I would like to draw the attention of parents to some important points of growth and development of a child with Down syndrome. Some features and problems can go unnoticed for a long time and have a negative impact on the development of the baby. Knowing about such "weak points", parents can keep them under control and seek help from specialists in a timely manner.
Of course, not everything listed below is necessarily characteristic of every child with Down syndrome. But the occurrence of such problems is possible, you need to be prepared for it.
Source: "Down Syndrome. The facts." Compiled by E.V. Polye. – 2nd edition, revised and supplemented. – Moscow: Charity Foundation "Downside Up", 2012.
In children with Down syndrome, the development of bones in the middle part of the face lags slightly behind the general development. Therefore, the baby's face may look flattened. The upper jaw can be small, so the mouth opening is also small. The sinuses are weakly expressed. Since the immunity of babies with Down syndrome is reduced, the nose can often become clogged with mucus, and then the child breathes with his mouth slightly open. With such breathing, the mucous membrane of the mouth and lips dries and the risk of new respiratory diseases increases. It is very important to ensure that the child's nose is free of mucus, and encourage the baby to breathe properly from an early age.
The skin of babies with Down syndrome is less elastic, drier and rough. The phenomena of exudative diathesis are not uncommon, and the skin is more prone to cracks.
To enhance blood circulation, and therefore "revitalize" the baby's skin, it is good to use "maternal massage", which a specialist can tell you about, as well as to slow down the child, turn him over from side to side, bathe regularly, using special oils (vaseline, peach, etc.).
Down syndrome has a number of ophthalmological problems that require treatment and correction. The structural features of the lacrimal canal can lead to conjunctivitis and lacrimation. Conservative therapy, as a rule, consists in massage of the nasolacrimal sac and treatment of conjunctivitis with local antibiotics.
Quite often, children with Down syndrome have strabismus. Due to hypotension of the eye muscles, they need more time for the eyes to move in a coordinated manner. Eye coordination can be accelerated by doing special exercises with the baby, which can be described by an ophthalmologist or a special teacher. Strabismus does not always affect the quality of vision, but it is necessary to consult a doctor about this.
Myopia and farsightedness, which is quite traditional for our society, also does not bypass children with Down syndrome. These visual distortions can be corrected with glasses.
Sometimes other eye diseases are detected in children with Down syndrome, so regular monitoring by a specialist is necessary.
Very often, children with Down syndrome have a violation of the balance of hormones produced by the thyroid gland.
Certain signs suggest that the thyroid gland is impaired:
· weight gain in the absence of an increase in height;
· noticeable lethargy, lethargy, decreased reaction speed;
· decreased appetite, constant constipation;
· the voice is hoarse, the hair is thinner, and the skin is drier than usual.
Thyroid diseases are successfully compensated by taking certain hormonal drugs. Timely diagnosis is necessary to determine the level of hormones in the blood (T3, T4 and TSH). Such an analysis should be done regularly (once a year), since abnormalities in the thyroid gland can appear at any time. If abnormalities of this kind are detected, the child needs to be monitored by an endocrinologist.
The structure of the upper respiratory tract in Down syndrome is characterized by narrowing of the nasopharynx and oropharynx, the eustachian tube, and the external auditory canal. During sleep, the muscles relax, and air access to the oropharynx may be partially or completely blocked by the root of the tongue. At the same time, the baby can snore, breathe intermittently, wake up often or take a specific pose in a dream (the head is thrown back, older children can sleep sitting). Sleep apnea leads to lethargy, daytime drowsiness, decreased physical development and worse behavior. Insufficient ventilation of the lungs can contribute to diseases of this organ. To prevent this dangerous phenomenon, it is necessary to lift the head end of the crib by 10 degrees and put the baby on its side. In some cases, tonsils are removed or other medical measures are carried out.
Quite often, children with Down syndrome have hearing loss. This is due to infectious diseases of the ears. There may also be congenital hearing loss. In about a third of cases, hearing loss is insignificant and does not require special medical measures, but you should definitely know about such hearing loss, since such problems need to be controlled.
From the first year of life, it is necessary to regularly monitor the state of hearing, since missed problems can negatively affect the overall development, in particular, the development of the baby's speech.
