Newborns with Down syndrome may have easily-distinguishable congenital defects of the gastrointestinal system, including duodenal atresia or imperforate anus. They may also have more subtle disorders such as partial upper GI obstruction (duodenal web), tracheo-esophageal fistula, Hirschsprung disease, or pyloric stenosis. They are at higher risk for gastroesophageal reflux disease (GERD), celiac disease, 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.
Assessment of gastrointestinal problems can be complicated by unrelated feeding issues. Some babies with Down syndrome have trouble coordinating their sucking and swallowing right after birth because of oral-motor issues, while others may be too fatigued 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 problems. However, with skilled intervention from nurses knowledgeable in feeding issues and lactation, most infants with Down syndrome can successfully breastfeed.