Respiratory illness in Down syndrome is common , and causes significant morbidity and hospitalisation . Common presentations include nasal congestion, respiratory infections, particularly pneumonia , sleep disordered breathing and recurrent wheeze. Contributing factors include associated congenital heart disease, anomalies of the airways, pulmonary vascular disease, immune dysfunction, hypotonia, gastroesophageal reflux and obesity. Sleep disordered breathing is also associated ( see topic page).

Respiratory infections tend to be more severe than in the general population requiring more intensive treatment and longer hospital stays. Respiratory symptoms should be treated early and aggressively to prevent such progression. Antibiotic prophylaxis may be recommend for some who are particularly at risk . The usual child hood vaccine schedule should be recommended , and additional immunisations ( see immunisation topic page) , including additional pneumococcal vaccines, influenza vaccine  , and RSV prophylaxis should be considered.

Presentations at DSMIG Meetings

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Additional Resources

Book Chapter – Respiratory Disease

Hazel Evans, Katy Pike,Marian McGowan and Sally Shott

ds-current-perspectives-book-coverDown Syndrome – Current Perspectives

Edited by Richard Newton , Shiela Puri and Liz Marder


An overview of respiratory problems in children with Down’s syndrome

Rachel Watts, H Vyas

Arch Dis Child 2013;98:812-817 doi:10.1136/archdischild-2013-304611


Respiratory tract infection related healthcare utilisation in children with Down’s syndrome

Logan Manikam, Anne G. M. Schilder, Monica Lakhanpaul,Peter Littlejohns,Emma C. Alexander, Andrew Hayward.

. 2020 Mar 14 : 1–8.
doi: 10.1007/s15010-020-01408-5 [Epub ahead of print]