Sucking Patterns in Infants with Down Syndrome admitted to a Level 4 Neonatal Intensive Care Unit.

Area of Science:

• Pediatrics
• Neonatology
• Developmental Pediatrics

Background:

• Infants with Down syndrome face significant challenges in growth and development, particularly with feeding difficulties shortly after birth.
• Hypotonia is a common characteristic in neonates with Down syndrome, affecting muscle tone and motor functions essential for feeding.

Purpose of the Study:

• To describe the sucking patterns of infants diagnosed with Down syndrome in a neonatal intensive care unit (NICU) setting.
• To identify common feeding and swallowing dysfunctions in this vulnerable population.

Main Methods:

• A retrospective review of medical records for infants with Down syndrome admitted to the University Pediatric Hospital NICU between 2012 and 2022.
• Infants were evaluated using a clinical swallow examination and the Neonatal Oral-Motor Assessment Scale (NOMAS).

Main Results:

• The study included 29 infants with Down syndrome; 81% exhibited generalized low muscle tone.
• Sucking patterns were predominantly disorganized (41%) or dysfunctional (52%), with only 7% showing mature sucking.
• Clinical signs of swallow dysfunction were prevalent, including wet or gurgly breathing (75%) and reduced oxygen saturation (20%).

Conclusions:

• Term infants with Down syndrome demonstrate a high prevalence of dysfunctional sucking, contrary to typical expectations.
• Formal oral motor and swallowing assessments are essential for neonates with hypotonia to determine feeding readiness and manage feeding/swallowing dysfunction.
• Evidence-based interventions and neurodevelopmental outcome monitoring can be informed by these comprehensive feeding and swallowing evaluations.