who have increased oral sensitivity often have difficulty accepting new tastes and textures – intervention by a Speech and Language Therapist at an early stage will encourage oral motor and feeding skills. Some infants with Down Syndrome may require the support of a Paediatric Dietitian for feeding difficulties, poor weight gain, weaning advice, and oral sensitivity.
Excessive weight gain is a problem for many older children and adults with Down Syndrome. Adolescents with Down Syndrome do not have the same growth spurt as adolescents in the general population. Adolescents and adults with Down Syndrome tend to be shorter than their peers, and have a lower resting metabolic rate of 10-15% than the general population which further predisposes to weight gain.
Down Syndrome and Diet-Related Issues
Heart Defects: 40-50% of babies with Down Syndrome have congenital heart defects ranging from a heart murmur to more severe conditions requiring cardiac surgery. Infants requiring cardiac surgery will benefit from the intervention of a Paediatric Dietitian to provide nutrition support prior to and post corrective cardiac surgery.
Thyroid Disorder: Thyroid disorder (usually hypothyroidism) occurs more frequently in people with Down Syndrome than in the general population. Blood testing to check thyroid function is normally carried out annually up to five years of age, and at least once every two years thereafter throughout life. Weight gain is a feature of hypothyroidism. Thyroid function should always be checked in those with rapid weight gain.
Coeliac disease: Coeliac disease is more common in people with Down Syndrome. Dietary intervention is required to manage coeliac disease with the implementation of a gluten-free diet for life. For more information on coeliac disease, see our fact sheet “Coeliac disease and a gluten-free diet.”
Diabetes: Diabetes is more common in people with Down Syndrome. A healthy balanced diet is important to help control diabetes and prevent long term complications.
Constipation: Children with Down Syndrome have generalised low muscle tone, which predisposes them to constipation. The onset of walking and improvement in abdominal muscle tone can help to alleviate difficulties with constipation. Ensuring an adequate fluid intake and eating a variety of fibre rich foods can help manage constipation. In addition laxative medication may be required.
Structural Problems of the Gut: Structural problems of the gut are more common in infants and children with Down Syndrome and generally require surgical intervention and support from a specialist dietitian.
Infection: Infants and children with Down Syndrome can be more vulnerable to infection, in particular chest, ear, nose, throat a nd eye infections. Repeated infections requiring antibiotics can impact on a child’s appetite. Inclusion of a daily probiotic yoghurt or probiotic yoghurt drink may promote the growth of healthy bacteria in the gut following antibiotics. Loss of appetite and food refusal because of illness can impact on a child’s nutritional status, growth and well-being.
Food Intolerances and Allergies: Some parents of children with Down Syndrome often wish to exclude cow’s milk from their child’s diet due to symptoms such as blocked or runny nose, wheeze, irritability, colic, crying.
Contrary to widespread belief, cow’s milk has not been scientifically proven to increase mucous production. There is no reason to exclude cow’s milk from a child’s diet unless a cow’s milk allergy has been proven. Goat’s milk and rice milk are not recommended for children. The protein in goat’s milk may be nutritionally inferior to that in cow’s milk. Rice milk is not suitable for children under the age of 4 ½ years. Soya infant formula is not suitable for infants under six months and is rarely recommended for children under one year of age. Soya milk substitute is not recommended as a main drink for children under two years of age.
Unsupervised dietary restriction can affect a child’s growth, and bone health, leading to nutritional deficiency and failure to thrive. It is advised to seek professional advice from your G.P. or a dietitian before milk is excluded from a child’s diet.
Vitamins and Minerals: There is no conclusive evidence to support the addition of vitamin and mineral supplements in the diet of an individual with Down Syndrome. Additional vitamins and minerals in the diet do not improve health status or intellectual functioning. It can be dangerous to exceed any recommended dose of vitamins or minerals.
Bottle-Feeding Your Baby
Most babies with Down syndrome grow properly and do just fine in the eating department. But some young babies with Down syndrome have a harder time sucking efficiently, due to their low muscle tone. Their mouths may be less “alert” or ready for feeding, and the extra effort they have to put out to eat gives them less endurance for getting through the whole meal.
Babies with Down syndrome and their parents usually find a few tricks that make feedings easier for everybody.
Breastfed babies with low muscle tone can lose interest while waiting for the milk to let-down. Some babies with Down syndrome find it harder to latch on to the breast or bottle nipple and maintain a good hold throughout the meal. These babies take many more breaks and end up eating less per feeding than you would expect for the amount of time spent. Swallowing excess air is common because the baby has a less efficient hold on the nipple.
