School of Molecular Sciences, The University of Western Australia, M310, 35 Stirling Highway, Crawley, 6008, Western Australia.
Int Breastfeed J. 2020 Aug 15;15(1):71. doi: 10.1186/s13006-020-00318-4.
The health and developmental advantages of human milk and breastfeeding are particularly important for infants with Down syndrome. However, they typically have shorter breastfeeding duration due to sucking issues that are not well understood. This case report describes serial measures of milk transfer volumes, sucking dynamics and tongue movement in a breastfeeding infant with Down syndrome. Management of maternal milk production enabled feeding of only breast milk until maturation of breastfeeding skills and the achievement of full breastfeeding by 6 months.
The mother of a term infant with Down syndrome and no associated health complications presented with concerns regarding adequacy of milk removal at the breast and low milk supply. We monitored sucking dynamics during breastfeeding by measuring intraoral vacuum strength, nutritive and non-nutritive suck rates and burst durations, and tongue movement using submental ultrasound. Breastfeeds were monitored at 4, 10, 14, 19 and 24 weeks, and maternal 24 h milk production was measured at 4, 10 and 24 weeks postpartum. We observed a weaker suck strength and shorter nutritive suck duration, and atypical tongue movement up to 19 weeks, with low milk transfer volumes. Regular breast expression was effective in increasing maternal milk production, providing expressed milk for all complementary feeds. Full breastfeeding was achieved by 6 months when reference sucking values were observed.
This case report illustrates that infants with Down syndrome may have low intraoral vacuum and limited nutritive sucking that persists for several months, likely due to delayed oro-motor development. In the absence of effective sucking human milk feeding can continue when milk production is stimulated with frequent and adequate breast expression. It is possible for infants with Down syndrome and no associated health complications to eventually establish full breastfeeding. Mothers that wish to breastfeed their infant with Down syndrome require anticipatory guidance and continuing lactation and family support.
人乳和母乳喂养对唐氏综合征婴儿的健康和发育有特别重要的优势。然而，由于吸吮问题尚未得到很好的理解，他们通常母乳喂养的时间较短。本病例报告描述了一位唐氏综合征母乳喂养婴儿的乳汁转移量、吸吮动态和舌运动的连续测量。通过测量口腔内负压强度、营养性和非营养性吸吮率和吸吮时长，以及使用颏下超声测量舌运动，对母乳喂养期间的吸吮动态进行监测。在 4、10、14、19 和 24 周时监测母乳喂养情况，在产后 4、10 和 24 周时测量产妇 24 小时乳汁产量。我们观察到，在 19 周之前，婴儿的吸吮力度较弱，营养性吸吮持续时间较短，且舌运动异常，导致乳汁转移量较低。定期进行乳房排空可有效增加产妇乳汁产量，为所有补充喂养提供母乳。当观察到参考吸吮值时，婴儿在 6 个月时实现了完全母乳喂养。
本病例报告表明，唐氏综合征婴儿可能口腔内负压较低，营养性吸吮持续时间有限，这种情况可能持续数月，原因可能是口运动发育延迟。在吸吮无效的情况下，通过频繁且充分的乳房排空刺激乳汁分泌，可以继续进行人乳喂养。唐氏综合征且无其他健康并发症的婴儿最终有可能实现完全母乳喂养。希望母乳喂养唐氏综合征婴儿的母亲需要得到预期指导和持续的哺乳支持。
