Down syndrome photo tutorial

July 7th, 2010

A couple of visitors have asked me how we can tell Verity has Down syndrome, since it was not immediately obvious to them.  I got to thinking…

Before Verity was born, I read plenty of descriptions of the physical features that often come along with Down syndrome.  But I would have loved to have seen photos.  I saw lots of cute faces, but as for the other features, I wasn’t sure what to expect.

So for any mothers who may come along behind me on this path, here is a visual guide to some Down syndrome features.  I hope it will de-mystify them for you.

Remember that while there is a long list of features that are commonly seen on individuals with Down syndrome, nobody has all the features.  And some of the features can be found on those without the extra chromosome.  This tutorial will necessarily be limited to the features that God built into our particular model.

Most of these pics were from Sunday morning, when she was 8 days old.  (Yes, this post has been in the making since then.  Is this what they call jet lag?)


Look at the palm of your hand.  You will see several lines, or creases, running diagonally across it.  Now look at Verity’s hand.  You see one single crease running horizontally along the middle of her palm.  This is called a “single palmar crease.”  She also has a short pinkie finger that just very slightly curves inward toward her other fingers.  The rest of her fingers are also shorter than average.  These features are all related to her extra chromosome.  We happen to think the uniqueness makes her hand extra cute~

This little piggy went to market…I mean…do you see a slightly wider space between Verity’s big toe and all the rest?  This space also dips lower into her foot.  This is what is called a “sandal gap.”

Her pinky toes curve inward toward the rest of her toes, but that is not from her Down syndrome, it’s from her Daddy!  Several of our other children got his quirky pinky toes, too.  (No, I didn’t resist kissing her sweet feet before moving on to the next pic!)

You can see in this next shot that Verity has smallish ears, and the tops of them are folded down.   Individuals with Down syndrome tend to have smaller-than-average ears and other facial features, with smaller-than-average inner passages to go with them.

One of the characteristics that are associated with Down syndrome is a slack jaw, with the mouth hanging open and the tongue protruding.  I have not included pics of this, since it is a changeable characteristic and not an unchangeable feature.  However, without the proper intervention, individuals with Down syndrome will invariably develop this characteristic to some degree.  For valuable information on how to prevent or correct it, please read this fascinating article on the Down syndrome tongue.

(“She is filling out nicely, isn’t she?” said her mother with a satisfied grin.)

When I took this picture, it was the first time I really looked carefully at Verity’s” nuchal fold.”  I suppose it’s because I had been keeping her decently dressed.  You probably know that the nuchal fold is a feature that ultrasound technicians try to measure early in a pregnancy to help them detect Down syndrome.  Before birth, the Down syndrome features that can be seen by ultrasound are called “markers.”  In real life, this extra skin of Verity’s is super soft and squishy and usually, as I said before, covered up.

I wanted a shot to show her “flat facial profile,” but her cheeks got in the way.  I posted this one anyway to show how bright-eyed she is.  She is very curious and turns toward sounds, especially voices, music, and the sound of water running.  She bats at objects that are close enough, and has grabbed onto some of them.  She loves being held more than anything else in the world, and makes a twinkly contented face when I talk or sing to her.  And tonight, she smiled right at me for the first time!  By the way, Down syndrome didn’t keep her from having dimples!

Not knowing ahead of time what to expect of her, we are extra delighted at her charming little baby ways.

Okay, another try.  Oops, can’t see the flat facial profile too well here, but here’s a glimpse of the twinkle-face she makes when she’s happy.  This was taken today after her meal, bath, and massage with Burt’s Bees Apricot Baby Oil.   <sigh of delight>

One more try and this time I think you can see the characteristic flat profile on her little 11-day-old face.  It’s a lot tougher to capture than I thought it would be.  Not that I mind sneaking in a few extra pictures, ahem.  This pic also shows the little fold at the top of her ear.

Last but far from least!  We are enchanted by this pair of almond-shaped eyes!

~Extra-ordinary is just ordinary with a little something extra.~

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35 Responses to “Down syndrome photo tutorial”

  1. Ruth Einfeld says:

    Thanks for sharing all that – our Esther does not have the Palmer Crease, but her big sister, Rachel does (didn’t know that until Esther was a few months old!).  Esther doesn’t have the nuchal fold either, but she has ears just like Verity’s!  I love those little cute ears!
    Once when we were at Children’s when she was about 4 weeks old, her doctor asked if he could bring in some students to teach about detecting DS in a newborn…only problem was, Esther was missing over half of them!
    Verity is so precious, sweet, and cute…I pray she does well in the weeks ahead!

