Newborns with Down syndrome may have easily distinguishable congenital defects of the gastrointestinal system. According to Mundakei and Purushottam (2020), GI abnormalities occur in approximately 12% of patients.
Here is a list of some of the other GI issues that can arise.
An increased incidence of celiac disease, up to 5-15%, has been reported in Down syndrome. Signs and symptoms include growth failure, abdominal pain, and loose stools. Celiac disease occurs more often in those with the human leukocyte antigen (HLA) heterodimers DQ2 (observed in 86-100% of individuals with celiac disease) and DQ8.
Children with Down syndrome are at higher risk for gastroesophageal reflux disease (GERD) and chronic constipation. Nurses caring for neonates with Down syndrome should be aware of the signs and symptoms of these disorders and monitor the baby carefully for signs of feeding problems or the inability to pass meconium.
Feeding issues unrelated to gastrointestinal problems can complicate the assessment of neonates. Newborns with Down syndrome may have initial difficulty establishing successful breastfeeding. Some babies with Down syndrome have trouble coordinating their sucking and swallowing right after birth because of oral-motor issues. At the same time, others may be too tired from medical problems, such as congenital heart disease during early infancy. Failure to thrive is always a possibility, particularly in the infant who has significant medical issues. However, skilled intervention from nurses knowledgeable in feeding issues and lactation can help make breastfeeding of infants with Down syndrome more successful.
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Mothers should be discouraged from breastfeeding babies with Down syndrome because it is too difficult for the infant to get enough nourishment.
References
Mundakel, G.T. & Purushottam, L. (2020). Down Syndrome clinical presentation. Pediatrics; Genetics and Metabolic Disease. https://emedicine.medscape.com/article/943216-clinical#b2
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