If your baby is born with a congenital condition such as Down syndrome or a cleft lip or palate, breastfeeding becomes more difficult and even more important. Breastfeeding can be a much-needed respite from the emotional rollercoaster of caring for a special-needs baby, and your child will reap the nutritional and immunological benefits of breast milk.

A baby with a cleft lip or palate can be more prone to upper respiratory problems such as colds, allergies and ear infections and these babies do much better when they get their mother's milk.

Breast milk helps babies with heart problems or cystic fibrosis gain weight and can also help prevent respiratory infections and bowel problems common with Down syndrome.

A baby with a cleft lip or palate may have difficulty latching on to your nipple. The cleft palate makes it hard for a baby to create an airtight seal on the breast. Your baby's ability to suck will depend on the size of the cleft, as well as on the size of your breast and the softness of your nipple.

A Down syndrome baby's muscles may be either underdeveloped or too stiff ("hypertonic"). Either condition can make it difficult to position the baby at your breast. The baby may also have problems in their mouth - the tongue may be over-large or the baby may have a flat palate which can affect the depth of latch and make your breasts sore.

Pierre Robin Syndrome has symptoms including a small jaw and receding chin. It is a rare condition which can also make it very difficult to breastfeed.

If your baby has been diagnosed with one of these conditions doesn't necessarily mean you won't be able to breastfeed. The only condition where you absolutely can't breastfeed is galactosemia, when the baby can't metabolize lactose.

The challenges are different for each condition but many of the solutions are similar. The first thing to do is t establish your milk supply. If your baby doesn't take to your breast immediately, you need to start pumping as soon as possible after the birth and pump every two or three hours, as often as a baby would feed. It's also important to make sure you stay well nourished and well rested.

Once you have established your milk supply and created a bond with your baby, it might be necessary to try special feeding positions or equipment. A Down syndrome or premature baby with poorly developed muscles needs a lot of physical body support on the head and upper back. Hold your baby under your arm, because you can support the baby's chin and jaw with the same hand that's supporting your breast.

Sometimes, a baby with special needs may be slow to take to the breast but it's generally best to avoid bottles and pacifiers, because a baby may then get used to the rubber nipples and refuse to go back to the breast, a state known as "nipple confusion". One helpful accessory is a nipple shield, which gives more definition and firmness to the nipple which can help a baby who is having difficulty latching on.

Even more than other children, special-needs babies must have routine checkups with a paediatrician to make sure they are developing normally and healthily. You'll also need support from your doctor, partner, and family, because learning to breastfeed your baby will take a great deal of patience and flexibility.

One of the best things to do is talk to other mothers who have been there. Your hospital should be able to refer you to a support group.