If treatment is necessary, it must be carried out. Medical appointments in these cases are practically the same as for ordinary children.
If a child is missing the simplest words by the age of 3, this is a serious reason to do audiometry. After each serious ARVI, it is necessary to do tympanometry to exclude otitis media, and, accordingly, hearing loss.
Obstructive sleep apnea syndrome
Most babies with Down syndrome have digestive organs working normally, but there is a possibility of problems in this area.
The most serious of these is a complete or partial blockage of the esophagus or duodenum. Such deviations are detected in the first days of the baby's life. The warning signs are vomiting, abnormal stools and signs of dehydration. Unfortunately, it is impossible to do without surgery here.
Another disease is the so-called Hirschsprung's disease, in which the baby's tummy heaves, but there is no bowel movement. The reason for this deviation is the lack of nerve fibers in the rectum, which is why part of it is practically paralyzed. In this case, surgical intervention is also necessary.
In general, hypotension of the intestinal tract can be the cause of constipation, which is well known to us. When the child begins to move more, muscle tone gradually increases, and these kinds of problems are resolved naturally.
Children with Down syndrome, like all children, breastfeeding is very indicated.
Despite the peculiarities of the structure of the maxillofacial apparatus, breastfeeding is quite possible, but at first it is not always easy. It should be borne in mind that a baby with Down syndrome can be breastfed for as long as it takes. Natural feeding not only provides the baby with the best nutrition, but also strengthens the immune system, prevents otitis media and develops muscles with which he will speak. In addition, breastfeeding helps the mother to establish a very good emotional contact with the child.
The efforts aimed at making the baby learn to suck will certainly not be in vain. As a rule, difficulties are quite surmountable, you just need to be patient!
When it comes time for the baby to switch to solid food, patience will also be needed. On how to help a child with Down syndrome learn to chew, eat with a spoon, etc., it is best to consult with an early development specialist. You should also be careful about possible allergic reactions to certain foods, especially cow's milk and wheat.
The genitals of boys and girls with Down syndrome have a normal appearance. In boys, the penis and testicles in the first two years of life are somewhat smaller than usual. In some cases, as it happens in ordinary children, the testicles are not lowered into the scrotum, and sometimes it is necessary to resort to surgical intervention.
There are no sharp differences in the development of primary and secondary sexual characteristics, that is, in the size of the genitals or pubic hair, is not manifested. Young people with Down syndrome have a beard and mustache that begin to grow somewhat later than their normal peers, and girls tend to have very small breasts. At about 12.5-13 years of age, girls begin menstruating. Men with Down syndrome are not capable of fertilization. Women are able to carry and give birth to a child, but it is very likely that he will also have Down syndrome.
Unfortunately, cardiac dysfunction in Down syndrome is not uncommon, and about 30 to 40% of children with the syndrome suffer from one or another abnormality in this area.
The severity of cardiac abnormalities varies from a small insufficiency, which disappears over time, to very serious, life-threatening heart defects that require surgical intervention, sometimes immediately.
Signs of heart failure include faded grayish or bluish skin, difficulty breathing, swelling of the eyelids and noises audible when listening. However, the clinical picture may be blurred, so children with Down syndrome in the first days of life need a careful examination by a cardiologist, as well as an ECG and EchoCG examination. When detecting abnormalities in cardiac activity that do not require surgery, children still need regular scheduled examinations by a specialist.
Muscular hypotension and weakness of connective tissues predispose to orthopedic problems such as hip dysplasia, dislocations or subluxations of the hips, instability of the kneecap, scoliosis, flat feet.
Therefore, a child with Down syndrome needs to be examined by an orthopedist.
The motor development of these babies is somewhat slower, it is more difficult for them to master coordinated body movements. It is very important to ensure that the baby regularly acquires motor experience. You can find out how best to do this from a motor development specialist.
Studies have shown that in Down syndrome, the structural features of the nervous system somewhat slow down the passage of signals through nerve fibers, so children need more time to process information and respond. For this reason, in particular, the pace of development of babies is slowed down. You should keep this in mind and, while studying with your child, be sure to take the necessary pauses, giving the baby time to process information! Otherwise, it may seem that the child does not understand and does not react, although in fact he simply does not have enough time to express his reaction!