Breastfeeding a child with special needs

Breastfeeding a child with special needs can present specific problems, but the benefits to both mother and child are numerous. Beyond giving proper nourishment, it allows the mother and child to bond.

Infants with special needs, such as those with a congenital heart defect , cleft defect, or hypotonia/Down syndrome will benefit greatly. These conditions make up the most common birth defects (CHD 8 in 1,000 births, cleft defects 1 in 700 births, and Down syndrome 1 in 800 births). These conditions all interfere with the sucking ability and the consequence is poor growth. Infants with cleft defects and Down syndrome are at risk for otitis media and middle ear effusion, and infants with CHD and Down syndrome are at risk for respiratory infections. Thus, the unique properties of human milk related to digestibility and immunologic protection have added value for these infants. In addition, breastfeeding promotes a special closeness between mother and infant that may enhance attachment in situations where the diagnosis of a defect is shocking and stressful.

Searches of Cinahl and Medline from 1994 to 2004 were done to locate research on breastfeeding for infants with these conditions. There were nine studies related to infants with CHD, twelve studies related to cleft defects, and three studies related to hypotonia/Down syndrome. There was only one randomized experiment that tested spoon-feeding versus BF for infants with cleft defects immediately post-surgical repair. Wound healing and weight gain were equivalent for infants fed by the two conditions, supporting the safety of BF. Four quasi-experimental studies supported breastfeeding for infants with cleft palates and CHD. The descriptive studies (15) focused on identifying feeding problems for these infants. Studies of parental reports (8 of the 15) described their infants’ difficulties with feeding, and decried the lack of support and information from professionals about breastfeeding. The case studies (4), representative of all three conditions, were testimonials written by mothers about how they accomplished breastfeeding for their infants. Clearly there is a need for research to help facilitate breastfeeding for infants with these conditions.

Even more than other children, special-needs babies must have routine checkups with a pediatrician to ensure that they are developing normally and healthily. You’ll also need emotional support from your doctor, partner, and family, since learning to breastfeed your baby will require a lot of patience and flexibility.

The Nursing Mothers Council provides breastfeeding information and support on their 24-hour referral hotlines. Call their National Referral Line at (650) 599-3669.

La Leche League International provides support for breastfeeding mothers. To find a group or trained leader in your area, call (800) 525-3843 or visit the La Leche League’s Web site. Accredited La Leche League leaders will also answer breastfeeding questions via e-mail.