What Are the Symptoms of Down Syndrome?

Medically Reviewed by Dan Brennan, MD on May 17, 2023
3 min read

It’s easy to fall into thinking that everyone with Down syndrome looks a certain way and has certain abilities, and that’s the end of the story. But it’s hardly reality. While Down syndrome affects people both physically and mentally, it’s very different for each person. And there’s no telling early on what its impacts will be.

For some people, the effects are mild. They may hold jobs, have romantic relationships, and live mostly on their own. Others may have a range of health issues and need help taking care of themselves.

No matter what symptoms a person with Down syndrome has, early treatment is key. With the right care to develop physical and mental skills -- and treat medical issues -- children with Down syndrome have a much better chance to reach their full abilities and live meaningful lives.

It varies, but people with Down syndrome often share certain physical traits.

For facial features, they may have:

  • Eyes shaped like almonds (may be shaped in a way that’s not typical for their ethnic group)
  • Flatter faces, especially the nose
  • Small ears, which may fold over a bit at the top
  • Tiny white spots in the colored part of their eyes
  • A tongue that sticks out of the mouth

They may have small hands and feet with:

  • A crease that runs across the palm of the hand
  • Short fingers
  • Small pinkies that curve toward the thumbs

They may also have:

  • Low muscle tone
  • Loose joints, making them very flexible
  • Short height, both as children and adults
  • Short neck
  • Small head

At birth, babies with Down syndrome are often the same size as other babies, but they tend to grow more slowly. Because they often have less muscle tone, they may seem floppy and have trouble holding their heads up, but this usually gets better with time. Low muscle tone can also mean babies have a hard time sucking and feeding, which can affect their weight.

Down syndrome also affects a person’s ability to think, reason, understand, and be social. The effects range from mild to moderate. Children with Down syndrome often take longer to reach important goals like crawling, walking, and talking. As they get older, it may take more time before they get dressed and use the toilet on their own. And in school, they may need extra help with things like learning to read and write and following directions.

Some also have problems with behavior – they may not pay attention well, or they can be obsessive about some things. That’s because it’s harder for them to control their impulses, relate to others, and manage their feelings when they get frustrated.

As adults, people with Down syndrome may learn to decide many things on their own, but will likely need help with more complex issues like birth control or managing money. Some may go to a college that can provide accommodations and modifications tailored to developmental and intellectual delays and may go on to live independently, while others will need more day-to-day care.

People with Down syndrome are more likely to have certain health problems, such as:

  • Hearing loss. Many have problems hearing in one or both ears, which is sometimes related to fluid buildup.
  • Heart problems. About half of all babies with Down syndrome have problems with their heart’s shape or how it works.
  • Obstructive sleep apnea. This is a treatable condition where breathing stops and restarts many times while sleeping.
  • Problems seeing. About half of people with Down syndrome have trouble with their eyesight.

They’re also more likely to have:

  • Blood conditions, such as anemia, where you have low iron. It’s not as common, but they also have a higher chance of getting leukemia, a type of blood cancer.
  • Dementia. This is an illness where you lose memory and mental skills. Signs and symptoms often start around age 50.
  • Infections. People with Down syndrome may get sick more often because they tend to have weaker immune systems.

They’re also more likely to be very overweight and have thyroid issues, blockages in their intestines, and skin problems.

People with Down syndrome have a shorter life span. 

Show Sources


CDC: “Facts about Down Syndrome.”

Mayo Clinic: “Down Syndrome.”

KidsHealth: “Down Syndrome,” “What’s an IEP?”

National Health Service (U.K.): “Down’s Syndrome.”

March of Dimes: “Down Syndrome.”

National Institutes of Health, Genetics Home Reference: “Down Syndrome.”

Children’s Hospital Boston, The Developmental Medicine Center: “Behavior and Down Syndrome: A Practical Guide for Parents.”

Alzheimer’s Association: “What is Dementia?”

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