  2. Joy Horton says:

    She is SO precious – and so chubby and YUMMY, Susanna!!! Thank you for these sweet pics of her! I’m eating them up! BTW, I have the single palmar crease on both of my hands!

  3. Shannon says:

    She is beautiful, Susanna! As a side note, several of my children have folded and/or quirky ears, I love it!

  4. She is precious and so cute. Thanks for sharing!

  5. Angiedawn says:

    She really is beautiful Susanna.I am just so happy that she is so loved and will continue to have so much love and care.She is just precious!!!!!!

  6. Christi says:

    She is absolutely charming.  A doll for sure!  Thanks for that photo tutorial!  You are so blessed.

    I am enjoying your blog.  It is full of the Lord and His work.  Thank you.
    missusmechanic from MOMYS

  7. Isadora says:

    That was absolutely lovely and your daughter is beautiful! Thanks so much for sharing.

  8. Tami Swaim says:

    I’m in love!

  9. Marilyn Osborn says:

    She is so precious, Susanna!  Thank you for sharing all of this and educating me (us).  I’m learning so much!

  10. 3kittens'mama says:

    Your baby is scrumptious!  Her name is beautiful and fits her well!

    Thank you so much for taking the time to post the pics and the informative, funny descriptions of Verity’s special features.  Very educational.  Learned a lot.

    Enjoy your blessing!  She is a lovely little person.

  11.  I have the sandal foot. I never saw anybody else with it other than my twin sis.

    She is a beautiful  baby. I don’t think I could ever put her down.

  12. Claudia says:

    Your baby is adorable, and it has educated me a lot. Im waiting for the result of analysis on my baby girl to know if she has DS. Since i saw your pictures, she has all these features :), the only one missing is the palm. My baby is already 2 months old and the doctor had not detected at all, but I saw your pictures and all of them my baby has, so I asked for the test, lets see on the following days.
    thanks again.

  13. Shirley Basham says:

    i love the pictures of the baby i hope that everything goes well she is a beautiful baby girl

  14. Beth says:

    Lovely tutorial!  Wonderful idea!   My favorite Ds features are the Brushfield spots and the palmar crease (my daughter only has one hand with the crease).  Verity is a beauty!
    I just wanted to clarify one thing–the tongue/open mouth position.  As you can see in Verity’s pictures, her mouth is closed and her tongue is easily inside her mouth.  Her tongue is not enlarged at birth.  She has low tone in her jaw, so without oral motor/muscle based therapy, she will eventually have an open mouth.   The open mouth (if you tilt your head back and allow your jaw to drop (relaxed) causes the tongue to relax and move forward.  (In your mouth the tongue doesn’t protrude as much since you’ve got a fully exercised tongue, but it does move forward!)  This is the start of the “enlarged tongue”.   The tongue is a muscle, and when it is not toned by keeping it in it’s rightful place, it will become flaccid.
    The key to a toned, in-the-mouth tongue is a strong jaw.  There ARE things you can do to help prevent the classic mouth posture.  It will improve Verity’s feeding skills as well as have a positive impact on her speech clarity.   See this post for explanation:

  15. Susanna says:

    Beth!  I am so relieved and happy I could cry! You are an answer to prayer!  I haven’t gotten all the way through the info you sent me, but I can tell it is EXACTLY what we need!  How did I miss reading this until now? I edited this post to include a link to SRJ’s article. THANK YOU!

  16. Brook (mommydue) says:

    I enjoyed each and every pic! She is blessed to have you & you her :)

  17. Holly Palmer says:

    She’s just beautiful!  Congratulations!

  18. Amy says:

    I just love her! Is there a “scratch ‘n sniff” computer program for the picture after her bath & baby oil? :D

  19. Danielle says:

    Thank you for taking the time to share. No doubt this post has been a blessing to many.

    She is beautiful, and I know you have heard and thought yourself a million times what a blessing *she* is but I cant help but praise God for the blessing that you are as her mommy. Your love for her and Gods best for you are apparent.

    Keep sharing your faith Momma!

  20. bridget says:

    I just stumbled onto your blog by mistake. I want to speak a blessing upon the life of your beautiful daughter. May she grow up to be healthy and strong with amazing beauty and grace upon her life, a mighty battle axe in the hands of God.