Despite these concerns, babies with Down syndrome and their parents usually find a few tricks that make feedings easier for everybody. Below are some of the techniques that often work.
WHAT CAN BE DONE?
Babies with low tone may need help using the muscle strength and control they have. They often prefer to be fed in a way that requires the least effort, rather than using their muscle control. To help encourage muscle strength, you need to “wake them up” or alert them before and during each feeding. Here are a few wake-up strategies; contact your baby’s doctor to review the appropriateness of these activities for your child.
Start the feeding when your baby is most awake or alert.
See if playing with your baby just before feeding helps increase attention for the meal. Play gentle tickle games with fingers, toys, or kissing around the face and neck. While supporting your baby’s head, dance with your baby so head and upper body control is stimulated. Bounce your baby gently in your lap. Of course, the dancing and bouncing should be done only if your baby can handle that much stimulation and has the head control necessary to participate without getting hurt.
Some parents find that a cool or tepid bath wakes up their baby before feedings. Others find that a brisk towel rub helps.
After waking up your baby’s body, focus the alerting on the face and mouth area. A cool washcloth on the face or gentle tapping around face and mouth may increase readiness for the bottle.
Some parents find that gently tickling or stretching the muscles around the lips and cheeks helps wake up the mouth. You can use fingers and washcloths.
Feed your baby in as upright a position as possible. The more your baby is up against gravity, the more active the muscles become. In addition, babies with Down syndrome seem to be more prone to ear infections. Upright feedings decrease the chance of liquid backing up in the ear canals, reducing the risk of infection.
Be sure that your baby is being fed in a chin tuck position. This position, with the head not too far back and not too far forward, seems to set up the neck and mouth muscles for the strongest sucking response. Try to rest your baby’s head – not neck – on your arm when holding during feedings, which automatically tucks the chin slightly. This position also can be achieved with pillows or arm rests.
An angled bottle, available commercially, may be used to keep the baby’s head at this angle until the end of the feeding. With a regular bottle, children must tip their heads back to get the last few drops. An angled bottle solves this problem. Cool the liquid.
Temperature may affect the efficiency and speed of your baby’s sucking and swallowing. After checking with your doctor, consider starting the baby at room-temperature formula and gradually chilling the formula until your baby can handle it straight from the refrigerator. This can increase not only the baby’s interest in sucking but also the amount that is sucked during the meal.
CHEEK AND TONGUE INVOLVEMENT
Some babies need to be reminded to suck during the meal by having a little attention drawn to their tongues. To increase tongue involvement, try tapping the nipple on the tongue or pressing up and down on the tongue regularly throughout the meal. This may serve to wake up the tongue, but should be discontinued or decreased if it disrupts the meal too much. Cheeks can be tickled, squeezed slightly, or tapped to keep them active during a feeding.
Breastfeeding a baby with special needs often requires extra patience and commitment. Your baby may latch on right from the start, or you may encounter some challenges as you begin your breastfeeding journey.
But you don’t have to navigate challenges alone; work with your healthcare team to figure out any problems and know that no matter what, your child won’t go hungry. Whether your child is fed breast milk, formula, or both, they will receive the nutrition they need.
The following are some things to keep in mind when breastfeeding a child with Down syndrome:
- A nipple shield may help your baby latch on. If your infant has trouble latching on or getting a good seal around the latch, consider asking your doctor or lactation consultant about using a nipple shield.10
- Babies with Down syndrome may tire easily during feedings. You may need to wake your baby up for feedings (at least eight to 12 times a day is recommended for infants) to ensure they get enough milk. If your baby falls asleep while feeding, try to wake them up with gentle touches or skin-to-skin contact. You can also try shorter, more frequent nursing sessions.3
- Your baby will need extra support during feedings. You may have to try different breastfeeding positions until you feel comfortable and confident that you can support your baby’s body, head, and jaw if necessary. You may also need a free hand to support your breast. A bed pillow or nursing pillow may be helpful when you’re just starting out.
- Help your baby relax before feedings. Your baby might arch their back and neck when you try to hold them for nursing. To help them feel calm and supported, try swaddling or choosing another breastfeeding position.
- Your child may have trouble with the coordination required to breastfeed. If they choke and gag as they work to suck, swallow, and breathe, try breastfeeding in an upright position.
- You may not be able to tell when your baby is hungry. Newborns with Down syndrome may give very subtle feeding cues if they give any at all. In the beginning, try to wake the baby and put them to the breast every hour or so to encourage breastfeeding.
