A Qualitative Study Investigating the Barriers and Enablers to Supporting Breastfeeding for Babies with Down Syndrome

Background Down Syndrome is the most common genetic condition in the UK. Breastfeeding has immediate and lifelong benefits, yet assumptions and barriers thwart it in babies with Down Syndrome. This primary research study aimed to explore maternal experiences, investigating enablers and barriers and how they may be overcome. Methods Using a multiple case study methodology, three mothers who either breastfed or attempted to breastfeed their baby with Down Syndrome participated in a semi-structured interview which were transcribed and analysed using reflexive thematic analysis. Results Of the three mothers interviewed, one had transitioned to formula, one was mixed feeding, and one had successfully breastfed. Two overarching themes were identified, each with three subthemes ‘Professionals Attitudes are Key’, and ‘A Huge Emotional Upheaval’. Mothers’ experiences were mixed, from negative and detrimental comments to highly engaged and supportive professionals. Two mothers were experienced at breastfeeding their prior children, but despite their knowledge, found accessing specialist expertise challenging. One mother was primiparous, her experience lacking emotional support and professional knowledge. Conclusions Despite World Health Organisation guidelines and the UNICEF Baby Friendly Initiative guidelines, there appears to be a gap facilitating breastfeeding babies with Down Syndrome, a specific population where effective implementation of the Baby Friendly Initiative may be transformative in both short- and long-term health and development for babies with Down Syndrome. Maternal perseverance and increased professionals’ expert support are key enablers. Access to specialist knowledge at diagnosis via specific care pathways and effective implementation of the Baby Friendly Initiative for mothers with a baby with Down Syndrome would optimise enablers and minimise barriers.