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Feeding challenges in the newborn with congenital heart disease




doi: 10.1097/MOP.0000000000001162.


Online ahead of print.

Affiliations

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Chitra Ravishankar.


Curr Opin Pediatr.


.

Abstract


Purpose of review:

Feeding challenges and growth failure are lifelong issues for infants with congenital heart disease. The purpose of this review is to summarize the literature on the topic from North America.


Recent findings:

Despite recognition of feeding challenges and ongoing national collaboration, >50% of infants with univentricular physiology continue to require supplemental tube feeds at the time of discharge from neonatal surgery. Preoperative feeding is now commonly used in prostaglandin dependent neonates with congenital heart disease. The value of a structured nutritional program with establishment of best practices in nutrition is well recognized in the current era. Despite implementation of these best practices, neonates undergoing cardiac surgery continue to struggle with weight gain prior to discharge. This suggests that there is more to growth than provision of adequate nutrition alone.


Summary:

The National Pediatric Cardiology Quality Improvement Collaborative continues to play a major role in optimizing nutrition in infants with congenital heart disease. This among other registries underscores the importance of collaboration in improving overall outcomes for children with congenital heart disease. Nurses should be encouraged to lead both clinical and research efforts to overcome feeding challenges encountered by these children.

References

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    1. Chen M, Riehle-Colarusso T, Yeung LF, et al. Children with heart conditions and their special healthcare needs — United States, 2016. Morb Mortal Wkly Rep 2018; 67:1045–1049.

    1. Medoff-Cooper B, Ravishankar C. Nutrition and growth in congenital heart disease: a challenge in children. Curr Opin Cardiol 2013; 28:122–129.

    1. Anderson JB, Beekman RH 3rd, Border WI, et al. Lower weight for age Z score adversely affects hospital length of stay after the bidirectional Glenn procedure in 100 infants with a single ventricle. J Thorac Cardiovasc Surg 2009; 138:397–404.

    1. Ravishankar C, Zak V, Williams IA, et al. Association of impaired linear growth and worse neurodevelopmental outcome in infants with single ventricle physiology: a report from the Pediatric Heart Network Infant Single Ventricle trial. J Pediatr 2013; 162:250.e2–256.e2.



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