Down syndrome medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Treatment of individuals with Down Syndrome depends on the particular manifestations of the disease. For instance, individuals with congenital heart disease may need to undergo major corrective surgery soon after birth. Other individuals may have relatively minor health problems requiring no therapy.

Medical Therapy

There is no specific treatment for Down syndrome. When breast-feeding, the baby should be well supported and fully awake. The baby may have some leakage because of poor tongue control. However, many infants with Down syndrome can successfully breast-feed. Obesity can become a problem for older children and adults. Getting plenty of activity and avoiding high-calorie foods are important. Before beginning sports activities, the child's neck and hips should be examined. Behavioral training can help people with Down syndrome and their families deal with the frustration, anger, and compulsive behavior that often occur. Parents and caregivers should learn to help a person with Down syndrome deal with frustration. At the same time, it is important to encourage independence.

Adolescent females and women with Down syndrome are usually able to get pregnant. There is an increased risk of sexual abuse and other types of abuse in both males and females. It is important for those with Down syndrome to:

• Be taught about pregnancy and taking the proper precautions
• Learn to advocate for themselves in difficult situations
• Be in a safe environment

If the person has any heart defects or problems, check with the physician about the need for antibiotics to prevent heart infections called endocarditis.

Special education and training is offered in most communities for children with delays in mental development. Speech therapy may help improve language skills. Physical therapy may teach movement skills. Occupational therapy may help with feeding and performing tasks. Mental health care can help both parents and the child manage mood or behavior problems. Special educators are also often needed.

Management of complications of Down syndrome

Parameter	Diagnostic tool	0 to 3 months	3 month to 1 year	1 year to 5 years	5 years to 12 years	Management
Growth	Anthropometry	At least twice in first year	Annually			Ensure optimal diet and physical exercise
Hearing evaluation for deafness, serous otitis media	BERA/OAE Tympanometry	At least twice in first year	Annually			Standard treatment and follow up as indicated
Eye evaluation for eye problems	Standard evaluation by an ophthalmologist/optometrist	At least twice in first year	Annually	Every 2 y	Every 3 y	Standard treatment and follow up as indicated
Thyroid profile for hypothyroidism	T4, TSH	At least twice in first year	Annually			Thyroxine and follow up as indicated
Cardiac evaluation	Clinical assessment ECG, ECHO	At initial contact and follow up in the presence of congenital heart disease				Follow up visits with pediatric cardiologists, as per need standard care
Hematological problems for leukemia and iron deficiency anemia	Review symptoms and Complete blood count	At least twice in first year	Monitor Hb as per need in the presence of iron deficiency anemia			Standard treatment for leukemia and anemia
Dental care	Dentist evaluation		Annually