The gastrointestinal (GI) system includes all the parts of your body -- from mouth to anus -- that are involved in the digestion of food. Beginning in the newborn period, people with Down syndrome have an increased likelihood of developing medical conditions that interrupt or interfere with this digestion. Some of these medical issues can be managed by a person's primary care physician; others might require the added recommendations of a GI specialist.
What types of GI issues might my baby be born with? How do you correct them?
Approximately 3 percent of infants with Down syndrome are born with an imperforate anus, meaning that there is no open anus through which stool can pass. This is easily identified when a physician examines a baby for the first time, and simple surgery can correct it.
Between 2 and 15 percent of infants with Down syndrome are born with Hirschsprung's disease, which results when the last part of their large intestine does not function properly because of a lack of certain nerve cells. As a result, children cannot properly expel stool. Symptoms of Hirschsprung's disease in early infancy include a swollen abdomen, vomiting, and an inability to expel stool. Children may also present later in life with severe constipation. If an infant has not passed stool in the first few days, a physician might consider getting an X-ray. However, a definitive diagnosis is made by a rectal biopsy (removal of a small piece of rectal tissue for examination under the microscope). The treatment involves surgically removing the portion of colon that does not function properly.
If a newborn with Down syndrome has severe vomiting from birth, he might be among the approximately 5 percent of babies with Down syndrome who have a duodenal obstruction, which means that the first part of the small intestine -- the duodenum -- becomes blocked. Usually this occurs because the duodenum developed differently during the fetal period. This can also occur when the pancreas, an organ that helps the body digest food, inappropriately wraps around the duodenum and obstructs it. The end result is that digested food cannot pass through the duodenum; surgery is curative.
If a newborn with Down syndrome is bubbling up milk during feedings and has frequent choking episodes, he might be among the 1 percent of babies with Down syndrome who have a tracheoesophageal fistula -- that is, an inappropriate connection between the trachea (the body's wind pipe) and the esophagus (the body's swallowing tube). With this condition, food inappropriately enters the wind pipe and the lungs. A doctor can diagnose this by passing a tube down a baby's nose or through a chest X-ray, or both. Surgical correction is curative.
Will my baby with Down syndrome be able to breastfeed?
Babies with Down syndrome often have low muscle tone (hypotonia) and sometimes have trouble forming a latch to breastfeed. However, with the help of lactation specialists, many mothers are able to provide all the known benefits of breastfeeding to their baby with Down syndrome. More information is available from La Leche League International.