Don’t get discouraged if it doesn’t go smoothly right away. Know that this is completely normal even for babies with no health issues. Be sure to seek assistance from a lactation consultant or a local breastfeeding support group if you need it.
Making Sure Your Child Is Getting Enough Breast Milk
Newborns who are sleepy and have a weak suck may not get a full feeding at each nursing session. Keep an eye out for signs that your baby is getting enough milk. You can also help encourage better feedings using these tips.
- Count your baby’s wet diapers. Look for at least six wet diapers a day once your milk “comes in.”
- Express a little bit of breast milk before starting a feeding to get the milk flowing and ready for your child when you bring them to the breast.
- Follow up with your pediatrician often to make sure your baby is gaining enough weight. Keep in mind that babies with Down syndrome tend to gain weight slowly, even if they are formula-fed. The Centers for Disease Control and Prevention (CDC) provides growth charts specific to Down syndrome.
- Keep your baby awake and sucking as long as possible during each feeding.
- Try switch nursing. This method involves switching breasts if your baby loses interest on one side.
- Your pediatrician may recommend supplementing to be sure your baby is getting the nutrition they need. You may want to try using a nursing supplementer device at the breast, or you can provide a bottle of your expressed breast milk or infant formula after each nursing session if recommended.
Your Breast Milk Supply
If you choose to breastfeed, it is important to establish and maintain a healthy supply of breast milk. Having enough breast milk available helps encourage your child to breastfeed. An abundant supply of milk also allows you to pump extra breast milk to give to your baby as a supplement if and when you need it.
Except in rare cases of true low supply, the amount of breast milk your body produces is a matter of supply and demand. The more your baby nurses, the more milk you will make. Putting them to the breast early and often and using frequent skin-to-skin contact can encourage nursing and breast milk production.
Pumping for Your Child
If breastfeeding isn’t going well, it can be difficult and stressful to keep trying. Some babies with Down syndrome are unable to breastfeed due to low muscle tone or other physical issues. But because breast milk is so beneficial for your baby, you may still want to provide it by a different route.
Pumping is a great way to continue giving your baby all the benefits of your breast milk even if they aren’t able to feed directly from the breast. While manual pumps are convenient and inexpensive, if you are exclusively pumping, you’ll want to invest in a high-quality electric pump.
Using a hospital grade or double electric breast pump is the most effective way to empty both breasts at once, stimulating them to produce more milk. If you’re exclusively pumping, try to pump every three hours to maintain your milk supply.
With that being said, if you are looking for a good bottle for your son or daughter with Down syndrome, here are a few that we had successes with during our bottle hunt. Feel free try one (or none) of them out. Like I said, these are just what worked for us, and may / may not work well for your child.
1. Philips AVENT BPA Free Classic Polypropylene Bottles
2. Playtex Drop-ins Nurser Bottles
The Playtex Drop Ins Nurser Bottle uses little “drop in” bottle liners that are supposed to help keep the air out of the bottle while your baby is drinking from them. My wife really liked them, but I personally didn’t. The bottles are fine, I’m just not a fan of the liners. I think they’re messy, and I found it sort of hard to push the liner up into the bottle as he was drinking. My hand was to big to fit inside the bottom of the bottle to push the liner up so I had to use a wooden spoon. To much work if you ask me. (Like I mentioned above, this is just my personal opinion. They are great bottles, I just didn’t like the liners.)
3. The First Years Breastflow Bottle
The First Years Breastflow Bottle is another great bottle. They are designed to mimic a mothers breast, which they claim allows for the breast milk or formula to flow naturally like their mothers breast. Noah did really well with this bottle, although not quite as well as he did with the AVENT bottle I mentioned above.
Bouns Bottle: Medela Storage Bottles
I wanted to mention these Medela Storage Bottles briefly. Although they are meant to store breast milk from the Medela Breast pump system, we found they worked really well for Noah once he was a little older (10-12 months) since he wasn’t really having a problem drinking from a bottle at that point and we weren’t as concerned with flow as we were when he was younger.
I liked these bottles because they are so small which enabled Noah (and his small hands) to hold on to them by himself. (The other bottles I mentioned are much bigger, and he had a hold time wrapping his small hand around them, and holding them by himself when they were full of liquid due to how heavy they became.) The only drawback is these bottles only hold 2 ounces so if you are doing a typical 8 ounce feeding you have to fill them up four times.