  21. Thank you for sharing this information. It’s something I’ve seen plenty in my life, but never in a baby so young. How irresistibly sweet!
    I wanted to give you a word of encouragement. My aunt, Dawn is her name, like the dawning sun, was born with Ds, with the extra chrome. She was born in the late 50’s and my grandmother was told to put her in an institution. They said with the severity of her Ds she would never walk, talk, or feed herself. “They” also said she would not live past the age of 18 due to heart murmur and the Ds itself. Well I can attest that she is living much longer than that, she is 52. She also gave those Dr’s a run for their money. Not only did she learn to walk and talk and feed herself. She learned in school, and learned to ride a horse, and learned reading and math. She is amazing at telling you who the actors were in a movie! She loves babies, animals, movies, amusement park rides and meeting new people. Every where you go she lights up a room and is loved by everyone who takes time to talk to her. She has traveled all over the US, and Canada. She’s lived on farms and in the city. She learned to cook small meals for herself and even convinced a real estate agent she was buying a house one time, LOL, she didn’t but she thought she would. She is determined, and smart, and proud of her accomplishments. Her life has been very full, but more importantly she’s added abundantly to the life of those around her.
    You are indeed very truly blessed! God has seen fit to give you the closest thing on earth to an angel! Thanks again for sharing!

  22. Susanna says:

    Staci, thank you so much for taking time to tell me this! I LOVED hearing it, and will read it more than once!

  23. I think this is very important. Thanks a lot.

  24. Missy says:

    I still love this post, Susanna!  What a little beauty!

  25. Susanna says:

    Thank you, Missy! I was just looking through old pictures this past week and getting all nostalgic. :D

  26. Trudie says:

    What a beautiful little princess! I love her name, I’m sure you know that “Verity” means “truth”. May the dear Shepherd bless and keep you both.

  27. Susanna says:

    Thank you, Trudie, what a precious comment!

  28. laura says:

    what a beautiful baby God bless her! she is sooo adorable. You are very blessed and so is she for having such a good mommy like you :)

  29. Jeremy says:

    Beautiful child. She is the 30% that has the uniqueness of the simian crease. I also happen to think it’s a pretty feature! Stay blessed
    An ultrasound tech

  30. Maya says:

    Verity is absolutely beautiful! Your post helped me a lot as a medical student studying for her pediatrics shelf exam. Thanks :).

  31. Michael says:

    She is so beautiful! Your photos have helped me a lot…we are currently going through the process of getting a diagnosis. Our precious baby doesn’t immediately look like a Down’s baby but does have some of the classic characteristics. Best of luck. God bless!

  32. Tessa says:

    I am a few years late reading your story with Verity and I have cried at the joyous sights of her and your family. I am a softie with siblings doting on a new baby and it makes me cry every time. I have to say that she is absolutely perfect. I have been an Occupational Therapy Assistant for 17+ years and I thank you for this education on the characteristics of Down syndrome. I have worked with my fair share of people with Down syndrome and you taught me a couple of new designer marks that I either didn’t know or forgotten. God bless you and your amazing family.

  33. shanara says:

    She’s beautiful god bless u

  34. Kathryn says:

    I was looking for pictures of the single palmar crease on the hands. I have heard it is common in down syndrome children, but I didn’t know what to look for in my own daughter. My sweet pea was born 7/1/15 with down syndrome. My older girls are in total aww of her, and we just adore her. I am thankful for parents, like you, who are trying to help educate newer parents in this “club” as well as the public. Thanks :)

  35. Rhonda says:

    I also am the parent of a beautiful special girl!! Jada was born with cp cere bral palsy, due to a terrible car accident when I was five and a half months along. She suffered a stroke in utero. They didn’t know until I took her to her pediatrician at two weeks after I noticed her eyes jumping…I had never seen anyone’s eyes do that except once when I was watching Stevie Wonder perform on TV. I truly thought she was blind. He scheduled me with a neurologist and very quickly the tests began. At two months old I began physical therapy wih Jada and our therapist was a mother of her own special angel!! What a blessing!! I learned so very much in those first few years and was so blessed to start our journey with someone who knew all about the challenges that lie ahead…We began tongue exercises as a game we played while driving and her in her carseat watching mama in the mirror!! She speaks beautifully today! God gives us these Angels so that we can share His glory!! I am so happy to share her with the world and I know you will be too! I pray many blessings on you and all the Happiness only He can give..Thank you so so much for showing us the pictures. She is truly beautiful Mom!!!

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