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.

中文翻译：

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患有唐氏综合症的母乳喂养婴儿的吸吮动力学改变：病例报告。

母乳和母乳喂养的健康和发育优势对唐氏综合症婴儿尤为重要。然而，由于对吸吮问题的理解尚不明确，他们的母乳喂养时间通常较短。本病例报告描述了对患有唐氏综合症的母乳喂养婴儿的乳汁输送量、吸吮动态和舌头运动的连续测量。母体乳汁生产管理使仅母乳喂养成为可能，直到母乳喂养技能成熟并在 6 个月内实现完全母乳喂养。一位患有唐氏综合症且没有相关健康并发症的足月婴儿的母亲担心乳房中的乳汁排出不足和乳汁供应不足。我们通过测量口腔内真空强度监测母乳喂养期间的吸吮动态，营养性和非营养性吸吮率和爆裂持续时间，以及使用颏下超声的舌头运动。在第 4、10、14、19 和 24 周监测母乳喂养，并在产后 4、10 和 24 周测量母亲 24 小时的产奶量。我们观察到较弱的吸吮力和较短的营养吸吮持续时间，以及长达 19 周的非典型舌头运动，以及低牛奶转移量。定期挤奶可有效增加母亲的乳汁产量，为所有辅食提供挤出的乳汁。当观察到参考吸吮值时，在 6 个月时实现了完全母乳喂养。本病例报告表明，唐氏综合症婴儿的口腔内真空度可能较低，并且持续数月的营养吸吮有限，这可能是由于口部运动发育延迟所致。在缺乏有效吸吮的情况下，如果频繁且充分地吸乳以刺激乳汁分泌，则可以继续母乳喂养。患有唐氏综合症且没有相关健康并发症的婴儿有可能最终建立完全母乳喂养。希望对患有唐氏综合症的婴儿进行母乳喂养的母亲需要预期的指导以及持续的哺乳和家庭支持。